Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study
Introduction: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contempor...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Published: |
Public Library of Science
2017
|
| Subjects: |
| _version_ | 1796960619102994432 |
|---|---|
| author | Lee, K.Y. Wan Ahmad, W.A. Low, E.V. Liau, S.Y. Anchah, L. Hamzah, S. Liew, H.B. Mohd Ali, R. Ismail, O. Ong, T.K. Said, M.A. Dahlui, M. |
| author_facet | Lee, K.Y. Wan Ahmad, W.A. Low, E.V. Liau, S.Y. Anchah, L. Hamzah, S. Liew, H.B. Mohd Ali, R. Ismail, O. Ong, T.K. Said, M.A. Dahlui, M. |
| author_sort | Lee, K.Y. |
| collection | UM |
| description | Introduction: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). Methods: This cross-sectional study was conducted from the healthcare providers’ perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. Results: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients’ comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. Conclusions: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia. |
| first_indexed | 2024-03-06T05:47:21Z |
| format | Article |
| id | um.eprints-19127 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:47:21Z |
| publishDate | 2017 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | um.eprints-191272018-09-05T08:50:26Z http://eprints.um.edu.my/19127/ Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study Lee, K.Y. Wan Ahmad, W.A. Low, E.V. Liau, S.Y. Anchah, L. Hamzah, S. Liew, H.B. Mohd Ali, R. Ismail, O. Ong, T.K. Said, M.A. Dahlui, M. R Medicine Introduction: The increasing disease burden of coronary artery disease (CAD) calls for sustainable cardiac service. Teaching hospitals and general hospitals in Malaysia are main providers of percutaneous coronary intervention (PCI), a common treatment for CAD. Few studies have analyzed the contemporary data on local cardiac facilities. Service expansion and budget allocation require cost evidence from various providers. We aim to compare the patient characteristics, procedural outcomes, and cost profile between a teaching hospital (TH) and a general hospital (GH). Methods: This cross-sectional study was conducted from the healthcare providers’ perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test. Results: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients’ comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost. Conclusions: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia. Public Library of Science 2017 Article PeerReviewed Lee, K.Y. and Wan Ahmad, W.A. and Low, E.V. and Liau, S.Y. and Anchah, L. and Hamzah, S. and Liew, H.B. and Mohd Ali, R. and Ismail, O. and Ong, T.K. and Said, M.A. and Dahlui, M. (2017) Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study. PLoS ONE, 12 (9). e0184410. ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0184410 <https://doi.org/10.1371/journal.pone.0184410>. http://dx.doi.org/10.1371/journal.pone.0184410 doi:10.1371/journal.pone.0184410 |
| spellingShingle | R Medicine Lee, K.Y. Wan Ahmad, W.A. Low, E.V. Liau, S.Y. Anchah, L. Hamzah, S. Liew, H.B. Mohd Ali, R. Ismail, O. Ong, T.K. Said, M.A. Dahlui, M. Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title | Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title_full | Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title_fullStr | Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title_full_unstemmed | Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title_short | Comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in Malaysia: A cross sectional study |
| title_sort | comparison of the treatment practice and hospitalization cost of percutaneous coronary intervention between a teaching hospital and a general hospital in malaysia a cross sectional study |
| topic | R Medicine |
| work_keys_str_mv | AT leeky comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT wanahmadwa comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT lowev comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT liausy comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT anchahl comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT hamzahs comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT liewhb comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT mohdalir comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT ismailo comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT ongtk comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT saidma comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy AT dahluim comparisonofthetreatmentpracticeandhospitalizationcostofpercutaneouscoronaryinterventionbetweenateachinghospitalandageneralhospitalinmalaysiaacrosssectionalstudy |