Cost-effectiveness analysis of chronic disease management : comparison between King Chulalongkorn Memorial Hospital and Public Health Center 16 Lumpini

Abstract

The objectives of this study was to analyze the cost-effectiveness of chronic disease management: comparison between King Chulalongkorn Memorial Hospital and Public Health Center 16 Lumpini during 1 Oct, 2003-30 Sep, 2004 focusing on the provider perspective. This was a descriptive retrospective study. The cost in this study focuses on the direct cost. The effectiveness was measured in terms of disease controllability. The results from the study revealed that : (1) The total management cost of diabetes mellitus with non-complicated patients at King Chulalongkorn Memorial Hospital and Public Health Center 16 Lumpini was 1,170,917.21 and 738,679.67 baht/year, respectively. The total cost of management of hypertension was also 840,797.66 and 946,625.30 baht/year, respectively. The unit cost of diabetes mellitus management at King Chulalongkorn Memorial Hospital and Public Health Center 16 Lumpini was 1,885.33 and 370.08 baht/visited, respectively. The unit cost of hypertension management was 1,054.95 and 370.08 baht/visited, respectively. (2) The effectiveness of diabetes mellitus management at King Chulalongkorn Memorial Hospital and Public Health Center 16 Lumpini was 34.79% and 22.58% and the effectiveness of hypertension disease management was 86.20% and 81.26%, respectively. (3) The cost-effectiveness of diabetes mellitus management at Public Health Center 16 Lumpini was more than King Chulalongkorn Memorial Hospital was. There were 10,655.99 and 20,522.39 baht/case disease controllability, respectively. Due to the hypertension disease management, there was the fact that Public Health Center was also more than King Chulalongkorn Memorial Hospital as the same as the diabetes mellitus management was. There were 3255.23 and 5,301.11 baht/case disease controllability, respectively. Public Health center, therefore, is considered to be an efficient place in cases of chronic disease with non-complicated patients more than teaching hospital does because Public Health center was more cost-effectiveness of chronic disease management than teaching hospital does. Thus, having the primary care unit at Public Health Center should be more appropriated than having the primary care unit at teaching hospital or tertiary hospital.