Economic analysis of reimbursement policy for open heart surgery in Thailand

Abstract

This study concerns with identification of significant Factors, which determine impatient charge of open-heart surgery in Thailand and propose the guideline of the reimbursement for open-heart surgery. The determinants underlying the analysis are the characteristic of patient, involved clinical physician practice, and characteristic of hospital. This study is three level hospitals. Available secondary data are reported as well as patient-record abstracts of the fiscal year 2001. The patient files are recorded and come from Health Insurance Office in Ministry of Public Health. Data analysis consists of quantitative and qualitative analysis by means of multiple regressions for patient records files. Finally, multivariate variance analysis is used to disclose price discrimination of criteria charge items of open-heart surgery. The major result of this study is a revised model of inpatient charge, including with five factors contributing to inpatient charge. Those are age of patient, length of stay, the Ministry of Public Health subsidized patient, intensity of operative procedure, and type of hospital. Explanatory variables are significantly related to inpatient charge, it is significantly affected by inpatient cost. In order to formulate a reimbursement policy for open-heart surgery by assumption that charges reflect the cost of providing care. Charge related factors should also reflect the cost so that they will be used for adjusting the reimbursement that reflects to inpatient charge. The suggestive guidance of reimbursement in open-heart surgery is the calculation of reimbursement to hospitals regarding to factors that reflect to inpatient charge and are subjected to implement inpatient charge policy. As mention above, factors have to be reengineered their internal management systems such as financial information system, internal audit system of medical records, and determinant standard price index.