Cost analysis of diabetic outpatients of health card holders and non-health card holders in Sena Hospital

Abstract

This study is concemed with the of low cost recovery in the public health facilities tha provide health care for chronic diseases. Diabetes is a chronic ad costly disease due to its complications. About 4% of Thai people have diabetes and the trend is set to dubble in the near future. The Health card Scheme is a good choice to enable patients to access healthcare services with unlimited benefit. As a result, the cost burden is pushed to the provider. The objective of this study is to analyze the provider cost for diabetics at OPD in Sena Hospital for both Health Card holders and non-Health Card holders. The non-Health Card holders are classified into 2 groups; the out of pocket and the elderly. The important control variable that should be of concern egarding effect on cost is age. The age group of 41-60 years is used for this study for both health card holders and the out of pocket group. Another group is the elderly for whom the age is above 60 years old. These 3 groups are classified into 3 kinds: (1) diabetics without complications, (2) diabetics with hypertension and (3)diabetics with heart disease. The study applied the direct distribution method for cost allocation. This study found that the cost per visit for diabetics in these 3 groups who are Health Card holders was 339.96 636.13 and 748.74 baht, respectively and the annual cost per person per year was 2,461.31, 5,209.90 and 6,311.88 baht, respectively. The cost per visit for diabetics out of pockets was 334.72, 631.17 and 746.72 baht, respectively, with the annual cost per person per year 2,413.33, 5,156.66 and 6,294.85 baht, respectively. the cost per visit for diabetics in the elderly group was 365.72, 706.19 and 750.98 baht, respectively, and the annual cost per person per year was 2,655.13, 5,889.62 and 6,383.33 baht. respectively. The average utilization rate among teh 3 groups of diabetics is quite hidh but slightly different among the elderly, the out of pocket and Health card holders at 8.07, 7.94 and 7.91 visits per person per year, respectively. However, the estimated cost per visit of the out of pocke cases in these 3 groups only based on small sample sizes. Especially, in diabetics without complications and diabetics with heart disease, the sample size was only one case each. The conclusion or comparison must therefore be done cautiously. Higher costs to a diabetic vary on the severity of the disease, its complications and the age factor. people of increased age tend to have more serious disease. The payment mechanism is also an important factor in determining consumer behavior. This is reflected in costs, which in result out of pocket patients moving to use Health Cards, as the above reasons.