Drug Expenditure for Medical Healthcare System in BMA Medical College and Vajira Hospital

Abstract

Drug Expenditure for Medical Healthcare System in BMA Medical College and Vajira Hospital

Siriganya Kobwanthanakun BSc (Pharmacy)*

Department of Pharmacy, BMA Medical College and Vajira Hospital

Objective: To study drug expenditure during the fiscal year 2006-2008 in BMA Medical College and Vajira Hospital.

Study design: Descriptive study.

Subjects: The out- and in-patient database of BMA Medical College and Vajira Hospital from the fiscal year 2006 to 2008 of 4 payment categories including Civil Service Medical Benefit Scheme (CSMBS), Universal Coverage Scheme (UC), Social Security Scheme (SSS) and paying in cash was studied.

Methods: We retrieved data from the records of out-and in-patients according to the study groups from the electronic database of BMA Medical College and Vajira Hospital. Data collected were: the number of patients, number of visits, cost of drugs, and the ratio of essential and non-essential drugs according to the National Drug List.

Main outcome measures: The cost of drugs per visit and the ratio of essential and non-essential drugs consumed.

Results: The number of both outpatients and inpatients were increasing steadily each year. The majority of patients was those who paid in cash 57.9% of total outpatients and 38.3% of total inpatients consecutively. The frequency of outpatient visiting was highest in CSMBS group, 4.4 visits per patient per year, compared with 2.1 visits per patient per year for paying in cash group. However, the numbers of admissions in each group of payment were almost equal, 1.1-1.3 visits per patient per year. The highest average annual drug cost per capita was in CSMBS group, 4,495 Baht per visit, which was 6.1 times of the cost per visit of SSS group, and 5.0 times of the cost per visit of UC group. The average drug cost per admission for an inpatient of CSMBS group was 14,714 Baht, 12 times of paying in cash group and 2.4 times of UC group. The ratio of non-essential drugs used was highest in CSMBS group, 61-74% of total outpatients' drug costs and 43-50% of total inpatients' drug costs, while the ratio of non-essential drugs used was lowest in UC group, 12-14% of total outpatients' drug costs and 20-25% of total inpatients' drug costs.

Conclusion: The drug expenditure for medical healthcare of BMA Medical College and Vajira Hospital tended to be increasing annually for both outpatients and inpatients. The drug expenditure per visit and the ratio of non-essential drugs used in the CSMBS group was higher than other groups.

Key words: Drug expenditure, Essential Drug (ED), Civil Service Medical Benefit Scheme (CSMBS), Universal Coverage Scheme (UC), Social Security scheme (SSS), cash

Vajira Med J 2009 ; 54 : 67 - 78