Wantana Verathaworn. Cost of treatment for total knee arthroplasty in osteoarthritis patient at Ramathibodi Hospital . Master's Degree(Hospital Administration). Mahidol University. : Mahidol University, 2004.
Cost of treatment for total knee arthroplasty in osteoarthritis patient at Ramathibodi Hospital
Abstract:
The objective of this study was to estimate the cost of treatment for Total Knee
Arthroplasty in Osteoarthritis patients at Ramathibodi Hospital, for the provider. It is descriptive
research with the direct cost to the service unit being used as the routine service cost in providing
services. The data was back collected to the fiscal year 2002. The medical care cost was estimated
for the forward 3 months. Stratified randomed sampling was used as the determination criterion to
select the samples. There were 39 cases in this study. The instrument used in this study was data
collection forms for the cost factors.
The study findings were that the patients had an average length of stay of 6.59 days
with an average treatment cost of 84,419.18 baht/case. This was composed of the routine service
cost, 4,776.90 baht/case, and the medical care cost of 79,642.28 baht/case. The cost factors with
the highest cost were medical supply and prosthesis cost with average cost of 57,200.35baht/case.
The next most substantial costs were the operation cost and medicine cost of 9,701.66 baht/case
and 6,590.33 baht/case respectively. When comparing the average treatment cost on the
Orthropaedic common ward (83,905.27 baht/case) and the Orthropaedic private ward (85,241.45
baht/case), it was found that there was no significant difference. When comparing the average
treatment cost between the patients with underlying disease (83,266.48 baht/case) and the patients
without underlying disease (86,076.20 baht/case), it was found that there was no significant
difference. The comparison between the treatment cost and the hospital service charge showed
that there was a significant difference (P–value < 0.001). The difference in the private ward was
1.88 times more than in the common ward.
The study recommendations were that there should be a team to manage the critical
pathway, case management, discharge planning, staff team working ability and appropriate
resource use in order to develop better cost management.