| Abstrakt: |
Background &objectives:Ischaemic heart disease (IHD)is a major contributor to the total death from noncommunicable diseases in Malaysia, therefore is associated with substantial economic burden to the healthcare sector. This study aimed to determine the direct medical costs ofmanaging ischaemic heart disease and its associated factors in a tertiary hospital in Malaysia. Methods: A retrospective study utilising secondary data from Casemix Unit, UKMMC was conducted among patients hospitalised for myocardial infarction (MI) and angina pectoris in 2018. The direct medical cost was measured from the healthcare provider perspective,using the tariff (sum of costs incurred per patient) provided in casemix data based on step-down costing approach. Associated factors which influenced direct medical costs were determined, such as gender, age group, comorbidities, cardiovascular-related procedures, and disease severity. Results:A total of 1317 patients were recruited into the study.The majority of admissions were attributable to angina pectoris (62.2%), while the remaining 37.8% patients were hospitalised due to MI. The total direct medical costs of treating IHD in 2018 was higher for angina patients (MYR 2,101,169.71) compared to MI patients (MYR 2,053,757.36). However, the average costs of treating MI patients were higher (MYR 4,124.01) compared to angina patients (MYR 2,565.53). The factors which influenced direct costs included older age, multiple comorbidities, type of cardiovascular-related procedures, length of stay, and severity of illness. Conclusion: Direct medical cost of IHD in 2018 incurred by UKMMC was substantial. Direct costs are highest in MI-related cases, which in most cases are associated with longer length of stay and a more complex medical intervention.Preventive measures and strategies to minimise direct costs should be targeted to address the major cost drivers as highlighted in this study. [ABSTRACT FROM AUTHOR] |
