ABSTRACT
This study aims to analyze the cost-effectiveness of Hypertensive Elderly Service in the OPD and the PCU of Hua Hin Hospital, Prachuap Khiri Khan Province. The 12 weeks cohort study from June to September 2007 was designed to evaluate the outcome of hypertensive elderly services at the two settings. By purposive selection of new hypertensive elderly patients age 60 years and above, the study included 54 patients from the OPD and 36 from the PCU. Both provider and patient perspective of cost analysis were taken into account. The provider costs data was collected from hospital records while the patient costs data was collected by interview and structured questionnaire. The effectiveness was measured as the average reduction in the systolic blood pressure. Both cost and outcome data were analyzed using descriptive and analytical statistics. The results showed that hypertensive elderly service at PCU was more cost-effective than the OPD of Hua Hin Hospital. The cost-effectiveness ratio was 75.05 Bt/mmHg for the hypertensive elderly service in the OPD and 32.60 Bt/mmHg for the PCU. The total costs of the OPD were 1,223.27 Baht while the total costs of the PCU was only 444.69 Baht. The sensitivity analysis of the service costs indicated that unit costs vary with the time used for the stage of patient screening. The study suggested that it is necessary to strengthening the capability of PCU in providing chronic care service in order to reduce the burden of costs to the hospital and to the patients. Health promotion and prevention programs should be encouraged and implemented to people of all ages though there is costs incurred from health promotion programs but it is worth in the long run in term of quality of life and reduction in the costs of treatment.
ABSTRACT
The rapid increase of health care costs in most countries resulted from higher demand for and expectations from new medical technology, expensive prescription drugs, an ageing population and a growing demand for health and long term care. Since health resources available for delivery of health care services are limited, a number of different groups who are involved including health service providers want to monitor value of resource used. The economic technique of health care cost evaluation is one of the tools available to help health decision makers choose wisely from a range of alternatives including use of resources and the implementation efficient programs. The economists use the concept of opportunity cost in deciding whether the resources are efficient used. The evaluation is about health care cost analysis, and involves evaluating the use of resources spent on the treatment of people with illnesses and assessing the costs of carrying out a set of activities in order to identify ways to do the most with a limited resources. Health care cost analysis is a form of economic evaluation technique that can be used to assess either the cost of a illness or the cost of a health care program or interventions. Health care activities are like other activities in the social economic that consume resources for producing goods and services. Therefore, it is necessary to understand the concepts and meanings of cost and health care costs.