PMID- 30881160
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 1179-1594 (Print)
IS  - 1179-1594 (Electronic)
IS  - 1179-1594 (Linking)
VI  - 12
DP  - 2019
TI  - Budget impact analysis of the new reimbursement policy for day surgery in 
      Thailand.
PG  - 41-55
LID - 10.2147/RMHP.S186196 [doi]
AB  - INTRODUCTION: In 2017 the Thai Ministry of Public Health proposed a new financing 
      mechanism to promote day surgery under the Universal Coverage Scheme - the main 
      public insurance arrangement for Thais. The key feature of the policy is health 
      facilities performing day surgery can claim the treatment expense based on 
      relative weight (RW) instead of adjusted RW (adjRW). Procedures for 12 diseases 
      (so-called "candidate procedures") are eligible for the new reimbursement. The 
      objective of this study was to assess the current day surgery situation in 
      Thailand and analyze potential budget impact from the new policy. METHODS: A 
      quantitative cross-section design was employed. Individual inpatient records of 
      the Universal Coverage Scheme during 2014-2016 were analyzed. Descriptive 
      statistics and simulation analyses were applied. The analyses were divided into 
      three subtopics: 1) case volume and expense claim, 2) utilization across 
      facilities, and 3) case mix index and budget impact. RESULTS: Overall, day 
      surgery accounted for 4.8% of admissions with candidate procedures. Inguinal 
      hernias, hemorrhoids, and common bile duct stones caused the largest sum of 
      admission numbers and admission days. Currently, the annual reimbursement for 
      candidate procedures treated as inpatient cases is around 290.8 million Baht (US$ 
      8.8 million), with about 12.4 million Baht (US$ 0.38 million) for day surgery 
      cases. If all candidate procedures were performed as day surgery and 
      diagnostic-related groups (DRG) version 6 was applied, the incremental budget 
      would amount to 1.9 million Baht (US$ 58,903). CONCLUSIONS: The new reimbursement 
      policy will likely lead to minimal budget burden. Even in the case of maximal 
      uptake of the policy, the needed budget would increase by just 15%. The marginal 
      budget increment was explained by the infinitesimal RW-adjRW difference. Apart 
      from the financial measure, other qualitative aspects of the policy, such as 
      infrastructure and health staff readiness, should be explored.
FAU - Suphanchaimat, Rapeepong
AU  - Suphanchaimat R
AD  - International Health Policy Program (IHPP), Ministry of Public Health, 
      Nonthaburi, Thailand, rapeepong@ihpp.thaigov.net.
AD  - Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, 
      Nonthaburi, Thailand, rapeepong@ihpp.thaigov.net.
FAU - Thungthong, Jutatip
AU  - Thungthong J
AD  - National Health Security Office, Bangkok, Thailand.
FAU - Sriprasert, Kriddhiya
AU  - Sriprasert K
AD  - National Health Security Office, Bangkok, Thailand.
FAU - Tisayaticom, Kanjana
AU  - Tisayaticom K
AD  - International Health Policy Program (IHPP), Ministry of Public Health, 
      Nonthaburi, Thailand, rapeepong@ihpp.thaigov.net.
FAU - Limwattananon, Chulaporn
AU  - Limwattananon C
AD  - Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
FAU - Limwattananon, Supon
AU  - Limwattananon S
AD  - Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
LA  - eng
PT  - Journal Article
DEP - 20190306
PL  - England
TA  - Risk Manag Healthc Policy
JT  - Risk management and healthcare policy
JID - 101566264
PMC - PMC6408916
OTO - NOTNLM
OT  - Thailand
OT  - budget impact
OT  - case mix index
OT  - day surgery
OT  - inpatient
COIS- Disclosure JT and KS are NHSO staff, but neither received any extra revenue for 
      this research apart from their regular monthly salary, nor were they involved in 
      the policy decision making process. The authors report no other conflicts of 
      interest in this work.
EDAT- 2019/03/19 06:00
MHDA- 2019/03/19 06:01
PMCR- 2019/03/06
CRDT- 2019/03/19 06:00
PHST- 2019/03/19 06:00 [entrez]
PHST- 2019/03/19 06:00 [pubmed]
PHST- 2019/03/19 06:01 [medline]
PHST- 2019/03/06 00:00 [pmc-release]
AID - rmhp-12-041 [pii]
AID - 10.2147/RMHP.S186196 [doi]
PST - epublish
SO  - Risk Manag Healthc Policy. 2019 Mar 6;12:41-55. doi: 10.2147/RMHP.S186196. 
      eCollection 2019.