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Fulltext The impact of casemix reimbursement on hospital revenue in Indonesia

Aljunid, Syed Mohamed, Amrizal Muhammad Nur, Irwan Saputra

Jurnal Sains Kesihatan Malaysia, 2020;18(2):1-8.
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The objective of this study is to examine the impact of the casemix reimbursement on the hospital revenue at three selected hospitals (Type B, C and D) reimbursed using 602 groups from 14,749 cases. The results of the study showed that the hospitals received 32.4% higher income when reimbursed with Indonesia Case Bases Groups (INA-CBG) as compared to fee-for-service. Type D hospitals is the biggest gainer with 81.0% increased in income followed by Type B hospital that obtained 34.7% higher revenue. In conclusion, the use of INA-CBG as a prospective payment method has benefitted the hospitals by the increase in the revenues. It is hope that additional resources gained in this programme will allow the hospitals to provide optimum care to the population. It is recommended that the JKA management will use the INA-CBG casemix data to monitor the performance of the hospitals to ensure that quality and efficiency of the services provided to the population is continuously maintained.

Matched MeSH terms: Fee-for-Service Plans
Fulltext A systematic review and meta-analysis of pharmacist-led fee-for-services medication review

Hatah E, Braund R, Tordoff J, Duffull SB

Br J Clin Pharmacol, 2014 Jan;77(1):102-15.
PMID: 23594037 DOI: 10.1111/bcp.12140

The aim was to examine the impact of fee-for-service pharmacist-led medication review on patient outcomes and quantify this according to the type of review undertaken, e.g. adherence support and clinical medication review.

Matched MeSH terms: Fee-for-Service Plans*
Fulltext Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Mohd-Tahir NA, Paraidathathu T, Li SC

SAGE Open Med, 2015;3:2050312115596864.
PMID: 26770795 DOI: 10.1177/2050312115596864

Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients' demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders are necessary to further strengthen the Malaysian healthcare system effectively.

Matched MeSH terms: Fee-for-Service Plans
Fulltext An analysis of ranibizumab treatment and visual outcomes in real-world settings: the UNCOVER study

Eldem B, Lai TYY, Ngah NF, Vote B, Yu HG, Fabre A, et al.

Graefes Arch Clin Exp Ophthalmol, 2018 May;256(5):963-973.
PMID: 29502232 DOI: 10.1007/s00417-017-3890-8

PURPOSE: To describe intravitreal ranibizumab treatment frequency, clinical monitoring, and visual outcomes (including mean central retinal thickness [CRT] and visual acuity [VA] changes from baseline) in neovascular age-related macular degeneration (nAMD) in real-world settings across three ranibizumab reimbursement scenarios in the Middle East, North Africa, and the Asia-Pacific region.
METHODS: Non-interventional multicenter historical cohort study of intravitreal ranibizumab use for nAMD in routine clinical practice between April 2010 and April 2013. Eligible patients were diagnosed with nAMD, received at least one intravitreal ranibizumab injection during the study period, and had been observed for a minimum of 1 year (up to 3 years). Reimbursement scenarios were defined as self-paid, partially-reimbursed, and fully-reimbursed.
RESULTS: More than three-fourths (n = 2521) of the analysis population was partially-reimbursed for ranibizumab, while 16.4% (n = 532) was fully-reimbursed, and 5.8% was self-paid (n = 188). The average annual ranibizumab injection frequency was 4.1 injections in the partially-reimbursed, 4.7 in the fully-reimbursed and 2.6 in the self-paid populations. The average clinical monitoring frequency was estimated to be 6.7 visits/year, with similar frequencies observed across reimbursement categories. On average, patients experienced VA reduction of -0.7 letters and a decrease in CRT of -44.4 μm. The greatest mean CRT change was observed in the self-paid group, with -92.6 μm.
CONCLUSIONS: UNCOVER included a large, heterogeneous ranibizumab-treated nAMD population in real-world settings. Patients in all reimbursement scenarios attained vision stability on average, indicating control of disease activity.

Matched MeSH terms: Fee-for-Service Plans