Study of the cost of care for psychiatric patients at Mueang Suang Community Hospital, Roi Et Province.

Abstract

     This study aimed to: 1) analyze the cost components of psychiatric treatment; 2) calculate the average cost per case and cost per service unit, classified by disease group; 3) compare costs between outpatient and inpatient services across fiscal years 2022–2024; 4) examine factors affecting treatment cost differences; and 5) propose guidelines for efficient psychiatric service cost management. Survey research was employed, utilizing retrospective data collected from the electronic medical record system of Mueang Suang Hospital, with cost analysis conducted through the Activity-Based Costing (ABC) methodology. The sample comprised 1,834 psychiatric outpatients and 309 inpatients diagnosed under ICD-10 codes F00–F99. Data were analyzed using descriptive statistics, and factors influencing treatment costs were examined using a Generalized Linear Model (GLM) with Gamma Distribution and Log Link Function.

     The findings revealed that: 1) The largest direct cost component for outpatients was medications and pharmaceuticals (57.64%), with a cumulative three-year total cost of 3,634,014.00 baht. For inpatients, medical and nursing services—including room charges, meals, and medical procedures—accounted for the highest proportion (69.88%), with a three-year cumulative cost of 1,313,336.00 baht. 2) The overall average cost per outpatient case across all disease groups ranged from 1,809.33 to 2,139.53 baht per case. 3) The average cost per inpatient case was 1.61 to 3.13 times higher than that of outpatients. 4) Statistically significant factors influencing outpatient costs included ICD-10 disease group, age, and number of treatment visits (Wald Chi-Square = 1,840.151, p < 0.001). For inpatients, significant factors comprised length of hospital stay (LOS) (Wald Chi-Square = 703.871, p < 0.001), ICD-10 disease group, and Civil Servant Medical Benefit Scheme (CSMBS) entitlement (p < 0.001). 5) The most urgently prioritized cost management strategies were pharmaceutical cost administration and reduction of hospital length of stay, particularly for patients with schizophrenia and substance-related disorders.