Publication: Determination of the financial burden borne by the healthcare provider in treating nasopharyngeal carcinoma (NPC) patient based on casemix system in Hospital Pakar Universiti Sains Malaysia (HPUSM)
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Date
2025-09
Authors
Hanan, Nur Andriana Sufea
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Abstract
Nasopharyngeal carcinoma (NPC), previously known as lymphoepithelioma, is an undifferentiated form of squamous cell carcinoma arising from the epithelium of the nasopharynx. It is the most common malignancy of the nasopharynx. In Malaysia, NPC is ranked as the fourth (5.2%) of all cancers and third (8.4%) most common cancer among the male population. NPC in Malaysia mostly occurs among Chinese (49%), followed by natives of Sabah and Sarawak (28%) and Malay (22%). Cancer is one of the most expensive medical conditions to treat in the world. The Ministry of Health Malaysia's cancer survey reported that the total treatment cost of nasopharyngeal cancer in Malaysia was approximately RM70,000 per individual. The general objective of this study was to determine the health financial burden borne in treating nasopharyngeal carcinoma (NPC) patients by the HPUSM based on the Casemix System output. The specific objectives of this study are to determine the prevalence of NPC cases treated in HPUSM from 2020 to 2022, to identify the clinical criteria of NPC cases, to investigate the treatment cost borne by the health care provider (HPUSM) in treating NPC patients based on the MY-DRG® Tariff, and to determine the associated factors of MY-DRG® Tariff between clinical criteria for NPC patients treated in HPUSM.
This retrospective cross-sectional study was conducted using secondary data obtained from the Medical Record Department, HPUSM, and financial data was provided by the Finance Department, HPUSM. The data was analysed using IBM Statistical Package for Social Science (SPSS) software version 28.0. The prevalence of NPC cases is 0.024% from 2020 to 2022. The clinical criteria identified from the data were length of stay (LOS), number of diseases, number of procedures, and disease severity. The average LOS of NPC patients treated in HPUSM is 5.71 days. The NPC cases data analysis showed 82.9% of patients have more than one complication and 31.4% patients have three complications, and this number of complications was the most frequently encountered by patients. While the majority of patients underwent one clinical procedure (48.6%). Most of the NPC patients treated in HPUSM were diagnosed with severity 2 (48.6%). The average MY-DRG® Tariff for NPC treatment is RM8647.77. There was a significant relationship between the number of diseases, number of procedures, disease severity, and MY-DRG® Tariff (p- value<0.05). The length of stay (LOS) was not significantly associated with the MY- DRG® Tariff (p>0.05). Findings from the study show that the tariff for the NPC treatment was associated with the number of diseases, number of procedures, and disease severity level. This study provides valuable information for future studies and research about the financial burden borne by the healthcare provider in treating NPC patients and it also can provide novel insights regarding the influence of significant factors on the financial burden borne by HPUSM.
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Keywords
Nasopharyngeal carcinoma , Casemix System