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Economic Impact of Inpatient Medication Reconciliation with Subtraction Strategy: A Cost Minimization Analysis
29 Pages Posted: 10 Mar 2025
More...Abstract
Background: Medication Reconciliation (MR) with the Medication Subtraction Strategy has been implemented in inpatient settings to optimize medication use and reduce costs. However, its financial impact and key influencing factors remain unclear. This study aimed to evaluate cost savings and determinants across healthcare schemes.
Methods: A retrospective analysis was conducted on hospitalized patients under the Civil Servant Medical Benefit Scheme (CSMBS), Universal Coverage Scheme (UCS), and Social Security Scheme (SSS). Patients were categorized by healthcare scheme and length of stay (LOS). Generalized Linear Mixed Models (GLMMs) assessed cost savings while controlling for clustering effects.
Findings: Among 563 patients, 324 underwent MR with subtraction. The highest per-patient cost savings were in SSS (508.5 ± 56.1 THB), while the lowest were in CSMBS (133.5 ± 23.6 THB). The GLMM showed healthcare scheme and LOS significantly influenced cost savings. Patients under SSS (IRR = 3.95, p < 0.001) and those with LOS > 21 days (IRR = 2.45, p < 0.001) had the highest savings. However, scheme-LOS interaction was not significant (p = 0.95).
Interpretation: MR with the subtraction strategy effectively reduced costs, yet negative reimbursement persisted, indicating expenses exceeded reimbursements. The strategy was most beneficial for SSS beneficiaries and long-stay patients, highlighting the need for financial policy adjustments to improve hospital sustainability.
Keywords: Medication Reconciliation, Economic Efficiency, Cost Minimization, Hospital Policy
Suggested Citation: Suggested Citation
