title: Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.
abstract: BACKGROUND
  The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital.
  
  
  METHODS
  All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs).
  
  
  RESULTS
  Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83.
  
  
  CONCLUSIONS
  A mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.
authors.affiliation: United Nations University-International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia. drsaadalezzi@gemail.com.|International Centre for Case-Mix and Clinical Coding (ITCC), University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. drsaadalezzi@gemail.com.
authors.forename: Saad Ahmed
authors.initials: SA
authors.lastname: Ali Jadoo
authors.affiliation: International Centre for Case-Mix and Clinical Coding (ITCC), University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. saljunid@gmail.com.
authors.forename: Syed Mohamed
authors.initials: SM
authors.lastname: Aljunid
authors.affiliation: International Centre for Case-Mix and Clinical Coding (ITCC), University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. amrizal65@gmail.com.
authors.forename: Amrizal Muhammad
authors.initials: AM
authors.lastname: Nur
authors.affiliation: International Centre for Case-Mix and Clinical Coding (ITCC), University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. zafar.he@gmail.com.
authors.forename: Zafar
authors.initials: Z
authors.lastname: Ahmed
authors.affiliation: Pharmacy of Hospital University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia. dexter@ppukm.uk.edu.my.
authors.forename: Dexter
authors.initials: D
authors.lastname: Van Dort
mesh_terms: D003953:Diagnosis-Related Groups / Q000191:economics*; D017721:Hospital Costs / Q000458:organization & administration; D006760:Hospitalization / Q000191:economics; D006785:Hospitals, University; D008296:Malaysia; D010593:Pharmaceutical Services / Q000191:economics*; D012189:Retrospective Studies