J Med Assoc Thai 2001; 84 (3):402

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Medical Cost and Illness Pattern Among Ramathibodi Medical Students
Assavanich K Mail, Tubtimtes S , Prueksaritanond S

KORNTHONG ASSA V ANICH, M.D.*,
SAISUNEE TUBTIMTES, M.Sc.*,
SOMJIT PRUEKSARIT ANOND, M.D.*
Background : In Thailand, health care expenditure has increased more than three times
from the 1982 to 1992. Health care of medical students does not reflect the actual costs because
of the strong personal relationship between doctors and patients (ie. medical students). Many items
are waived in the patient's favour. The objectives of study in medical students were analysed in
unit cost, cost recovery, illness pattern and health service uses.
Method : From May 1997 to April 1998 the prescription cost and illness pattern were
retrospectively studied and analysed. There were 1,063 out-patient visits and 8 in-patient cases
from 416 medical student case records of Ramathibodi Hospital. The annual subscription for
medical student is 700 baht per person per year, but the actual medical costs are higher 53,213
baht, excluding investment, materials and labour cost. The most common illness was upper respi-
ratory tract infection. The average cost per prescription was 163 baht (range 6-1391 baht) and the
sixth year students spent more than the fourth and fifth years. Frequency of consultation was
more in the fourth than the fifth and sixth year students and total medical students (namely 4.01,
1.66, 1.92, 2.55 times/student/year respectively). The consultation was done in the emergency
room (72. 0%) more often than in the health clinic (
l.
9% ).
Conclusion : Medical students should attend special clinics regularly, except in an emer-
gency, to get continual medicare and save medical costs. Determining the maximum medical cost
per student per year is a strategy of saving cost. To promote understanding and allay anxiety,
medical students should have the benefit of health promotion, prevention and orientation as they
are in continual contact with all forms of contagious diseases.
If
this preventive measure is effec-
tive, the incidence of illness should be lower and the cost reduced.
Key word : Medical Cost, Illness Pattern, Medical Student

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