COMPARATIVE COST ANALYSIS OF HEALTH CLINICS ENCOUNTERS IN MALAYSIA_PRELIMINARY FINDINGS

Abstract

Public primary healthcare facilities vary in service complexity and resource utilisation, potentially influencing healthcare expenditure per patient encounter. Understanding cost variation across facility types is important for improving resource allocation and operational efficiency. This study compared encounter-related costs between large health clinics (type 2) and small health clinics (type 6) in Malaysia to identify differences in resource utilisation and cost drivers across public primary care settings. A comparative descriptive analysis was conducted using outpatient encounter data from type 2 and type 6 health clinics. A top-down costing approach was used to estimate average cost per encounter. Cost components included direct, overhead, laboratory, imaging, and drug costs. Data were obtained from the Teleprimary Care-Oral Health Clinical Information System (TPC-OHCIS), laboratory and imaging service records, prescription databases, and administrative records. Descriptive statistics using STATA v18 summarised encounter costs and patient age profiles. A total of 722 encounters from large clinics and 234 from small clinics were analysed. Average total cost per encounter was higher in small clinics compared with large clinics (RM238.63 vs RM100.06). Small clinics demonstrated higher laboratory (RM80.58 vs RM21.01), overhead (RM79.09 vs RM27.02), imaging (RM3.11 vs RM0.05), and direct costs (RM4.01 vs RM1.69). Drug costs were comparable between facilities. Cost variability was greater in small clinics (RM83.10–RM708.16) than large clinics (RM28.71–RM612.92). Patients attending large clinics were older on average (54.95 vs 38.45 years). Small health clinics demonstrated substantially higher encounter costs despite smaller infrastructure size, mainly driven by laboratory, overhead, and imaging expenditures. These findings may support resource planning and cost optimisation within Malaysia’s public primary healthcare system.