METHODS: Patients aged 50 years and over hospitalised with a vertebral fragility fracture from 1/2/2016 to 31/1/2017 were identified from radiology and hospital records. Patients sustaining vertebral fractures due to either major trauma or malignancy were excluded. Data was collected on patient demographics, fracture details, hospitalisation details and health outcomes.

RESULTS: 208 patients with acute vertebral fragility fractures were hospitalised over a 12 month period. The mean (SD) age was 80.5 (11) years, of which 68% were female. 94% presented to the Emergency Department (ED) as their first point of contact, of which 70% were subsequently hospitalised. Two-thirds presented with a single level vertebral fracture predominantly around the thoracolumbar region. The majority (87%) were non-operatively managed by general physicians, of which most were under Geriatric Medicine. The median length of stay was 12 (IQR 6-20) days and inpatient mortality was 3%. 52% of patients went on to have a bone health assessment.

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.