The Analysis of Unit Cost for Laparoscopic Liver Cancer Surgery and Perioperative Nursing Activity Base Costing, National Cancer Institute

Abstract

       This research is a descriptive study that aims to examine the cost per unit of laparoscopic liver cancer surgery and the cost of surgical nursing activities at the National Cancer Institute. The study conducted a retrospective analysis of data on labor costs, material costs, and investment costs in the fiscal year 2021, as well as observing the practice of surgical nursing activities. The population and sample groups used in the study included data on (1) labor costs, materials costs, investment costs, and statistics of patients who received surgery services in the fiscal year 2021, (2) operating room nurses who worked while collecting data (a total of 25 people), and (3) the cost of surgical nursing activities by observing the nursing activities with a total of 295 patients. The data collection period was from 1 November - 31 December 2022. There are three sets of tools used in this research, which consist of: Set 1 - Surgical Nursing Unit Cost Record Form; Set 2 - Surgical Nursing Activity Dictionary in the Operating Room at the National Cancer Institute; and Set 3 - Cost Data Form for Surgical Nursing Activities. The content validity of these tools was 0.96, and the confidence level was 0.90. The results showed that the unit cost of surgical nursing work at the National Cancer Institute has an average cost value of 41,988.97 baht, with a total direct cost ratio of labor cost: investment cost: material cost of 10.07: 83.32: 6.61. The highest cost per unit was found in liver cancer surgery, which is equal to 247,634.24 baht. Surgical nursing activities, when classified by surgical phase, were found to have the highest cost during the post-operative period, which was 6,316.85 baht, followed by the operative period at 25.53 baht, and the pre-operative nursing activity had the lowest cost, which was equal to 14.30 baht. The highest cost of nursing activities during the surgical period was found in lung cancer branch surgery, which had the highest cost in all stages of surgery, while gastrointestinal cancer surgery had the lowest cost for pre-operative and post-operative nursing activities.

       These results provide empirical data that executives should pay attention to managing manpower sufficiently suitable for workload, clearly assigning duties to perform duties, developing a nursing practice guideline as a guideline for surgical practice, and implementing a development process with a mentoring system (professional), especially in the surgical practice section, as it is cost-intensive. These improvements can increase efficiency and improve the performance of surgical nurses.