Unit Cost Analysis of Health Services in Tambon Health Promoting Hospitals, Ubon Ratchathani Province

Abstract

Introduction: Tambon Health Promoting Hospital (THPH) is the first level of contact between individuals and the health care system. This studyvs objective was to estimate THPH costs of providing health care services that will be beneficial for effective and economical resource management. Methods: This descriptive research was conducted to estimate the cost of services provided using the perspective of the provider. Electronic database, xJHCISy for the fiscal year 2015, and THPH accounting documents (General Ledger account: GL) were used. Purposive sampling was used to select twelve THPHs from four area zones, with each zone having three different hospital sizes. Results: The average full cost of all participating THPHs was 2.7 million baht. The labor cost (LC) accounted for 64% of the full cost, while the material cost (MC) was 24% and the capital cost (CC) was 12%. The average full costs were 3.9, 2.4, and 1.7 million baht for the large, medium and small size THPHs respectively. The proportion of full cost for LC, MC and CC was similar for all THPH sizes and the labor cost was the major expense and accounted for at least 60% in all cases. The average unit cost per capita of all samples was 488 baht. Large THPHs had the lowest average unit cost per capita of the three sizes. The average unit cost for an outpatient visit was 64 baht. The large THPHs had the highest unit cost of outpatient (OP) visits and this was due to it having the lowest ratio of OP visits per population. The average cost recovery of all THPHs was 0.76. The cost recovery showed the same trend regardless the size of THPH. Conclusions: The labor cost is the major proportion of total expenses, at about two-thirds of the full cost. In addition, the cost recovery of most THPHs was less than one. Study findings indicate the importance of human resource management as well as economical scale and risk management on THPH potential development in terms of effective and economical outcomes.