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.