A Compared Cost Analysis for Health Care Services in Tambon Health Promotion Hospitals Before and During the COVID-19 Pandemic Period Fiscal Year 2019-2021

Abstract

This study aimed to estimate and compare the unit costs of health care services before and over Covid-19 pandemic period in Tambon Health Promoting Hospitals. The activity-based costing (ABC) of Covid 19 activities are also presented. This study estimated the accounting costs per unit under the providers' perspective, based on the empirical costing approach. Thirty-six Tambon Health Promoting Public Hospitals were randomly selected, from 6 regions of Thailand. Labor, material, and financial costs were collected for the fiscal year 2019, so to represent a normal period. Whereas the fiscal years 2020 and 2021 were collected to represent the variations due to Covid-19 pandemic. The results were presented in both total costs and unit costs for each activity.

The results showed that, from fiscal year 2019 to fiscal year 2021, the median total cost for each Tambon Health Promoting Hospital increased by 4,061,557 Thai Baht (THB), 4,078,242 THB, and 4,308,141 THB, respectively. While from fiscal year 2020 to fiscal year 2021, it increased by 4,078,242 THB. When dividing all costs into three categories, the study showed the labor costs accounted for the majority of total cost ranging from 66.16% to 66.86%. During that same period, in terms of ABC, it was found that the median cost for a treatment service was at 116 THB, 113 THB, and 128 THB, respectively. The health promotion activities presented at 139 THB, 114 THB, and 120 THB, respectively. Moreover, the ABC of disease control activities shown at 3,228 THB, 2,673 THB, and 2,890 THB, respectively. The ABC of screening for Covid-19 by using RT-PCR presented the lowest median cost, between 163 - 202 THB. By contrast, disease investigation activities showed the highest median cost, between 1,003 – 2,001 THB.

Although it is not significant in term of variation from one year to another, knowing the costs and resources used between normal and emerging disease outbreak situations is beneficial to service providers in resource management. It is also beneficial to payer in order to estimate the service reimbursement.