Financial sustainability of an autonomous hospital : a feasibility study of Setthathirath Hospital in Lao PDR

Abstract

The objectives of this study are to analyze the cash flow and the financial status of the Setthathirath hospital during the last 5 years (2004-2008), and to evaluate the financial sustainability during the years 2009-2013 if it becomes the autonomous hospital. The study tries to investigate the financial sustainability of the hospital in three different scenarios: (1) Scenario A: total revenues and expenditures increase according to the trend in the past 5 years; (2) Scenario B is the same as Scenario A, except a 20% increase in salaries in year 2009 and the subsequent years (2010-2013) by 5%; and (3) Scenario C is the same as Scenario B, except a 5% reduction in government budget allocated to the hospital from the year 2008, according to government policy on the autonomous hospital. The methods of study are based on the cash flow analysis, the trend analysis, and the ratio method. Data used for analyzing total revenues and total expenditures are obtained from the financial records of the hospital during the years 2004-2008. Since data on capital expenditures are inadequate and incomplete, total expenditures in this thesis will restrict only to recurrent expenditures. The findings indicate that total revenue is higher than total expenditures during the years 2004-2008. However, if the trend of total revenues and expenditures in the years 2009-2013 remains the same as the years 2004-2008 as in the Scenario A, the net revenue of hospital will be negative. This is probably because labor costs paid from government budget and especially non-government budget dramatically increase. Thus, in the three scenarios above, Setthathirath hospital will face the financial deficit. If the hospital tries to avoid reducing labor cost, material cost, and other expenditures, which may lead to low the quality of health care, it has to increase non-government revenues by 5.4% in 2009 and 21.4% in 2013 from medical services such as initiation of evening clinics, non-medical services, health insurance, and donation in order to be financial sustainability.