Financial sustainability of evening clinics in Public Hospitals : a case study of Khon Kaen Hospital

Abstract

This study was intended to evaluate the financial sustainability of the evening clinics in Khon Kaen Hospital. The study tried to describe utilization and characteristics of the clients; to compare satisfaction between the day-time clinic and the evening clinic; and to examine the equity of service provision among clients under different health insurance scheme. The methodology of study intended the measurement of revenues and analyzed the financial sustainability in terms of cost recovery ratio, based on the data in the 1997 fiscal year. Utilization and characteristics of clients of the evening clinic were analyzed by using individual record of the evening clinic during the same period in order to illustrate the trend of utilization and its effect on financing systems. In addition, clients of the day-time clinics and the evening clinic were interviewed to compare their satisfaction. The results of study showed that cost recovery ratio of the evening clinic at Khon Kaen Hospital in 1997 was 103.3%.; the Social Security Scheme had the highest cost recovery ratio (373.1%); while the Health Card Scheme had the lowest cost recovery ratio (44.5%). The utilization of the Health Card tends to increasing every year. In addition, the study also indicated that clients were satisfied with the evening clinic more than the day-time clinics. The recommendation for Khon Kaen Hospital is that the financial management system of the evening clinic should to improve as well as a private organization and the financing systems of various health insurance scheme in Thailand which were subsidized by government should improve the cost recovery ratios.