Cost analysis of Heart Transplantation at Chulalongkorn Hospital in Thailand

Abstract

The objective of this study are to examine the cost of heart transplantation from the day of surgery to the day of discharge and to establish the methods of costing for heart transplantation procedure. In the study, costing principles have been reviewed; cost models were developed for the retrospective determination of direct cost for heart transplantation through the individual consumable of cost categories and the apportionment of resource area costs. The costs were calculated per patient related to individual treatment of patients with respect to volume and unit costs. Using the theoretical framework, an empirical analysis of the cost data of 12 patients was undertaken from the relevant departments in Chulalongkorn Hospital. The total provider cost for the operation was calculated. In this study, the total provider cost of heart transplantation from the day of operation to the day of discharge is averaged to be Bt288,262 in 1994' s price. The costs are classified by input, of which 91% of the total cost is recurrent cost and only 9% is capital cost. Among the recurrent cost components, the personnel cost is 46%, which is the highest category. The second comes the drug cost which is 20% and the third is supply cost, which accounts for 16% of the recurrent cost. The important implication from this study is that the hospital incur most of the cost for heart transplantation, while cost recovery is a minor part of the total.