COST ANALYSIS OF TEACHING HOSPITAL: A CASE OF FACULTY OF MEDICINE VAJIRA HOSPITAL

Abstract

This study focused on cost analysis of the Faculty of Medicine Vajira Hospital in the fiscal year 2015. The objectives are the evaluation of service costs and the cost estimation of five most common DRG codes. The faculty’s organization is studied for the identification of cost centers and dividing into the non revenue producing cost center (NRPCC), the revenue producing cost center (RPCC), and the final cost center. The final cost center consists of the patient service (PS) cost center and the nonpatient service (NPS) cost center. The full cost are allocated to the final cost center by step-down method. The results show that the total cost is 2,210,211,175 Baht. The labor cost is 1,358,985,449 Baht, which is sixty one percent. The material cost is 636,967,811 Baht, which is twenty nine percent. The capital cost is 214,257,915 Baht, which is ten percent. The average cost per OPD visit is 2,003 Baht. The forensic OPD has a highest cost, 5,162 Baht per visit. The average cost per inpatient day is 6,712 Baht. The ophthalmologic ward has a highest cost, 20,267 Baht per inpatient day. The average cost per admission is 87,647 Baht. The pediatric intensive care unit has a highest cost, 271,009 Baht per admission. The average cost of health promotion service is 1,754 Baht per project. The total cost of medical education is 93,206,719 Baht and the cost per one student for the whole curriculum is 1,400,364 Baht. The DRGs cost per RW and the estimated cost of five common DRGs are calculated. The result is 38,821 Baht per RW which is higher than the reimbursement rate 73 percent. The chronic ischemic heart disease has highest estimated cost of 227,865 Baht. In conclusion, the labor cost is the highest cost component, 61 percent. The health care service cost is higher than the reimbursement, 73 percent and the DRG code of chronic ischemic heart disease has highest cost. For these reasons, the faculty manager has to further analyse the resource utilization of each cost center for the efficiency improvement and implying the data cost of each DRG code for the prospective reimbursement from health insurance schemes in the future.