Unit cost analysis of Phnom Penh Heart Center in Campodia : the fiscal year 2006

Abstract

To calculate and analyze cost and unit cost per admission, per bed-day and per visit at Phnom Penh Heart Center in the fiscal year 2006, by focusing on providers’ perspective. Then the result which was obtained from the calculation of the unit cost at Phnom Penh Heart Center was compared to WHO-CHOICE model and some available studies from Thailand to find whether the unit cost was unusually high or low in order to be a guideline for policy makers and Ministry of Finance in budget allocation purpose.The estimated provider cost per patient day at Phnom Penh Heart Center (PPHC) was US$38.1; cost per visit was US$51.9 and cost per admission was US$308.1. Unit cost of WHO-CHOICE model was US$3.39 per visit at OPD and US$12.89 per bed-day at IPD. The average cost per bed day of heart transplantation surgery unit at Chulalongkorn Memorial Hospital was US$183.6 and the average cost per bed day of Phnom Penh Heart Center of Cambodia was US$203.5.This study also found that the provider cost for the treatment of heart disease of patients at PPHC- the maximum cost component was the material cost, following in order by the capital cost and labour cost. In PPHC, the percentage of cost shared by material, cost capital cost and labour cost was 45.5%, 27.3% and 27.2% of the total unit cost respectively. The unit cost of both OPD and IPD at PPHC was found higher than the unit cost of OPD and IPD of WHO-CHOICE because the PPHC was a heart surgery hospital. Hence, the cost includes the high cost of medical equipments, while the WHO-CHOICE model is not included the capital cost and salary or wage in the calculated model. In addition, the model of WHO-CHOICE was mainly calculated by all general hospitals in developed and developing countries. Even though the unit costs of PPHC was higher than the WHO-CHOICE project, the average cost per admission of surgery patients at PPHC ($5,087.5) was found lower than the average cost per admission ($11,013.0) of heart transplantation surgery unit at Chulalongkorn Memorial Hospital in Thailand.This study found that sources of finance was 24.8% from donation part, 64.0% from out of pocket payment and 11.2% from the government budget out of the total cost of US$1,992,766.6. The source of finance from the government part is therefore not enough to support the health service at PPHC in 2006.