Unit cost and cost recovery analysis of community hospitals : a case study of Thongsaenkhan hospital

Abstract

This study intends to study the cost, unit cost and cost recovery of Thongsaenkhan community hospital in fiscal year 2000 from provider's perspective. Total cost of Thongsaenkhan hospital was 28,892,655 baht. The proportion of capital, labor and material cost was 38:37:25. The majority of hospital cost (67%) was paid by budget revenue allocated from the government while 33% was paid by non-budget revenue. The hospital spent about 87% for curative care and 13% for preventive care. Unit costs of OPD, Dental clinic, Health promotion clinic and IPD were 266, 593, 1,138, and 4,215 baht per visit consecutively. Total hospital revenue was 28,049,691 baht. Governmental budget was the major source of hospital revenue (69%), while the non-budget source was only 31%. The latter included payments from various health insurance/welfare schemes, user charges, donation, and interest income. Total hospital cost recovery was 0.97 and non-budget cost recovery was 0.30. The insurance scheme providing the maximum cost recovery was CSMBS (1.37) while the minimum belonged to the underprivileged group (0.85). With the universal coverage policy, Thongsaenkhan hospital cost recovery will be lower than the situation in fiscal year 2000 (only 0.88). This means that the hospital may not survive with the newly proposed capitation-based budget. Based on the break-even analysis Thongsaenkhan hospital will survive with the capitation of 1,373.23 baht per head which is higher than the proposed rate. Alternately, the size of registered population must be at least 37,857 people which is larger than that of Thongsaenkhan district.