Cost-Effectiveness of Hospitals Under the new Deal VS Conventional System in Cambodia

Abstract

The objective of this study was to evaluate the cost-effectiveness of the public hospital under the New Deal System (Sotnikum Hospital) and under the conventional system (Kralanh Hospital) in Cambodia. The total costs of both hospitals in year 2002 were estimated from providers' perspective. The effectiveness was measured in terms of the number of inpatients and outpatients, and the proportion of health care provision comparing to target population in each catchment area. Thirty-two inpatients and twenty-seven outpatients were also selected to assess the patients' satisfaction before and after the implementation of the New Deal system. The hospital costs were obtained from calculating capital costs including depreciation, and recurrent costs from the hospital records and the financial reports. The total costs of health cre provision of Sotnikum Hospital and Kralanh hospital were derived from adding the three cost components i.e. capital costs, labor costs, and material costs together. The finding indicated that the hospital under the New Deal system had more cost-effectiveness than the hospital under the conventional system from the aspect of the number of inpatients i.e. US$ 89.4 vs 154.0 per discharged patient, and US$ 9.2 vs 14.7 per patient day. With regard to the coverage rate of inpatient per 1,000 target population, the hospital under the New Deal system had less cost-effectiveness than the hospital under the conventional system i.e. US$ 19.209 vs 14,921 per coverage rate of discharged patients and US$ 1,931 vs 1,477 per coverage rate of patient days. For the number and the coverage rate of outpatients, the hospital under the New Deal system had less cost-effectiveness than the hospital under the conventional system i.e. US$ 5.7 vs 3.3 per new OPD case, US$ 4.6 vs 2.6 per OPD visit, US$ 1,237 vs 325 per coverage rate of new OPD case, and US$946 vs 263 per coverage rate of OPD visit. This was probable because the increase in the number of patients was still not high enough. Thus, the hospital under the new Deal system should emphasize more on measures to attract more patients. With respect to the satisfaction for the health care provision, patients were more satisfied with the New Deal system than the conventional system.