Analysis of expenditure of free referred care to India for fiscal year 1994-2004

Abstract

The objective of this Analysis of Expenditure was to provide information on expenditures for free referred care to India for policy makers and care providers in Bhutan. The study aimed to describe expenditures related to health care, broad treatment outcomes and effectiveness of referred care to India. A total of 3,020 patients’ data referred by different medical specialties during the fiscal years 1999-2004 were collected and treatment outcomes and effectiveness were defined by a team of medical experts at Jigme Dorji Wangchuck National Referral Hospital, Thimphu. The results showed there were more males referred than females. The operating expenditure of free referred care has been increasing over the 5 year period and during 2002-03 and 2003-04 there was an increase of over 10%. This is a cause for concern on future sustainability. A combined treatment outcomes of “recovered” or “improved” for all centers and medical specialties remained over 86.1%, except for Gynaecology/Obstetrics which was 77.8% only. Similarly treatment effectiveness also remained over 100% for all medical specialties except Gynae/Obs at 97.2%. This study is a first attempt of its kind in Bhutan by providing a first step in expenditure analysis for referred health care to India. Further studies are required to ascertain expenditure, outcomes and effectiveness of free health care in India. Future efforts to conduct effectiveness study requires a pre-determined goal so that appropriate data are recorded to facilitate monitoring and evaluation.