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Operating costs of health centers in Samut Sakhon, fiscal year 1999

ศิริวรรณ พิทยรังสฤษฏ์; Siriwan Pitayarangsarit; ธีรธัช กันตามระ; วิโรจน์ ตั้งเจริญเสถียร;
Date: 2544
Abstract
Samut Sakhon, a small province in Central region has three districts, Muang, Banphaeo and Krathumbaen. Banphaeo hospital, the first autonomous hospital in Thailand through Public Organization Act, 2542 BE. will be financed through capitation according to population size in the district. This will have significant changes to financing mechanism at provincial health office and health centers in the district. The objective this study is to assess unit cost (covers labor and material costs, excludes capital depreciation costs) of services provided by health centers in order that Banphaeo hospital could fairly purchase care from health centers. We assess operating cost in fiscal year 2542 BE., among all health centers in the province. Staff time allocation survey was done to allocate labor cost to various key activities of health center, material cost was directly collected for each activities. Cost from general administration and reporting function were allocated to service activities using simple allocation method. Results: operating expenditure per capita population at health center was 120 Baht per year, (110 Baht from health centre and 10 Baht from District Health Office). Annual operating expenditure was 834,136 Baht per health centre, of which 56% was labor and 44% material cost. Each health center was staffed by 4.16 health workers. Time allocation reported 22% contributed to curative services, 27% to administrative function, 18% on health promotion activities and 30% community based services. Curative services consumed 40% of total operating expenditure, most were drugs and supplies. Unit operating cost for curative service at health center was 59 Baht per visit (range 53 to 65), health promotion and mother child health services was 100 Baht per visit (range 88 to 120). If cost from District Health Office was included, unit cost would increase by 9%. Unit cost was influenced by staffing intensity, magnitude of labor cost and productivity. Unit cost is one of several tools for proper resource allocation. This study provides evidence on how hospital could purchase services from health center that reflects operating cost. Several options are capitation base on population size, total cost inclusive for each group of activities, or unit cost per service rendered. It depends on how to stimulate proper service behavior by health center. However, current funding available at health center from central government and local administration should be taking into account to purchase services from health centers.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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