Abstract
The objective of this study was to examine characteristics of non-profitable hospitals, as compared to profitable hospitals, in Thailand. Administration national data for 640 public hospitals of fiscal year 2002 from Ministry of Public Health were analyzed. A two-part model estimated by logistic regression and ordinary least-squares regression was used to examine the likelihood of hospital loss and the amount of loss, respectively. The results showed that various managerial, service mix, and market variables were significantly associated with the likelihood of hospital loss. An increase in average hospital Universal Coverage (UC) inpatient day per number of the UC and the concentration of hospital market could significantly increase the likelihood of hospital loss, while an increase in the average Civil Servant Medical Benefit Scheme (CSMBS) hospital inpatient day per number of the CSMBS inpatients and average Social Security Scheme (SSS) hospital inpatient day per number of the SSS inpatients decreased the likelihood of hospital loss. The ratio between total patients and number of full-time employee was positively associated with the likelihood of hospital loss, but it required cautious interpretation since it was confounded by the employee salaries that was not included in this study. Beside managerial, service mix, and market variables, the hospital characteristics also were associated with the amount of loss. The larger hospitals and hospitals located in central area of Thailand tended to have higher amount of loss. The results also suggested that managing the number of hospital employee, inventory, and patient hospitalization could control the amount of loss. In conclusion, most of identified determinants of hospital loss were manageable. The ramification of this study was to help policy makers understand the hospital loss situation in Thailand after implementing the UC scheme and design policy to resolve the hospital loss problems.
