Abstract
Unit cost analysis has often been used as a tool to determine the efficiency of a health-care facility.
Policy makers employ the unit cost of health services in order to make decisions on resource allocation
and for efficiency improvement. This descriptive study was aimed at calculating the unit cost for each cost
center in Mae Sariang District Hospital by collecting financial and accounting secondary data during
fiscal years (FY) 2003 and 2004. The study then evaluated a change in the unit costs of the health services
in each cost center for the two-year period. This study applied the principle of cost analysis and the manual
of unit cost analysis for district hospitals affiliated with the International Health Policy Program (IHPP).
Costs in the study were defined as accounting costs with a provider’s perspective.
The results showed the following proportion of labor costs, material costs, and capital costs in FY
2003 and 2004: 57.73; 27.59; 14.68 and 61.61; 31.61; 6.78, respectively. Average unit costs of all outpatient
departments were Baht 257.01 and 256.33 respectively. Those of all in-patient departments were 4,579.31
and 4,944.22 Baht per case admission, respectively, and the unit costs per adjusted relative weights were
6,575.79 and 7,177.76 Baht, respectively. Compared with the out-patient departments, the unit cost of
dental services was the highest (679.28 baht per visit) in FY 2003 and the counseling service department
had the highest cost (684.39 baht per visit) in FY 2004. Among in-patient wards, the intensive care unit
(ICU) had the highest cost in both years (14,327.40 and 12,338.29 baht respectively per case admission). A
comparison between both years revealed an increase in the number of ambulatory visits and in-patientdays
in most departments. Compared with unit costs in FY 2003, half of the out-patient service centers
had a higher unit cost, but most of the in-patient departments, except for the male ward, could operate at
a cheaper in-patient-day. The data collection methods and the unit cost calculations as described in the Manual of Unit Cost
Analysis for District Hospitals, which were used in the study, were practical and easy. The proportion of
the labor costs to total costs of Mae Sariang Hospital was similar to that of other district hospitals. The
average unit cost of out-patient services was not very different from that of other 90-bed hospitals, but the
average unit cost per in-patient case was higher. Specialists practicing in the hospital and the provision of
ICU services and preterm baby care may explain the more expensive unit cost for in-patient care. In terms
of cost efficiency, an increasing number of patients and the total expenditure in some service centers actually
resulted in an increase in the unit cost; thus, several service centers surprisingly turned out a cheaper
unit cost for visits as well as unit cost of in-patient-days. The findings may indicate greater efficiency of
resource utilization. However, the quality of health services and relative weight of diagnosis-related groups
should be taken into account.
