Abstract
This descriptive study was designed to determine the unit cost and cost recovery in
Charttrakarn Hospital in Phitsanulok Province in fiscal year 2006 from the provider’s
perspective. The hospital’s operations were classified into three categories: non-revenueproducing center (NRPCC), revenue-producing cost center (RPCC), and patient service cost center (PS). The total direct cost of each cost center/activity was determined by
combining labor cost, material cost with capital cost. After that, the direct costs of NRPCC
and RPCC were allocated to PSCC as indirect costs by using the step-down method. Then
the full cost of each PS was calculated from direct plus indirect costs. Dividing the final
full cost of each cost center by its output provides the unit cost.
The results show that the total cost of the hospital in the year 2006 was 44,257,662
baht, with the proportion of LC: MC: CC = 53:37:10. The unit cost of the whole out-patient
service was 417 baht per visit, while the unit costs of the out-patient cost center, dental
health cost center and family practice cost center were 348, 603 and 1,205 baht/visit respectively. The unit costs of the in-patient service were 4,287 baht/case, 1,756 baht/day,
and 7,005 baht/relative weight (RW). The total cost recovery of the hospital was 0.94. The
scheme with maximum cost recovery was CSMBS (1.28); the second highest was that of
VHCS (1.22), followed by the universal coverage scheme at 0.91.
Recommendations:
1. Costs and unit costs among hospitals should be compared carefully. The details
of cost identification, cost allocation and unit cost determination should be considered,
because they vary among studies. Besides hospital revenue, the meaning should be clarified and defined with regard to the extent of revenue as well as its components. Furthermore, the value of the money in different periods of time is not the same, so it should not
be compared directly.
2. Governmental budget allocation criteria for the entire country should be assessed
for appropriateness according to the various cost characteristics among hospitals operating in different contexts.
3. Each hospital should set up an effective information system for collecting an essential database on hospital accounting, resources consumption, workload of hospital
service, and other important data. The system should be able to assess the financial situation, hospital costing and hospital performance
