Abstract
The objective of this study is to estimate unit cost per day of long term care for dependent elderly in
Lamsonthi district from government spending perspective. Long term care services comprised services
from hospital, services from formal care assistance and services from family. Unit cost of services from
hospital was calculated using data from cost accounting of Lamsonthi hospital, which used a traditional
costing method of Ministry of Public Health. Unit cost of services from local government mainly was
salary of formal care-assistants. Cost of long term care services from family member was estimated using
opportunity cost concept, which opportunity cost was assumed equal to labour cost of formal-care assistants.
Total cost of long term care of hospital services were disaggregated into 3 products; severe dependent
service, moderate dependent service and mild dependent service using allocation by labour approach.
Workload of physiotherapists using simple time motion study was used as an allocation criteria
for disaggregate 3 products of the long term care. The result showed that total actual cost of long term care
service unit in 2012 of Lamsonthi hospital was 4.5 million Baht and total actual cost of formal care assistant
was 420,000 Baht in the studied district. Unit costs per day of long term care from services of both
Lamsonthi hospital and formal care assistant without opportunity cost of family members were 41 Baht,
64 Baht, and 101 Baht for mild, moderate, and severe dependence, respectively. Sensitivity analysis for
estimation unit costs per day of long term care include opportunity cost of family members was done by
replacement of support from family members with formal care assistant using ratio of time spending for
dependent elderly among family members and formal care assistant from Siriphan Sasat et al.(9).Unit cost
per day of mild, moderate, and severe dependence increase to 41 Baht, 128 Baht, and 200 Baht, respectively.
However unit cost of long term care depends on level of dependence and level of support from
family. This study found that the cost of severe dependent elderly, who depend totally on formal careassistants,
is still only one fifth of the cost of long term care in private nursing home. However, further
studies are needed to confirm result of this study, which has limitation on statistics and came from only
one district.
