Abstract
Banphaeo hospital is going to be the first autonomous hospital in Thailand: non-profit and government subsidiary hospital. This paper aims to show the background, methodology and philosophy of the hospital subsidiary budgeting for the year 2000 ehich their rational is based on the Banphaeo hospital's mission. It's mission is to provide universal coverage of basic health service package in Banohaeo district. The basic health service package consists of health promotion, prevention, primary health care, rehabilitation, and curative service for the health cardholder.
Thus, the Banphaeo hospital subsidiary budgeting is based on capitation. It will pay to the tertiary care hospital for referred patients and to subcontractors for gatekeeper services too. The new budgeting method will change the service concept by aiming at holistic care not the quantity of curative care.
However, this budget should be only for the operating cost, not including with capital cost, which should be proposed by each item project.
The subsidiary budgeting use the data from morbidity rate and admission rate from Health and Welfare survey of National Statistics Office and average operating cost from several costing studies. Per capita budget is consisted of curative expenses and health promotion expenses. For the curative expense, this study uses outpatient department care (OP) cost (morbidity rate X OP cost per visit) plus Inpatient department care (IP) cost (admission rate X IP cost per case). For the health promotion expenses, this study estimate 20% of per-capita subsidiary budget.
From the calculation above, Banphaeo which is located in the rural of central Thailand will receive per-capita subsidiary health budget about 562 baht per year and per capita subsidiary health promotion about 149 baht per year, all together 712 baht per year. Yet, changing from a public hospital to an autonomous hospital will increase salary up to 150% thus the curative cost will rise to 633 baht. Ultimately, summing up with 149 baht of health promotion, the per capita budget will be 782 baht per year.
The researchers analyze the financial feasibility and found the operating expense is about 100.4 millions. Banphaeo population is 91,000, less Civil Servants Medical Benefit Scheme and health insurance 10% the hospital will receive 64 millions per year (91,000*0.9*782) from government and 39 millions from other revenue. Finally, the researchers do believe that it is possible for Banphaeo hospital to provide the universal health care coverage to the Banphaeo population. Moreover, this study can apply this method of budgeting to the whole kingdom.
