Abstract
The cost of health service is an important indicator for hospital administrators in making decision for efficient health service provision. The study aimed at exploring hospital care cost and unit cost of the top five diseases of patients hospitalized at the Queen Sirikit Medical Center, Ramathibodi Hospital, in fiscal year 2016. This was a retrospective study from health care provider’s perspective covering patients hospitalized to a special medical ward of a university hospital in Bangkok. Costing data were collected using a standard tool of unit cost analysis categorized by source of expenses, namely labor cost, material cost, and capital cost. Cost analyses consisted of two major processes: 1) hospital cost and 2) cost center analysis using top-down costing method. Top-down costing included four steps: 1) cost center identification, 2) direct cost determination, 3) indirect cost determination and 4) total cost determination. Unit cost analysis of top five diseases was classified by diagnosis upon hospital admission. Results show that the annual total cost was approximately 12,448,667 Thai baht: direct cost and indirect cost was 10,373,889 and 2,074,778 baht, respectively. For the direct cost; the proportions of labor cost, material cost, and capital cost were 88 : 8 : 4. Unit costs of the top five diseases were as follows: neoplasms 19,145 baht/day and 142,769 baht/admission, diseases of the genitourinary system 17,167 baht/ day and 182,710 baht/admission, diseases of the musculoskeletal system and connective tissue 15,495 baht/day and 122,765 baht/admission, diseases of the circulatory system 12,901 baht/day and 144,488 baht/admission, and diseases of the respiratory system 9,414 baht/day and 98,573 baht/admission. Results from this study could be utilized as guidance for cost management by reduction in the unnecessary admission days while maintaining quality. This will provide benefits and efficiency improvements in resource use to Ramathibodi Hospital and clients.
