Activity-Based Costing of Hemodialysis for End-Stage Renal Disease Hospitalized Patients under the Universal Health Care Coverage Policy in Fiscal Year 2017: A Case Study of Rajavithi Hospital

Authors

  • Supattra Loharojwichean, M.Sc.
  • Sukhontha Kongsin, Ph.D
  • Sukhum Jiamton, M.D.
  • Udom Krairittichai, M.D.
  • Phusit Prakongsai, M.D., Ph.D

Keywords:

Activity-based costing, Hemodialysis, In-patient, Universal health coverage, Rajavithi Hospital

Abstract

Background : End-Stage Renal Disease is a global health concern as well as Thailand’s public health also increasing cost of service and treatment. From financial analysis of hemodialysis activities is therefore important to manage and improve the financial cost, service and treatment system for new standard in the future.

Objective : The research aimed at analyzing costs of hemodialysis using activity-based costing approach among end-stage renaldisease patients hospitalized at the Rajavithi Hospital in the fiscal year 2017.

Method : Based on provider’s perspective, the proportions of resources are consumed in each recurring activity and investment costs. Medical records were retrieved from hospital database retrospectively during May and December, 2018. We also conducted prospective data collection on standard time of each activity. Research participants were 133 patients at the hemodialysis unit with 713 sessions of hemodialysis. There were 34 operational officers who worked at the hemodialysis unit involved with those participants. The secondary data on costs data (labor, material, and investment costs) and activity log were analyzed for frequency distribution, mean, percentage and standard deviation using calculated function in Microsoft excel version 2010.

Results : Results revealed that the total costs of hemodialysis in the fiscal year 2017 were 1,547,170.83 baht (mean = 2,169.95 baht). Nevertheless, the hospital could reimburse only 1,109,300 baht in the fiscal year 2017 which equal to 1,555.82 baht per session in average. It was found that the hemodialysis patient care unit incurred the highest portion of the total costs at 367,986.85 baht or 516.11 baht per session, whereas hemodialysis patient coordination unit incurred the lowest portion of the total costs at 89,084.92 baht or 124.94 Baht per session. The material costs were the highest portion at 803,474.83 baht (51.93%) followed by labor cost of 677,929.40 baht (43.81%). Whereas the investment cost were 65,766.59 baht which was lowest portion. The proportion of the material costs to the labor costs to the investment costs were 51.93 to 43.81 to 4.25.

Conclusions : The results could be used for recommendation to the decision makers in order to allocate the budget for the hemodialysis service. Furthermore, the research findings also could be used as a guideline for the budgeting management in order to reduce neither unnecessary nor inefficient costs.

Downloads

Download data is not yet available.

References

Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41:1-12.

Chuasuwan A, Praditpornsilpa K, editors. Thailand renal replacement therapy year 2014. Bangkok: Nephrology Society of Thailand; 2014.

National Health Security Office. National Universal Health Coverage Fund Management Manual for Fiscal Year 2016: Managing Chronic Kidney Failure Patient Service Budget.Bangkok: Thanapress; 2016.

Chayakul C. Hemodialysis Clinical Practice Recommendation 2014. Bangkok: The Nephrology society of Thailand; 2014.

Kongsin S. Introduction to health economics. Bangkok:Department of Public Health Administration. Faculty of Public Health Mahidol University; 2011.

Baingern S. Activity-based costing of admission among patients with malaria, Out Patient Department,Tropical Medicine Hospital (fiscal year 2009), Faculty of Tropical Medicine, Mahidol University. (THESIS) Bangkok: Mahidol University; 2011.

Rajavithi Hospital. Annual medical record statistics 2014- 2016. Bangkok: Hemodialysis Unit, Rajavithi Hospital;2016.

Klaayaprasong P, Euamanapong C. Nursing practice recommendation for hemodialysis and peritoneal dialysis.Bangkok: Thai Nephrology Nurse Society; 2015.

The Nephrology society of Thailand. Handbook of Hemodialysis and Plasma Filtration for Kidney Patients 2018,Bangkok: Subcommittee on Guidelines for Hemodialysis and Plasma Filtration. The Nephrology Society of Thailand; 2018.

Munshi SK, Vijayakumar N, Taub NA, Bhullar H, Lo TN,Warwick G. Outcome of renal replacement therapy in the very elderly. Nephrol Dial Transplant 2001; 16: 128-33.

Phunmuangrat S, Ruangwuthikai R, Yongvanich K, Phaaphan N. The cost of providing patients with chronic kidney disease using time driven Activity-Based Costing (TDABC) for Hemodialysis Unit Buddhasothorn Hospital Chachoengsao Province. Ph.D. in Social Sciences Journal 2017; 7: 164-76.

Meesawat S. Activity-based costing of dental service in dental clinic, dental public health division, Atsamart Hospital, Roiet province. (THESIS) Bangkok: Mahidol University; 2011.

Singchangchai P. Health economics for health services.Songkhla: Chanmuangkarnpim; 2014.

Published

10-03-2021

How to Cite

1.
Loharojwichean ส, Kongsin ส, Jiamton ส, Krairittichai อ, Prakongsai ภ. Activity-Based Costing of Hemodialysis for End-Stage Renal Disease Hospitalized Patients under the Universal Health Care Coverage Policy in Fiscal Year 2017: A Case Study of Rajavithi Hospital. j dept med ser [Internet]. 2021 Mar. 10 [cited 2022 Aug. 14];45(4):184-92. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/249807

Issue

Section

Original Article