Service Cost Management for Community Hospitals in Songkhla Province

Abstract

     This descriptive research aimed to study: 1) the service cost management of the   community hospitals, categorized by cost types including labor cost, material cost, capital cost, and cost ratio, in 15 community hospitals, 2) the cost of outpatient services per visit,   inpatient services per case, and per adjusted relative weight (AdjRW), 3) the cost to selling price ratio according to the size of community hospitals and 4) analyze the efficiency of cost management services of community hospitals in Songkhla Province, and this, by using   historical data from the fiscal years 2019 to 2021, inclusively, and collecting qualitative data for management with POSDCORB model.

     The study found that total cost of community hospitals in Songkhla Province, from the fiscal year 2019 to 2021, amounted 136,775,864.37 baht, 141,011,045.80 baht, and 159,219,017.83 baht, respectively. For the cost ratio: LC, MC, and CC were equal to 67.29: 25.75 : 6.96, 67.86 : 24.95 : 7.19, and 63.92 : 29.43 : 6.66, respectively. The labor cost had the highest proportion (63.17 – 70.72), followed by material cost (22.88 – 30.55), and capital cost (5.82 – 7.63), respectively. Small community hospitals had the highest labor costs (70.72, 70.59, and 67.20), most of which were salaries and regular wages (53.68%, 53.38%, and 53.74%). Material costs corresponded to medicines (34.88%, 33.89%, and 37.58%). Percentages for capital costs for equipment depreciation were 63.98%, 65.40%, and 64.53%, respectively. The average outpatient costs per visit were 732.64 baht, 812.92 baht, and 573.90 baht, respectively. Inpatient costs per case were 10,028.45 baht, 12,133.41 baht, and 22,683.55 baht, respectively. While inpatient costs per AdjRW were 17,882.60 baht, 20,989.98 baht, and 30,017.98 baht, respectively. The cost to selling price ratio was 1,8114, 1,9640, and 1,2317 (loss), respectively. The highest costs to selling price ratio were 2,1557, 2,4352, and 1,3490, respectively. For all those 3 years, the number of small community hospitals that passed the efficiency of cost management for service criteria were as follows: 11 places for outpatient cost per visit, 9 places for inpatient cost per AdjRW, and 3 places for Case Mix Index (CMI).

Therefore, the provincial financial management committee should carry out the financial planning and human resource management by taking into account for sufficiency, potential, expenses and service performance. Furthermore, implementation of the management of the budget, that is the main income of the 3 funds, system development for collecting medical expenses, reduction of unnecessary expenses, mechanisms to monitor expenditures in accordance with criteria with participation of relevant agencies, and continuously report the progress of performance should be done.