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Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

Authors: Thet Mon Than, Yu Mon Saw, Moe Khaing, Ei Mon Win, Su Myat Cho, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately.

Methods

A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015–2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010.

Results

The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals.

Conclusion

The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the available resources.
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Literature
1.
go back to reference Newbrander W, Lewis E. Hospital costing model manual. Management Sciences for Health. USAID: Health Reform and Financing and Sustainability Project; 1999. Newbrander W, Lewis E. Hospital costing model manual. Management Sciences for Health. USAID: Health Reform and Financing and Sustainability Project; 1999.
2.
go back to reference Bringing UHC into focus. In: Boerma T, Evans D, Evans T, Flores G, Eozenou PH, Hogan D, et al. Tracking universal health coverage: first global monitoring report. WHO, World Bank Group: WHO press. Geneva; 2015. p. 6–15. Bringing UHC into focus. In: Boerma T, Evans D, Evans T, Flores G, Eozenou PH, Hogan D, et al. Tracking universal health coverage: first global monitoring report. WHO, World Bank Group: WHO press. Geneva; 2015. p. 6–15.
3.
go back to reference Green A, Ali B, Naeem A, Vassali A. Using costing as a district planning and management tool in Balcochistan. Pakistan Health Policy Plan. 2001;16:180–6.CrossRefPubMed Green A, Ali B, Naeem A, Vassali A. Using costing as a district planning and management tool in Balcochistan. Pakistan Health Policy Plan. 2001;16:180–6.CrossRefPubMed
5.
go back to reference Olukoga A. Unit costs of inpatient days in district hospitals in South Africa. Singap Med J. 2007;48:143–7. Olukoga A. Unit costs of inpatient days in district hospitals in South Africa. Singap Med J. 2007;48:143–7.
7.
go back to reference Aboagye AQ, Degboe AN, Obuobi AA. Estimating the cost of healthcare delivery in three hospitals in southern Ghana. Ghana Med J. 2010;44:83–92.PubMedPubMedCentral Aboagye AQ, Degboe AN, Obuobi AA. Estimating the cost of healthcare delivery in three hospitals in southern Ghana. Ghana Med J. 2010;44:83–92.PubMedPubMedCentral
8.
go back to reference Younis MZ, Jaber S, Smith PC, Hartmann M, Bongyu M. The determinants of hospital cost: a cost-volume-profit analysis of health services in the occupied territories: Palestine. Int J Pharm Pract. 2010;18:167–73.PubMed Younis MZ, Jaber S, Smith PC, Hartmann M, Bongyu M. The determinants of hospital cost: a cost-volume-profit analysis of health services in the occupied territories: Palestine. Int J Pharm Pract. 2010;18:167–73.PubMed
9.
go back to reference Ministry of Health. The third wave reform process. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:9. Ministry of Health. The third wave reform process. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:9.
10.
go back to reference Ministry of Health. Health Financing in Myanmar. In: Health in Myanmar. Ministry of health. Nay Pyi Taw, Myanmar. 2014;2014:13–4. Ministry of Health. Health Financing in Myanmar. In: Health in Myanmar. Ministry of health. Nay Pyi Taw, Myanmar. 2014;2014:13–4.
11.
go back to reference Ministry of Health and Sports. Health systems challenges. In: Myanmar National Health Plan (2017–2021). Ministry of Health and Sports. Nay Pyi Taw, Myanmar; 2017. p. 4–5. Ministry of Health and Sports. Health systems challenges. In: Myanmar National Health Plan (2017–2021). Ministry of Health and Sports. Nay Pyi Taw, Myanmar; 2017. p. 4–5.
12.
go back to reference Ministry of Health. Health statistics: government health expenditure. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:145. Ministry of Health. Health statistics: government health expenditure. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:145.
13.
go back to reference Riewpaiboon A, Malaroje S, Kongsawatt S. Effect of costing methods on unit cost of hospital medical services. Tropical Med Int Health. 2007;12:554–63.CrossRef Riewpaiboon A, Malaroje S, Kongsawatt S. Effect of costing methods on unit cost of hospital medical services. Tropical Med Int Health. 2007;12:554–63.CrossRef
14.
go back to reference Myint P, Sein TT. Myanmar health systems in transition policy notes series, policy notes #1; what are the challenges facing Myanmar in progressing towards universal health coverage? World Health Organization; 2015. Myint P, Sein TT. Myanmar health systems in transition policy notes series, policy notes #1; what are the challenges facing Myanmar in progressing towards universal health coverage? World Health Organization; 2015.
15.
go back to reference Sein TT, Myint P, Tin N, Win H, Aye SS, Sein T. Financing. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014, p.61–77. Sein TT, Myint P, Tin N, Win H, Aye SS, Sein T. Financing. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014, p.61–77.
16.
go back to reference Ministry of Health. Curative services. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:42. Ministry of Health. Curative services. In: Health in Myanmar. Ministry of Health. Nay Pyi Taw, Myanmar. 2014;2014:42.
18.
go back to reference Sein TT, Myint P, Tin N, Win H, Aye SS, Sein T. Physical resources. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014. p.78–92. Sein TT, Myint P, Tin N, Win H, Aye SS, Sein T. Physical resources. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014. p.78–92.
19.
go back to reference Shepard DS, Hodgkin D, Antony YE. Analysis of hospital costs: a manual for managers. Geneva: World Health Organization; 2000. Shepard DS, Hodgkin D, Antony YE. Analysis of hospital costs: a manual for managers. Geneva: World Health Organization; 2000.
20.
go back to reference Tsilaajav T. Costing study for selected hospitals in the Philippines. Manila: Technical Assistance to the Health Sector Policy Programme in the Philippines; 2009. Tsilaajav T. Costing study for selected hospitals in the Philippines. Manila: Technical Assistance to the Health Sector Policy Programme in the Philippines; 2009.
21.
go back to reference Mogoyorosy Z, Smith P. The main methodological issues in costing healthcare services: a literature review. Centre for Health Economics. N Y; 2005, p. 20–103. Mogoyorosy Z, Smith P. The main methodological issues in costing healthcare services: a literature review. Centre for Health Economics. N Y; 2005, p. 20–103.
22.
go back to reference Lesong C, Damian W. Cost and unit cost calculations using step-down accounting. Health Policy Plan. 2004;19:127–35.CrossRef Lesong C, Damian W. Cost and unit cost calculations using step-down accounting. Health Policy Plan. 2004;19:127–35.CrossRef
24.
go back to reference Than-Tun-Sein, Phone-Myint, Tin N, Win H, Aye SS, Sein T. Pharmaceutical care. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014. p.121–126. Than-Tun-Sein, Phone-Myint, Tin N, Win H, Aye SS, Sein T. Pharmaceutical care. In; The Republic of the Union of Myanmar; health system review. WHO Regional Office for the Western Pacific. Manila; 2014. p.121–126.
25.
go back to reference Flessa S, Dung NT. Costing of services of Vietnamese hospitals: identifying costs in one central, two provincial and two district hospitals using a standard methodology. Int J Health Plann Manag. 2004;19:63–77.CrossRef Flessa S, Dung NT. Costing of services of Vietnamese hospitals: identifying costs in one central, two provincial and two district hospitals using a standard methodology. Int J Health Plann Manag. 2004;19:63–77.CrossRef
26.
go back to reference Pena AD, Ndiaye M. Developing hospital efficiency-cost control measures. World Hosp Health Serv. 2002; 38: 2–9, 41, 43. Pena AD, Ndiaye M. Developing hospital efficiency-cost control measures. World Hosp Health Serv. 2002; 38: 2–9, 41, 43.
27.
go back to reference Minh HV, Giang KB, Huong DL, Huong LT, Huong NT, Giang PN, et al. Costing of clinical services in rural district hospitals in northern Vietnam. Int J Health Plann Manag. 2009;25:63–73. Minh HV, Giang KB, Huong DL, Huong LT, Huong NT, Giang PN, et al. Costing of clinical services in rural district hospitals in northern Vietnam. Int J Health Plann Manag. 2009;25:63–73.
28.
go back to reference La Foucade AD, Scott E, Theodore K. Estimating the cost of hospital services in a small island state: a case study of the Milton Cato memorial Hospital in St Vincent and the Grenadines. West Indian Med J. 2005;54:116–22.CrossRefPubMed La Foucade AD, Scott E, Theodore K. Estimating the cost of hospital services in a small island state: a case study of the Milton Cato memorial Hospital in St Vincent and the Grenadines. West Indian Med J. 2005;54:116–22.CrossRefPubMed
29.
go back to reference Millis AJ, Kapalamula J, Chisimbi S. The cost of the district hospital: a case study in Malawi. Bull World Health Organ. 1993;71:329–39. Millis AJ, Kapalamula J, Chisimbi S. The cost of the district hospital: a case study in Malawi. Bull World Health Organ. 1993;71:329–39.
30.
go back to reference Stock GN, McDermott C, McDermott M. The effects of capital and human resource investments on hospital performance. Hosp Top. 2014;92:14–9.CrossRefPubMed Stock GN, McDermott C, McDermott M. The effects of capital and human resource investments on hospital performance. Hosp Top. 2014;92:14–9.CrossRefPubMed
31.
go back to reference Yong PL, Saunders RS, Olsen LA, editors. Synopsis and overview. In; The healthcare imperative: lowering costs and improving outcomes: workshop series summary. Institute of Medicine, Washington (DC), USA; 2010. p. 1–69. Yong PL, Saunders RS, Olsen LA, editors. Synopsis and overview. In; The healthcare imperative: lowering costs and improving outcomes: workshop series summary. Institute of Medicine, Washington (DC), USA; 2010. p. 1–69.
32.
go back to reference Hospital DR, Global Budgeting. Health, nutrition and population (HNP) discussion paper. Washington DC: The World Bank; 2004. Hospital DR, Global Budgeting. Health, nutrition and population (HNP) discussion paper. Washington DC: The World Bank; 2004.
Metadata
Title
Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?
Authors
Thet Mon Than
Yu Mon Saw
Moe Khaing
Ei Mon Win
Su Myat Cho
Tetsuyoshi Kariya
Eiko Yamamoto
Nobuyuki Hamajima
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2619-z

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