เรื่องที่ Hb_thesis2
ประเภท HOSPITAL BASE
ชื่อเรื่อง A STUDY OF UNIT OF OUT-PATIEN AND IN-PATIEN SERVICE OF KHON KAEN HOSPITAL IN THE FISCAL YEAR 1996
ชื่อผู้แต่ง Walaiporn Patcharanarumol
ที่มา Thesis, Chulalongkorn University, 1997
ปีที่ทำ Fiscal year 1996
บทคัดย่อ This is a description retrospective study of unit cost in Khon kaen Hospital in the fiscal year 1996. All departments in the hospital are divided in to 53 total cost centers which are classified into 4 categories as Non Revenue Producing Cost Center (NRPCC). Revenue Producing Cost Center (RPCC). Patient Service Area (PS) and Non Patient Service Area (NPS) . Total direct cost is calculated from labor cost, material cost and capital cost by each cost center. Appropriate allocation criteria are used to allocate total cost from NRPCC and RPCC and PS and NPS by simultaneous equation method

The study revealed that the total direct cost of the hospital is 411,086,423 bath. The proportion of labor cost ; material cost;: capital cost is 48; 45; 7 The total cost is composed of cost from NRPCC 17% RPCC 50% PS 32% and NPS 1 % only. The unit cost of out patient service areas is 236 Baht/visit. The dental department shows the highest unit cost of out patient service areas (533 Baht/visit) but the unit cost of obstetric-gynecological out – patient service is the lowest one (136 bath/visit ). The unit cost of in-patient service is 1,242 Baht/day. Surgical intensive care unit has the highest unit cost (4,720 Baht/day) but the gynecological ward has the lowest one (721 Baht/day)

This study provides the basic information for managerial decision making and service pricing. The results of study are used as a guideline for other health economic studies.

วิธีการศึกษา This study is a descriptive study. Unit cost of out-patient and in-patient service at Khon Kaen Hospital is determined in the health care facilities. It is a retrospective study in the fiscal year 1996. There are 5 steps :
  1. Cost centre identification and grouping
  2. Direct cost determination
  3. Allocation criteria determination
  4. Full cost determination
  5. Unit cost calculation
วิธีคิดค่าเสื่อมราคา Capital cost is the cost of depreciation of all equipment, building and other assets. The depreciation will be calculated by the straight-line method. The estimated useful life of the hospital assets is followed in “Estimated useful life of depreciable hospital assets of American Hospital Association”. All buildings are estimated to have a 25-year useful service life.
วิธีการกระจายต้นทุน The simultaneous equation method is used to determine the direct costs of absorbing cost centres that are transferred from all transient cost centres.
ผลการศึกษา  

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Table: Cost structure in each cost centre

Cost Centre Labor Cost % Material Cost % Capital Cost % Total Direct Cost %
NRPCC

50.59

42.01

7.40

100

RPCC

27.55

63.84

8.61

100

PS

77.09

18.28

4.63

100

NPS

71.48

25.89

2.63

100

Total

47.89

45.05

7.06

100

Table: Number of out-patients and in-patients visited at Khon Kaen Hospital in fiscal year 1994 - 1996

Fiscal Year

1994

1995

1996

No. of out-patients (visits)

295,027

325,093

348,671

No. of in-patients ( Cases)

36,735

43,121

43,381

ตารางแสดง Unit Cost of out-patient service areas

Code Patient service areas Full Cost Patient UNIT COST
(Baht) ( visit) ( baht / visit)
C01 OPD-MEDICAL SERVICE

15,846,971.00

41,550

381.00

C02 OPD-SURGICAL SERVICE

8,049,877.00

36,726

219.00

C03 OPD-ORTHOPEDIC SERVICE

4,504,719.00

11,885

379.00

C04 OPD - OD. & GYN. SERVICE

5,257,401.00

38,794

136.00

C05 OPD-OPHTHALMOLOGICAL SERVICE

3,528,626.00

18,675

189.00

C06 OPD- ENT SERVICE

2,624,117.00

10,808

243.00

C07 OPD-PEDIATRIC SERVICE

4,784,668.00

28,427

168.00

C08 OPD- GP SERVICE

12,890,252.00

84,899

152.00

C09 OPD-DENTAL SERVICE

8,494,352.00

15,947

533.00

C10 EMERGENCY & FORENSIC SERVICE

16,329,951.00

60,960

268.00

TOTAL OF OUT-PATIENT SERVICE AREAS

82,310,934.00

348,671

236.00

ตารางแสดง Unit Cost of in patient service areas

CODE IN-PATIENT SERVICE AREAS

FULL COST

LENGTH OF STAY

UNIT COST

(BAHT)

(DAY)

(BAHT/DAY)

C11 IPD-FEMALE MEDICAL WARD

30,819,918.00

15,170

2,032.00

C12 IPD-MALE MEDICAL WARD

28,891,040.00

26,401

1,094.00

C13 IPD FEMALE SURGICAL,WARD

21,671,869.00

19,528

1,110.00

C14 IPD-MALE SURGICAL WARD

22,006,648.00

16,136

1,364.00

C15 IPD-TRAUM,ATIC WARD NO 1

16,402,801.00

11,535

1,422.00

C16 IPD-TRAUMATIC WARD NO 2

16,764,704.00

9,988

1,678.00

C17 IPD-UROSURGICAL WARD

28,917,824.00

27,731

1,043.00

C18 IPD-EENT WARD

15,783,185.00

10,380

1,521.00

C19 IPD -OBSTETRIC WARD

16,849,249.00

6,928

2,432.00

C20 IPD GYNECOLOGICAL WARD

9,002,325.00

12,484

721.00

C21 IPD-MALE ORTHOPEDIC WARD NO 1

13,032,151.00

14,357

908.00

C22 IPD-MALE ORTHOPEDIC WARD NO 2

11,455,953.00

13,235

866.00

C23 IPD-FEMALE ORTHOPEDIC WARD

11,103,103.00

14,701

755.00

C24 IPD-PED WARD (0-8mos)

12,835,467.00

15,873

809.00

C25 IPD-PED WARD (8 mos - 14 yrs)

14,368,781.00

15,283

940.00

C26 IPD-PED WARD (CHRONIC DISEASE)

6,972,906.00

9,571

729.00

C27 PRIVATE SECTION WARD

13,756,621.00

12,958

1,062.00

C28 MEDICAL ICU

10,384,141.00

2,915

3,562.00

C29 TRAUMATIC ICU

10,480,516.00

2,451

4,276.00

C30 SURGICAL ICU

11,380,410.00

2,411

4,720.00

TOTAL OF IN-PATIENT SERVICE AREAS

322,879,612.00

260,036

1,242.00

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