Setting prices for reproductive health services in a public hospital in Guatemala

Abstract

Hospital Roosevelt administrators requested assistance from FRONTIERS to help establish a fee schedule for the Reproductive Health Unit (RHU). The RHU had set the goal of paying its own personnel costs after one year of operation. The FRONTIERS study included three elements: a cost study to calculate full economic costs of the RHU as well as ongoing financial requirements; a willingness-to-pay (WTP) and ability-to-pay (ATP) survey to gauge demand for services and to assess the economic status of potential RHU clients; and scenarios showing different ways for the RHU to expand services and reduce prices while earning enough revenue to cover its monthly financial obligations. The FRONTIERS study found that the RHU was easily earning enough revenue to break even but was unable to meet demand for tubal ligation because of limited access to surgical facilities. Several options were outlined for increasing production of tubal ligation while continuing to generate revenue to cover the expenditures for which the RHU is responsible. This paper details a study on how prices are set for reproductive health services in Hospital Roosevelt in Guatemala. Results of this study are presented in four main sections which include: results of cost analysis brief socioeconomic profile of current clients of the Hospital Roosevelt system evidence on client demand and willingness-to-pay for various services at the RHU and estimate on total RHU revenues. (excerpt)