Abstract
Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates under government-sponsored insurance schemes.
Highlights
In health care systems, hospitals provide primary care, serve as referral institutes for higher-level care, and train health care workers
We found that except for the private teaching hospitals, none of the study hospitals achieved an 80 percent occupancy rate during our study period, and the rate was only 42 percent in the charitable hospital
Apart from general operating theatres, the study hospitals have special operating theatres as well; for example, the tertiary care hospital has orthopaedics, ophthalmology, and cardiothoracic operating theatres, the private hospital has a cardiothoracic operating theatre, and the private teaching hospital has a gynaecology operating theatre; the outputs of these operating theatres are omitted from Table 2
Summary
Hospitals provide primary care, serve as referral institutes for higher-level care, and train health care workers Those benefits are costly [1], : hospitals require more human and financial resources than any other institution in the sector [2]. A major World Bank study found that the share of public sector health resources consumed by hospitals in developing countries ranged from 50 to 80 percent [3]. In both developed and developing countries, hospitals are viewed as vital and necessary community resources that should be managed for the benefit of the community. The study revealed a dearth of unit cost data for health care services, especially in low- and middle-income countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
