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Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia
BACKGROUND: Knowledge of the costs of health services improves health facility management and aids in health financing for universal health coverage. Because of resource requirements that are often not present in low- and middle-income countries, costing exercises are rare and infrequent. Here we re...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822335/ https://www.ncbi.nlm.nih.gov/pubmed/31667671 http://dx.doi.org/10.1186/s13561-019-0246-6 |
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author | Jacobs, Bart Hui, Kelvin Lo, Veasnakiry Thiede, Michael Appelt, Bernd Flessa, Steffen |
author_facet | Jacobs, Bart Hui, Kelvin Lo, Veasnakiry Thiede, Michael Appelt, Bernd Flessa, Steffen |
author_sort | Jacobs, Bart |
collection | PubMed |
description | BACKGROUND: Knowledge of the costs of health services improves health facility management and aids in health financing for universal health coverage. Because of resource requirements that are often not present in low- and middle-income countries, costing exercises are rare and infrequent. Here we report findings from the initial phase of establishing a routine costing system for health services implemented in three provinces in Cambodia. METHODS: Data was collected for the 2016 financial year from 20 health centres (including four with beds) and five hospitals (three district hospitals and two provincial hospitals). The costs to the providers for health centres were calculated using step-down allocations for selected costing units, including preventive and curative services, delivery, and patient contact, while for hospitals this was complemented with bed-day and inpatient day per department. Costs were compared by type of facility and between provinces. RESULTS: All required information was not readily available at health facilities and had to be recovered from various sources. Costs per outpatient consultation at health centres varied between provinces (from US$2.33 to US$4.89), as well as within provinces. Generally, costs were inversely correlated with the quantity of service output. Costs per contact were higher at health centres with beds than health centres without beds (US$4.59, compared to US$3.00). Conversely, costs for delivery were lower in health centres with beds (US$128.7, compared to US$413.7), mainly because of low performing health centres without beds. Costs per inpatient-day varied from US$27.61 to US$55.87 and were most expensive at the lowest level hospital. CONCLUSIONS: Establishing a routine health service costing system appears feasible if recording and accounting procedures are improved. Information on service costs by health facility level can provide useful information to optimise the use of available financial and human resources. |
format | Online Article Text |
id | pubmed-6822335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-68223352019-11-06 Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia Jacobs, Bart Hui, Kelvin Lo, Veasnakiry Thiede, Michael Appelt, Bernd Flessa, Steffen Health Econ Rev Research BACKGROUND: Knowledge of the costs of health services improves health facility management and aids in health financing for universal health coverage. Because of resource requirements that are often not present in low- and middle-income countries, costing exercises are rare and infrequent. Here we report findings from the initial phase of establishing a routine costing system for health services implemented in three provinces in Cambodia. METHODS: Data was collected for the 2016 financial year from 20 health centres (including four with beds) and five hospitals (three district hospitals and two provincial hospitals). The costs to the providers for health centres were calculated using step-down allocations for selected costing units, including preventive and curative services, delivery, and patient contact, while for hospitals this was complemented with bed-day and inpatient day per department. Costs were compared by type of facility and between provinces. RESULTS: All required information was not readily available at health facilities and had to be recovered from various sources. Costs per outpatient consultation at health centres varied between provinces (from US$2.33 to US$4.89), as well as within provinces. Generally, costs were inversely correlated with the quantity of service output. Costs per contact were higher at health centres with beds than health centres without beds (US$4.59, compared to US$3.00). Conversely, costs for delivery were lower in health centres with beds (US$128.7, compared to US$413.7), mainly because of low performing health centres without beds. Costs per inpatient-day varied from US$27.61 to US$55.87 and were most expensive at the lowest level hospital. CONCLUSIONS: Establishing a routine health service costing system appears feasible if recording and accounting procedures are improved. Information on service costs by health facility level can provide useful information to optimise the use of available financial and human resources. Springer Berlin Heidelberg 2019-10-30 /pmc/articles/PMC6822335/ /pubmed/31667671 http://dx.doi.org/10.1186/s13561-019-0246-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Research Jacobs, Bart Hui, Kelvin Lo, Veasnakiry Thiede, Michael Appelt, Bernd Flessa, Steffen Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title | Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title_full | Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title_fullStr | Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title_full_unstemmed | Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title_short | Costing for universal health coverage: insight into essential economic data from three provinces in Cambodia |
title_sort | costing for universal health coverage: insight into essential economic data from three provinces in cambodia |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822335/ https://www.ncbi.nlm.nih.gov/pubmed/31667671 http://dx.doi.org/10.1186/s13561-019-0246-6 |
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