Cost of Outpatient Department Services at a Community Health Center of Bankura, West Bengal

BACKGROUND: Changing trends of privatization and globalization of health care compel the hospitals to practice cost accounting for providing accurate information about the cost of patient care. OBJECTIVES: The objectives were to determine unit cost and to identify major cost areas of outpatient department (OPD) services provided by the community health center (CHC) of Bankura district, West Bengal. MATERIALS AND METHODS: A cross-sectional study was conducted at Amarkanan CHC in 2016. Work sampling (WS) and time motion (TM) study were conducted for assessing the workforce cost, otherwise complete enumeration was done to assess the cost of different service areas such as medicine, logistic, maintenance, transport, electricity, building, equipment, and furniture. A predesigned pro forma and a questionnaire were used for WS and TM study and for interviewing the key informants for collection of information pertaining to different costs. Unit cost of different services as well as overall unit cost was estimated. RESULTS: If a patient received injection, undergone dressing, and had electrocardiogram and X-ray both done in a day, then the total cost of OPD services for workforce was Rs. 85.33/. Cost of logistics per patient per day was maximum in X-ray room. Manpower exerted the maximum cost incurred by the government to conduct OPD in Amarkanan CHC. Overall, the unit cost in OPD incurred by the government was Rs. 44.53/-. CONCLUSION: Close monitoring is required by aligning the staffing pattern and patient activities and having adequate number of staff with right skill at right place and time for efficiency, productivity, and cost-effectiveness.