Unit cost analysis of Phnom Penh Heart Center in Campodia : the fiscal year 2006

To calculate and analyze cost and unit cost per admission, per bed-day and per visit at Phnom Penh Heart Center in the fiscal year 2006, by focusing on providers’ perspective. Then the result which was obtained from the calculation of the unit cost at Phnom Penh Heart Center was compared to WHO-CHOICE model and some available studies from Thailand to find whether the unit cost was unusually high or low in order to be a guideline for policy makers and Ministry of Finance in budget allocation purpose.The estimated provider cost per patient day at Phnom Penh Heart Center (PPHC) was US$38.1; cost per visit was US$51.9 and cost per admission was US$308.1. Unit cost of WHO-CHOICE model was US$3.39 per visit at OPD and US$12.89 per bed-day at IPD. The average cost per bed day of heart transplantation surgery unit at Chulalongkorn Memorial Hospital was US$183.6 and the average cost per bed day of Phnom Penh Heart Center of Cambodia was US$203.5.This study also found that the provider cost for the treatment of heart disease of patients at PPHC- the maximum cost component was the material cost, following in order by the capital cost and labour cost. In PPHC, the percentage of cost shared by material, cost capital cost and labour cost was 45.5%, 27.3% and 27.2% of the total unit cost respectively. The unit cost of both OPD and IPD at PPHC was found higher than the unit cost of OPD and IPD of WHO-CHOICE because the PPHC was a heart surgery hospital. Hence, the cost includes the high cost of medical equipments, while the WHO-CHOICE model is not included the capital cost and salary or wage in the calculated model. In addition, the model of WHO-CHOICE was mainly calculated by all general hospitals in developed and developing countries. Even though the unit costs of PPHC was higher than the WHO-CHOICE project, the average cost per admission of surgery patients at PPHC ($5,087.5) was found lower than the average cost per admission ($11,013.0) of heart transplantation surgery unit at Chulalongkorn Memorial Hospital in Thailand.This study found that sources of finance was 24.8% from donation part, 64.0% from out of pocket payment and 11.2% from the government budget out of the total cost of US$1,992,766.6. The source of finance from the government part is therefore not enough to support the health service at PPHC in 2006.

本研究以服务提供者视角为核心，对2006财年金边心脏中心（Phnom Penh Heart Center, PPHC）的单次入院、每床日及单次就诊的总成本与单位成本开展测算与分析。随后将金边心脏中心的单位成本测算结果，与世界卫生组织-CHOICE模型（WHO-CHOICE）以及泰国境内已公开的相关研究进行对比，以判断其单位成本是否存在异常偏高或偏低的情况，进而为政策制定者与财政部开展预算分配工作提供参考依据。

测算结果显示，金边心脏中心的单患者日服务提供者成本为38.1美元，单次就诊成本为51.9美元，单次入院成本为308.1美元。世界卫生组织-CHOICE模型的单位成本为：门诊（Outpatient Department, OPD）单次就诊3.39美元，住院（Inpatient Department, IPD）每床日12.89美元。泰国朱拉隆功纪念医院心脏移植外科单元的平均每床日成本为183.6美元，柬埔寨金边心脏中心的平均每床日成本则为203.5美元。

本研究同时发现，金边心脏中心心血管疾病患者治疗的服务提供者成本构成中，占比最高的项目为物料成本，其次依次为资本成本与人力成本。金边心脏中心的物料成本、资本成本及人力成本分别占单位总成本的45.5%、27.3%与27.2%。

研究表明，金边心脏中心门诊与住院的单位成本均高于世界卫生组织-CHOICE模型的对应值，这是由于金边心脏中心为心脏外科专科医院，其成本包含高额的医疗设备投入；而世界卫生组织-CHOICE模型在测算过程中未纳入资本成本与薪酬开支。此外，世界卫生组织-CHOICE模型主要基于发达国家与发展中国家的综合医院数据构建。

尽管金边心脏中心的单位成本高于世界卫生组织-CHOICE项目的测算值，但其外科患者单次入院平均成本（5087.5美元）仍低于泰国朱拉隆功纪念医院心脏移植外科单元的单次入院平均成本（11013.0美元）。

本研究还显示，2006年金边心脏中心总运营成本为1992766.6美元，其资金来源构成为：捐赠占比24.8%，自费支付占比64.0%，政府预算占比11.2%。可见，政府预算投入不足以支撑金边心脏中心当年的医疗服务运营。

搜集汇总

背景与挑战

背景概述

该数据集是2006年柬埔寨金边心脏中心的单位成本分析研究，计算了每次入院、每日床位和每次就诊的成本（如每次入院成本为308.1美元），并与国际模型和泰国数据比较，发现其成本结构以材料成本为主，资金来源主要依赖患者自付。