Trends in Financial Management of the Hospital under the Office of the Permanent Secretary, Ministry of Public Health: A Qualitative Study

Abstract

The objectives of this study were to: 1) studying the causes and factors of success/loss, lack of financial liquidity of the hospitals management, and 2) proposing financial management guidelines for the hospitals. The sample comprised 8 financial managers, working at the health region level and ministerial level. Data collection were collected by in-depth interviews, using structured interview forms. Data analyses was carried out using content analysis.

The results found 8 themes of causes and success factors in hospital financial management: 1) nationally, set aside 10 percent of the money for management 2) adaption 3) leadership 4) provide additional income, reduce expenses 5) accounting software 6) reduce labor costs and adopt information systems 7) e-bidding procurement system and 8) Planfin preparation. There were found 10 themes of causes and factors of financial management failure: 1) inadequate budget allocation 2) capitation 3) allocation of the universal health coverage scheme budget downturn 5) incapability of hospital administrators 6) lack of leadership 7) labor cost 8) material cost 9) incorrect accounting information system and 10) operating expenses do not meet the fiscal plan.

The policy recommendations for financial management guidelines are as follows: financial administration should be more decentralized to health regions and provinces; changing the method of budget allocating by excluding salary from the health capitation; setting a sharing fund to help hospitals with problems; increasing budgets for health regions; joint management using virtual accounts; and increasing joint financial management within health regions.