Cost of Emergency Patients in Public Hospitals for Financial Policy Recommendation to the Universal Coverage for Emergency Patients (UCEP)

Abstract

The objective of this study was to estimate the cost of emergency patients in public hospitals for financial policy recommendation to the Universal Coverage for Emergency Patients (UCEP). Financial and service information for the fiscal year 2019 was gathered from eight hospitals, two of which were gener­al hospitals of the Department of Medical Services, four regional hospitals, and two general hospitals of the Office of the Permanent Secretary, Ministry of Public Health. The traditional cost method with the cost matrix method was applied to analyze the unit cost of emergency patients. We used the cost ma­trix in two steps: (1) cost distribution of the fundamental cost centers to each patient based on the services received; (2) summing all medical activity costs on each patient and reporting them as individ­ual patient data.

The result showed that there were a total of 82,811 emergency patients from eight hospitals, 20,503 were triaged as resuscitation patients (red), and 62,308 emergency patients (pink). Labor costs were the highest share of the overall costs, followed by material costs, and capital costs. Unfortunately, the pres­ent study could analyze complete cost information from only one hospital (hospital A). The total cost of 18,027 emergency patients was THB 472,317,273. The average cost per person was THB 26,201, and the average cost per adjusted relative weight by diagnosis related group was THB 9,661. This costing method that required accurate hospital financial and emergency medical service information reported only data from one hospital. Further studies should explore alternative appropriate costing methods that data from more hospitals could be analyzed as more representative.