Cost analysis of national hospitals
Objective: The objective of this study is to provide a baseline overview of national hospitals' actual costs, resources and services.
Methodology: Top-down costing approach was used in this study. Data were collected from all 18 national hospitals in Kabul and entered and analyzed using the Hospital Cost Allocation Tool (HOSPICAL). The HOSPICAL Tool allows users to analyze total and unit costs and revenue for each department within a hospital. To the extent possible, expenditure and staffing data was verified through examination of receipts, invoices and central MoPH documents (such as procurement receipts), as well as health management information system (HMIS) data, where applicable.
Results: The average bed occupancy rate (BOR) across all national hospitals is 58 percent far lower than the conventional target of 85 percent. Excluding outliershospitals with an average length of stay (ALOS) of 10 days or morethe ALOS is 4.1 days.
The total cost of national hospitals is $22,767,304. On average, inpatient services at national hospitals cost $11,702 per occupied bed per year, or $32 per occupied bed per day. The total cost per inpatient is approximately $131. However, the cost per outpatient visit is $4.17, which is roughly in line with the cost to provide outpatient services through the Basic Package of Health Services (BPHS). Due to the large number of doctors, salaries make up a high percentage of hospital costs (61%).
Learning Areas:Administration, management, leadership
Discuss the challenges in the tertiary care hospital administration and leadership in a developing country (Afghanistan) Evaluate the current trends in tertiary care hospitals of Afghanistan Learn about the actual costs, resources and services of National Hospitals in Afghanistan
Keyword(s): Cost Issues, Hospitals
Qualified on the content I am responsible for because: I have been working with the Health Economics and Financing Directorate of the Ministry of Public Health for just over two years. Hospital cost analysis has been a topic of interest for me and I am coauthor of this study. I have been coauthor of other studies such as "The Cost Analysis of Essential Package of Hospital Services in Afghanistan, and The Inequalities in Healthcare Utilization and Benefit Incidence Analysis of Publicly Financed Health Facilities.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.