Hospital Cost Analysis in Developing Countries: A Methodological Comparison in Vietnam

Abstract

Context: Health-care expenditure is increasing worldwide. To control costs and increase efficiency, health economics has been applied by hospital management. Determining the unit cost of medical services is essential for health economics analysis, including health-care financing. Aims: The aim of this study is, therefore, to explore the unit cost analysis of medical services in Vietnam as well as the effects of applying different costing methods. Materials and Methods: A standard costing approach was applied to calculate the unit cost of medical services in two provincial hospitals. During the unit cost calculation, the micro-costing method and the ratio of cost to charge (RCC) method were compared. For both hospitals, the total cost as well as the proportion of capital, labor, and material costs were calculated and compared. The unit cost analysis covered 776 services in Ha Nam Hospital and 2064 services in Thu Duc Hospital. Results: Although both hospitals offer the same level of service, they differ in terms of other characteristics. Hence, their costs are quite different. Comparing the results calculated using the micro-costing method and the RCC method, the unit costs of the same services were also found to be quite different. The present study should prove particularly valuable in relation to the methodological comparison of hospital service cost analysis in developing countries such as Vietnam. Conclusions: The micro-costing method proved to be the most accurate method when calculating the unit cost of medical services since it was best able to reflect the consumption of resources.