The Cost Analysis of the Private and Public Health Facilities for Delivering Outpatient Services: A Study Conducted in Bangladesh
Main Article Content
Abstract
The government of Bangladesh tries to provide free healthcare services locally through community clinics, satellite clinics, Union Health & Family Welfare Center (UH&FWC), etc. But all these facilities still unable to fulfill the local demand. So, people visit private medical institutions to receive proper treatment. They need to pay for each unit of private healthcare services. The study considered eight UH&FWC in rural areas and eight private clinics in urban areas from 8 districts of Bangladesh. We accumulated the various categories of cost-related data of these facilities e.g. physicians and other staff's salary, hospital rent and other equipment costs, etc. and also the number of patients treated by each facility each month. Thus, we estimated the per month cost of producing each unit of outpatient services. The cost of producing per unit outpatient services differed from facilities to facilities. The cost in the UH&FWC ranged from BDT 178 ($2.09) to BDT 197 ($2.32). At the same time, this cost in the private clinic was BDT 87 ($1.02) to BDT 92 ($1.08). The health care cost between public and private health facilities altered due to the variation in cost and utilization of services from these health facilities. However, private health facilities are more efficient than public health facilities. If we would like to reduce the cost of public health facilities, we must ensure transparency in the facilities
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
IJCERT Policy:
The published work presented in this paper is licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. This means that the content of this paper can be shared, copied, and redistributed in any medium or format, as long as the original author is properly attributed. Additionally, any derivative works based on this paper must also be licensed under the same terms. This licensing agreement allows for broad dissemination and use of the work while maintaining the author's rights and recognition.
By submitting this paper to IJCERT, the author(s) agree to these licensing terms and confirm that the work is original and does not infringe on any third-party copyright or intellectual property rights.
References
Begum F, Alam S, Hossain A. Funds for treatment of hospitalized patients: Evidence from Bangladesh. Journal of Health, J Health Popul Nutr. 2014; 32(3): p. 465-470. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC4221452/
Hollingsworth A, Soni A, Carroll A, Cawley J, Simon K. Gains in health insurance coverage explain variation in Democratic vote share in the 2008-2016 presidential elections. PLOS ONE. 2019;14(4): p. 1-16. doi: 10.1371/journal.pone.0214206
Branning G, Vater M. Healthcare spending: Plenty of blame to go around. Am Health Drug Benefits. 2016; 9(8): p. 445-447. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394555 /
China: health expenditure per capita 2018 | Statista
[Internet]. Statista. 2020 [cited 24 October 2020]. Available from: https://www.statista.com/statistics/279401/per-capitahealth-expenditure-inchina/#:~:text=Per%20capita%20health%20expenditure %20in%20China%202008%2D2018&text=The%20grap h%20shows%20health%20expenditures,yuan%20in%20t he%20previous%20year.
Danilova M. ‘Free’ healthcare in Russia has cost. Los Angeles Times [Internet]. 2007 [cited 24 October 2020]; Available from: https://www.latimes.com/archives/laxpm-2007-jul-15-adfg-rushospitals15-story.html
How does UK healthcare spending compare with other countries? - Office for National Statistics [Internet]. Ons.gov.uk. 2020 [cited 24 October 2020]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/ healthandsocialcare/healthcaresystem/articles/howdoesuk healthcarespendingcomparewithothercountries/2019-08- 29#:~:text=As%20a%20percentage%20of%20GDP,the% 20remaining%20six%20G7%20countries.
Italy: per capita expenditure on health 2006-2019 | Statista [Internet]. Statista. 2020 [cited 24 October 2020]. Available from: https://www.statista.com/statistics/788710/per-capitaexpenditure-on-health-initaly/#:~:text=Per%20capita%20expenditure%20on%20h ealth%20in%20Italy%202006%2D2019&text=This%20s tatistic%20illustrates%20the%20expenditure,estimated% 202%2C565%20euros%20in%2020.
China: health expenditure per capita 2018 | Statista
[Internet]. Statista. 2020 [cited 24 October 2020]. Available from: https://www.statista.com/statistics/279401/per-capitahealth-expenditureinchina/#:~:text=Per%20capita%20health%20expenditur e%20in%20China%202008%2D2018&text=The%20gra ph%20shows%20health%20expenditures,yuan%20in%2 0the%20previous%20year.
Li X, Krumholz H, Yip W, Cheng K, De Maeseneer J, Meng Q et al. Quality of primary health care in China: challenges and recommendations. The Lancet. 2020;395(10239):1802-1812. doi: 10.1016/S0140- 6736(20)30122-7
Tandon A. India’s per capita health spending dismal Rs 1,657. The Tribune [Internet]. 2019 [cited 24 October 2020]; Available from: https://www.tribuneindia.com/news/archive/nation/indias-per-capita-health-spending-dismal-rs-1-657- 855027#:~:text=NEW%20DELHI%3A%20India%20con tinues%20to,is%20a%20mere%20Rs%201%2C657.
Kasthuri A. Challenges to healthcare in India - the five A's. Ind J Community Med. 2018; 43(3): p. 141-143. doi:10.4103/ijcm.IJCM_194_18
Pakistan Health expenditure per capita, 1960-2018 - knoema.com [Internet]. Knoema. 2020 [cited 24 October 2020]. Available from: https://knoema.com/atlas/Pakistan/Health-expenditurepercapita#:~:text=Pakistan%20%2D%20Current%20health %20expenditure%20per%20capita&text=In%202017%2C%20health%20expenditure%20per,average%20annual %20rate%20of%208.57%25.
Sarwar A, Qureshi H. Awareness and willingness to buy private health insurance and a look into its future prospects in Pakistan. Eur J Business Soc Sci. 2013; 2(1): p. 69-81.
The Constitution of the People’s Republic of Bangladesh
[Internet]. Bdlaws.minlaw.gov.bd. 2020 [cited 24 October 2020]. Available from: http://bdlaws.minlaw.gov.bd/act-367.html
Pavel M, Chakrabarty S, Gow J. Cost of illness for outpatients attending public and private hospitals in Bangladesh. Int J Equity Health. 2016; 15(1). doi: 10.1186/s12939-016-0458-x
Fahim S, Bhuayan T, Hassan M, Abid Zafr A, BF, Rahman M, et al. Financing health care in Bangladesh: Policy responses and challenges towards achieving universal health coverage. Int J Health Plann Manage. 2018; 34(1): p. e11-e20. doi: 10.1002/hpm.2666
Brekke K, Sorgard L. Public versus private health care in a national health service. Health Econ. 2007; 16(6): p. 579-601. doi: 10.1002/hec
Financing health services in developing countries: an agenda for reform. [Internet]. Vol. 22, Bulletin of the Pan American Health Organization. Washington DC: World Bank; 1988. 416–429 p. Available from: http://documents.worldbank.org/curated/en/46809146813 7379607/pdf/multi-page.pdf
Migotti M. Paying a pice, fcing a Fine, cunting the Cost: The dfferences that mke the dfference. Ratia Juris. 2015; 28(3): p. 372-391. doi: 10.1111/raju.12088
Harsvardhan R, Singh I, Sharma D. A cost analysis study of inpatient care services at a large tertiary care teaching institute at New Delhi, India. Int J Research F Hospital and Healthcare Admin. 2014; 2(1): p. 15-18. doi: 10.5005/jp-journals-10035-1009
Vo T, Chaikledkaew U, Hoang M, Nguyen H, Riewpaiboon A. Hospital cost analysis in developing countries: A methodological comparison in Vietnam. Asian J Pharm. 2017;(Special Issue): p. 8-18. doi: 10.22377/ajp.v12i01.2341
Plante C. The differentiation between for-profit and nonprofit hospitals: Another look. Res Healthcare Fin Manage. 2009; 12(1): p. 7-17. doi: 10.2139/ssrn.1911696
Bazzoli G, Clement J, Hsieh H. Community benefit activities of private, nonprofit hospitals. J Health Polit Policy Law. 2010; 35(6): p. 999-1026. doi: 10.1215/03616878-2010-036
Horwitz J, Nichols A. Hospital ownership and medical services: Market mix, spillover effects, and nonprofit objectives. J Health Econ. 2009; 85(5): p. 924-937. doi: 10.1016/j.jhealeco.2009.06.008
Principe K, Adams E, Maynard J, Becker E. The impact of the individual mandate and internal revenue service form 990 schedule H on community benefits from nonprofit hospitals. Am J Public Health. 2012; 102(2): p. 229-237. doi: 10.2105/AJPH.2011.300339
Risor B, Lisby M, Sørensen J. Comparative costeffectiveness analysis of three different automated medication systems implemented in a Danish hospital setting. Appl Health Econ Health Policy. 2018; 16(1): p. 91-106. doi: 10.1007/s40258-017-0360-8
Marshall M, Crowther R, Almaraz-Serrano A, Creed F, Sledge W, Kluiter H, et al. Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care. Health Technol Assess. 2001; 5(21). doi: 10.3310/hta5210
Lin E, Yin T, Kuo B, Chang W, Tsai S. A comparison of effectiveness and cost between two models of care for individuals with schizophrenia living in Taiwan. Arch Psych Nurs. 2001; 15(6): p. 272-278. doi: 10.1053/apnu.2001.28688
Jester R, Hicks C. Using cost-effectiveness analysis to compare hospital at home and in-patient interventions: Part2. J Clin Nurs. 2003; 12(1): p. 20-27. doi: 10.1046/j.1365-2702.2003.00686.x