hospital cost

HOSPITAL COST AROOJ SHABBIR Roll # 03 MHRM

DHQ HOSPITAL DHQ HOSPITAL KASUR

KASUR

TYPES OF COST 

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Fixed Costs & Variable Costs: Fixed costs are the expenses that are the same no matter how much you are producing e.g rent, business licenses, etc. Variable costs change as production levels change e.g materials, labour, shipping, etc. Marginal Costs (or incremental costs): This is the cost of building one additional unit at a given level of production. At some point, though, there will be a step up when a new facility is needed, or another person needs to be hired, so the marginal cost cannot be projected out very far. Direct Costs & Indirect Costs: Direct costs can be traced to a specific product, such as materials or labour from that production team. Indirect costs are the overhead of doing business—marketing, accounting, etc—that don’t flow down to a single product. Cost of Goods Sold (COGS): This is the cost related to making a product. It generally includes labour, materials, and factory overhead. This is an accounting term, and finds its way into income statements. It is a summary of the direct expenses associated with making a product.

TYPES OF COST 

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Standard Cost: Standard Costs are the set costs for a product, used for accounting purposes to determine the COGS. They are generally calculated annually, and account for the current estimate as to how much a product costs. The difference between the standard cost and the actual cost is called variance. Opportunity Costs: This is the cost related to the value you are giving up by using your resources for one option over another option. Sunk Costs: These are the costs that you have already paid and are perhaps the most misunderstood of all costs. The money you have already spent is irrelevant in determining the value of continuing a project. They are gone no matter what. What matters is the amount it will still cost to finish a project. Tangible Costs & Intangible Costs: Tangible costs are the ones that you can measure e.g time, money, kilowatts, etc. Intangible costs are the ones that can’t be easily measured e.g trust, job satisfaction, morale, etc.

TYPES OF COST 

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Explicit cost and implicit cost: Explicit cost includes these payments which are made by the employer to those factors of production which do not belong to the employer himself. The implicit or imputed costs arise in case of those factors which are owned and supplied by the employer himself. Social cost: Social cost is the total cost of the society which includes the directed and indirect costs that the society pays for the production of the commodity. Accounting Cost and Economic Cost: All these expenses incurred by a producer that enter the accounts of the accountant in course of production is known as accounting cost. Economic cost takes into account the accounting cost of his production and the costs arising out of his personal labour and capital investment. His personal labour and capital invested could have earned remuneration of otherwise employed somewhere else. But these remunerations are not received by the entrepreneur himself. When these remunerations are added in the accounting cost, this constitutes economic costs.

CALCULATING COSTS When doing cost calculations the basic aim should be to identify all the inputs to the health care process and to quantify them in order to attach monetary values to them.  According to DHQ Hospital Kasur the following two costs apply.  The two basic categories of cost at this hospital are:  Capital cost  Recurrent cost 

CAPITAL COST The price of items that last longer than 1 year come under the category of capital cost.  These items maybe land, building, equipments, instruments, Lenin, bedding etc. 

1. LAND DHQ hospital is built on state land. Only the area of surgical indoor, surgical outdoor and emergency operation theatre was first built.  The total area of land is 206 canals. 

2. BUILDING The building of DHQ hospital kasur about 38 years old.  The W.H.O recommends the life span of the building for about 20 years but experts of the building department considered the life span of the building of about 60 years.  The actual cost was calculated as 410/sq.feet. 

3. EQUIPMENT 

The capital cost also consists of different equipments such as iron bed, nursing trolley, stature, office table, bench, b.p apparatus, autoclave, anesthesia machine....etc.

Monthly Expenditure Statement under head grant no. Pc 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

Medical Lab and Equipment Machines Total Equipment Charges

800000

0

794845

794845

5155

52020000 52,820,000

10171178 10,171,178

41845884 42,640,729

52017062 52,811,907

2938 8,093

4. BEDS AND PROTECTIVE CLOTHING 

Present Bed strength of the hospital is 197 beds.

Monthly Expenditure Statement under head grant no. Pc 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Uniform and 16000 Protective Clothing Bed and Linen 1085000 Total 1,101,000 Furniture and Bedding Charges

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

0

15800

15800

200

126138 126,138

956600 972,400

1082738 1,098,538

2262 2,462

RECURRENT COST The price of items that are consumed during the course of 1year and are purchased regularly are known as recurrent cost.  Examples of these items are salaries, drugs etc. 

1. SALARIES 

Different sanctioned strength and vacancy positions of the hospital are as follows:

Monthly Expenditure Statement under head grant no. Pc 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

Pay of Medical Staff

50188998

4639675

46696626

51336301

-1147303

Pay of Other Staff

13950000

1197530

12929542

14127072

-177072

Total Employee salary

64,138,998

5,837,205

59,626,168

65,463,373

-1,324,375

2. DRUGS AND SUPPLIES  

The supply for medicines is very limited. Even though the patients have increased , the overall supply of the budget for medicines has decreased 25%.

Monthly Expenditure Statement under head grant no. Pc 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

Medicine

500000

229708

233628

463336

36664

Total Medicine Charges

500,000

229,708

233,628

463,336

36,664

3. MAINTENANCE AND REPAIR 

A hospital has many everyday faults in their equipment which requires both time and money to mend.

Monthly Expenditure Statement under head grant no. Pc - 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

Repair of Transport Repair of machinery Furniture and fixtures Repair of computer hardware

615000

46485

566039

612524

2476

2465000

481305

1981960

2463265

1735

1690000

0

1688170

1388170

1830

60000

0

60000

60000

0

0

20000

20000

0

527,790

4,316,169

4,843,959

6,041

Computer 20000 Science Total Repair 4,850,000 and Maintenance

4. UTILITIES All the electricity, gas and telephonic bills would fall in this category.  Furthermore it consists of legal fee, stationary, advertisement, newspaper, rent rate and tax etc..... 

Head of Account

Budget

Previous Expenditure 0 30000

Up to Date Expenditure 0 30000

Balance

0 30000

Present Expenditure 0 0

Legal fee Post and telegraphic Telephones Gas Electricity F.A Rent rate and tax T.A Transportation POL Stationary Print and Publications Newspaper Advertisement EF and on celebration Cost of other store Computer stationary Others X-Ray films Total utilities

225000 175000 12913000 200000 0 475000 125000 11500000 260000 2550000

36965 47600 2911401 0 0 117149 23200 3131726 9750 45455

183472 126950 10000010 200000 0 327424 95950 8188271 249981 2501512

220437 174550 12911411 200000 0 444573 119150 11319997 259731 2546967

4563 450 1589 0 0 30427 5850 180003 269 3033

15000 225000 50000

510 19400 0

9566 205223 50000

10076 224623 50000

4924 377 0

1535000

26850

1495311

1522161

12839

150000

0

149556

149556

444

1665000 1450000 33,543,000

112890 1444540 7,927,436

1549041 0 25,362,267

1661931 1444540 33,289,703

3069 5460 253,297

0 0

GRAND TOTAL Monthly Expenditure Statement under head grant no. Pc - 21016-07 - Health Services 0731 - General Hospital services, 073101 - General hospital Services, DHQ Hospital Kasur for the month of 6/2012 Head of Account

Budget

Present Expenditure

Previous Expenditure

Up to Date Expenditure

Balance

Total Employee Allowance

64138998

5837205

59626168

65463373

-1324375

Total Equipment 52820000 Charges

10171178

42640729

52811907

8093

Total Furniture and Bedding Charges

1101000

126138

972400

1098538

2462

Total Medicine Charges

500000

229708

233628

463336

36664

Total Repair and 4850000 Maintenance

527790

4316169

4843959

6041

Total utilities Grand Total

7927436 24,819,455

25362267 133,151,361

33289703 157,970,816

253297 -1,017,818

33543000 156,952,998

PERFORMANCE INDICATORS S.NO. PERFORMANCE INDICATOR

2010

2011

2012(6 MONTHS)

1

No. of outdoor patients

210102

275525

174315

2

No.of Indoor patient

27009

28162

18332

3

No. Of casualty outdoor patient

94025

160375

89426

4

No. Of dialysis conducted

1281

1301

743

5

No. Of deliveries conducted

1061

3160

1761

6

No. Of operations conducted

2836

4331

2380

7

No. Of TB dots program

192

314

256

8

No. Of EPI statistics center

3920

7864

4765

9

Progress of Hepatitis control program

157

200

206

10

Bed occupancy rate

92.58%

96.33%

101.66%

11

MLC

1921

2400

1106

12

Post Mortem

130

203

89

INPATIENT AND OUTPATIENT COMPARISON

700000

600000 500000 2012(6 months) 2011 2010

400000 300000 200000 100000 0 Inpatients

Outpatients

Bed Occupancy Rate

2010 2011 2012

SUGGESTIONS ? All electric lights should be replaced by energy savers.  The window Ac’s should be replaced by split Ac.  There are too much of allowances, they should be reduced. 

Thank you