Cost of primary health care in universal insurance at Health Center 16, Bangkok Metropolitan Administration.

The purpose of the present study was to illustrate the cost of services in health promotion and prevention, out patient (OPD) and dental care in Health Center (No. 16) Bangkok Metropolitan Administration. The analysis of the cost components could be used as key data for future planning, budgeting and resources preparing for the short and long terms. The cost centers were categorized to be executive, services and supporting unit. The simultaneous equation method was employed to allocate all costs from other associated cost centers to the service unit. The unit cost per visit was 372.76 baht, while the unit cost per capitation was 532.83 baht. The unit cost of health promotion and prevention per capitation was 288.95 baht, whereas the unit cost of OPD care per capitation was 183.47 baht and the unit cost of dental care per capitation was 55.37 baht. The labor cost accountedfor 83.67 per cent, capital cost 6.09 per cent and material cost 10.24 per cent of the total cost. Unit costs of OPD and dental care were lower than the proposed budget while the unit cost of health promotion and prevention was higher. This could be due to some patients seeking OPD care from King Chulalongkorn Hospital instead, while the health promotion and prevention offering was more than that normally offered in other Health Centers. The improvement of labor efficiency and the decrease of labor cost would be the short and long run strategies respectively.

Cost of producing a medical doctor at Chulalongkorn University.

To illustrate the cost of producing a medical doctor through a 6-year curriculum and the analysis of the cost components of the Faculty of Medicine, could be used as key data for future planning, budgeting and preparation for the autonomous university. The cost centers were categorized to be executive, education support and education unit. The simultaneous equation method was employed to allocate all costs from other associated cost centers to the education unit. The unit cost per enrolled student was 2,161,124 baht and 8,217 Baht/Student Credit Hour (SCH), while the unit cost per graduate was 2,174,091 baht and 8,267 Baht/SCH. The labor cost accounted for 69.46 per cent, capital cost, 26.42 per cent and material cost, 4.12 per cent of the total medical doctor production cost. The three most costly departments were,: Department of Medicine (13.24%), Department of Obstetrics and Gynecology (11.73%) and Department of Paediatrics (9.87%). The cost-fee ratio (cost/fee) was 95:5 which suggested that medical students obtain 95 per cent subsidy from the government budget or the society. If the University becomes autonomous and less dependent on public budget, the fee may have to be adjusted higher to cover the cost. The percentage of drop out and repeat students was 0.00-0.88 per cent with a delay duration of about 6 months to one year only. The opportunity cost of six years' study for a student attending the medical school was 544,956 baht which raised the total cost per graduate to 2,719,047 baht from student/societal perspective.