Factors Affecting Loss Performance of Government Hospitals under the Office of the Permanent Secretary of the Ministry of Public Health, Thailand

Abstract

Financial losses of government hospitals under the Office of the Permanent Secretary of the Ministry of Public Health in Thailand has been reported since 2010. In 2017, there were 382 hospitals reporting financial lossed of altogether THB 3,160 million. This research aims to study the current situation of operations and factors affecting the performance of financial losses in hospitals under the Office of the Permanent Secretary, Ministry of Public Health in Thailand. The study aimed to covered the profit or loss based on operating margins. The evaluting factors included general hospital charateristics, managerial process, service mix and market characteristics of the hospitals. This study used secondary data of fiscal year 2017 (from October 2016 to September 2017). Data were collected from 896 hospitals nationwide. Both descriptive and inferential statistics were employed in this study. They included frequency, percentage, mean, standard deviation, and binary logistic regression analysis. The results showed that majority of the government hospitals with financial loss were medium community hospital (level F2); situated in the public health zone 1; had lower average time trade service payment period; lower average time Civil Servant Medical Benefit Scheme (CSMBS) collection period; lower average time inventory management period; lower proportion of inpatient per total patients; lower proportion of inpatient procedures per all procedures; lower proportion of number of days spent on number of patients using Alien Card (AC) insurance; lower proportion of hospital beds per total beds in the province; lower proportion of Universal Healthcare beneficiaries per total number of patients; lower proportion of CSMBS users per total number of patients and lower proportion of AC users per total number of patients. From binary logistic regression analysis, the hospital type, hospital zone, and the proportion of inpatient per total patients were found to be associated with operating financial loss in government hospitals under the Office of the Permanent Secretary, Ministry of Public Health in Thailand (p<0.05).