Cost Recovery of Medical Rehabilitation under the Universal Health Coverage Scheme at Udon Thani Hospital

Abstract

          This retrospective descriptive study was aimed at determining the cost recovery of medical rehabilitation under the Universal Health Coverage Scheme, using a prevalence-based approach. The cost was calculated by standard method and micro-costing method from a provider perspective. Those eligible to participate in the study were physically disabled persons under the terms of the UC scheme. The data was collected from either outpatients or inpatients at Udon Thani hospital in the fiscal year 2006.

         It was found that the majority of medical rehabilitation costs were for prosthesis, orthosis and assistive devices (69.05%). The remaining costs consisted of hospitalization costs (17.09%), physical therapy costs (5.35%), occupational therapy costs (4.53%), assessment and diagnosis costs (3.13%), drug costs (0.62%) and phenol block costs (0.23%). Overall, the total cost averaged 8,365.07 baht/person/year. With regard to the revenue, the hospital was reimbursed by the National Health Security Office (NHSO) in accordance with its itemized and price schedule. Thus, the cost recovery was calculated based on the services under NHSO’s schedule only. The findings revealed that the cost recovery was 36.77 per cent of the total cost (labour cost, material cost and capital cost). Where the costs comprised only material costs, the cost recovery was 59.47 per cent. In conclusion, according to the itemized and price schedule in the fiscal year 2006, the reimbursement for medical rehabilitation services under the UC scheme did no cover the costs. This needs to be addressed urgently by the responsible authorities. These findings generate data which facilitate better financial management. They can provide the hospital administrators to improve administration under scarce resources to gain maximum benefit. The policy maker may use these findings to reconsider the itemized and price schedule of medical rehabilitation services in order to support the hospital to recover their costs. Thus, the providers are encouraged to deliver more efficient services to a large number of disabled persons, in turn, resulting in greater self-reliance.

Key words: cost recovery, medical rehabilitation, Universal Health Coverage Scheme