HOSPITAL COST

AROOJ SHABBIR Roll # 03 MHRM

DHQ HOSPITAL DHQ HOSPITAL KASUR

KASUR

TYPES OF COST

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 businessmarketing, accounting, etcthat dont 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

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 cant be easily measured e.g trust, job satisfaction, morale, etc.

TYPES OF COST

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

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 Present Expenditure Previous Expenditure Up to Date Expenditure Balance

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

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
Pay of Medical Staff Pay of Other Staff

Budget

Present Expenditure
4639675 1197530

Previous Expenditure
46696626 12929542

Up to Date Expenditure
51336301 14127072

Balance

50188998 13950000

-1147303 -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 Total Medicine Charges

500000 500,000

229708 229,708

233628 233,628

463336 463,336

36664 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 Repair of Transport Repair of machinery Furniture and fixtures Repair of computer hardware Budget 615000 2465000 Present Expenditure 46485 481305 Previous Expenditure 566039 1981960 Up to Date Expenditure 612524 2463265 Balance 2476 1735

1690000
60000

0
0

1688170
60000

1388170
60000

1830
0

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

0
527,790

20000
4,316,169

20000
4,843,959

0
6,041

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 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

Budget 0 30000 225000 175000 12913000 200000 0 475000 125000 11500000 260000 2550000 15000 225000 50000

Present Expenditure 0 0 36965 47600 2911401 0 0 117149 23200 3131726 9750 45455 510 19400 0

Previous Expenditure 0 30000 183472 126950 10000010 200000 0 327424 95950 8188271 249981 2501512 9566 205223 50000

Up to Date Expenditure 0 30000 220437 174550 12911411 200000 0 444573 119150 11319997 259731 2546967 10076 224623 50000

Balance 0 0 4563 450 1589 0 0 30427 5850 180003 269 3033 4924 377 0

1535000
150000 1665000 1450000 33,543,000

26850
0 112890 1444540 7,927,436

1495311
149556 1549041 0 25,362,267

1522161
149556 1661931 1444540 33,289,703

12839
444 3069 5460 253,297

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 Total Employee Allowance Budget 64138998 Present Expenditure 5837205 10171178 126138 Previous Expenditure 59626168 42640729 972400 Up to Date Expenditure 65463373 52811907 1098538 Balance -1324375 8093 2462

Total Equipment 52820000 Charges Total Furniture and Bedding Charges Total Medicine Charges 1101000

500000

229708 527790 7927436 24,819,455

233628 4316169 25362267 133,151,361

463336 4843959 33289703 157,970,816

36664 6041 253297 -1,017,818

Total Repair and 4850000 Maintenance Total utilities Grand Total 33543000 156,952,998

PERFORMANCE INDICATORS
S.NO. PERFORMANCE INDICATOR
1 2 3 4 5 6 7 8 9 10 No. of outdoor patients No.of Indoor patient No. Of casualty outdoor patient No. Of dialysis conducted No. Of deliveries conducted No. Of operations conducted No. Of TB dots program No. Of EPI statistics center Progress of Hepatitis control program Bed occupancy rate

2010
210102 27009 94025 1281 1061 2836 192 3920 157 92.58%

2011
275525 28162 160375 1301 3160 4331 314 7864 200 96.33%

2012(6 MONTHS)
174315 18332 89426 743 1761 2380 256 4765 206 101.66%

11
12

MLC
Post Mortem

1921
130

2400
203

1106
89

INPATIENT AND OUTPATIENT

COMPARISON

700000

600000
500000 400000 300000 200000 100000 0 Inpatients Outpatients 2012(6 months) 2011 2010

Bed Occupancy Rate

2010 2011 2012

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

Thank you