Student Dissertation

Agency : Cost Management, Cardiac Catheterization Laborarory

Objective : The study had the following objectives: To analyze the cost of various packages charged from patient in Cardiac Catheterization Laboratory of Soni Manipal Hospital, Jaipur and compare them with actual cost. a. To furnish data for decisions and suggest variations in cost of packages for competitive pricing and enhanced patient satisfaction. b. To indicate to the management any uneconomic use or waste which is thereby revealed

Background : Cost management is one of the critical success factors for the hospitals. It provides information for strategic, operational, clinical and human resource decision making. Cost analysis would help to arrive at the cost of production of every unit by close analysis of expenditure. It indicates to the management any uneconomic use or waste which is thereby revealed. It also aids in pricing and to furnish data for decisions. The cost of services also influences revenue to the extent that they influence pricing decisions. Hospital must remain profitable in order to serve the community effectively and to embrace capital markets for plant and technology modernization. Substantial ef¬ficiency gains could be made by reforming hospital payment mechanisms. The study focuses on ascertaining the cost of providing the service and to assess whether the packages are cost worthy or not. This study is carried out in the Cardiac Catheterization laboratory of Sonni Manipal Hospital, Jaipur, Rajsthan.

Methodology : The study was carried out at S K Soni Manipal Hospital, Jaipur as retrospective and analytical study for period Jan 2013 to Jan 2014.The sample population basically comprised of all types of procedures carried out in Cath Lab. A total of 991 major procedures were studied out of total 1101 procedures of 2013. The real time observations and data of 45 procedures were collected. Costing was studied under direct cost and Indirect cost. After calculating the actual cost of each procedure, it was compared with the price of package being charged from the patient to set its credibility. Following framework was used to calculate the actual cost of package: Actual cost of package -- Direct labour cost +direct material cost +over-head cost Direct material cost -- Cost of stay in CCU -- Medicine cost -- Cost of consumables -- Cost of Diagnosis Over-head cost -- Electricity cost -- Equipment cost -- Depreciation charges of building -- Cath lab maintenance charges -- Charges due to inventory

Findings : After the analysis of data following results were drawn out: 78 a. CAG package • CAG procedures are about 63% of total procedures with a buffer amount of Rs 1506. • Hospital is not making any noticeable profit from CAG package (17% only).Total revenue generated in 2013 from this is Rs 965346. • Major cost element in CAG procedures is stay in CCU and labour cost. Cost element Cost Stay in CCU Rs 2004 ( 24% of total cost ) Labour cost Rs 1720 ( 20% of total cost ) b. PPI package • CAG procedures are about 2.8% of total procedures with a buffer amount of Rs 2212. • Hospital is not making any noticeable profit from PPI package (9.7% only).Total revenue generated in 2013 from this procedure is Rs 712264. • Major cost element in PPI procedures is stay in CCU and labour cost. Cost element Cost Stay in CCU Rs 12024 ( 53% of total cost ) Labour cost Rs 4300 ( 19% of total cost ) c. PTCA package • PTCA packages are about 33% of total procedures and is generating a fair amount of margin per procedure ( about 240% ).It’s the major revenue generator procedure in Cath Lab. • Revenue generated by PTCA package in year 2013 alone is Rs 9636816 • Major cost element in PTCA procedures is stay in CCU and consumables. Cost element Cost Stay in CCU Rs 8350( 41% of total cost ) Consumables Rs 4418 ( 22% of total cost )

Recommendations : In today’s world when numbers of people with heart problems are increasing specially at young age, it becomes very important for a Hospital to critically analyze the cost of any package so that maximum benefits can be delivered to the patient at the minimum cost and with least hassles. Moreover such exercise will generate more revenue for the hospital by increasing the number of patient in- flow and give better competitive standing.


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