Interviews were recorded and transcribed. Agency for Healthcare Research and Quality, Rockville, MD. As recognition standards evolve along with the definition, so will the costs of obtaining and retaining PCMH certification. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. This Practical Guide was developed based on the experiences and lessons learned from the 15 AHRQ Estimating Costs grants. About CME: CME Corp is the nation’s premier source for healthcare equipment, turnkey logistics, and biomedical services, representing 2 million+ products from more than 2,000 manufacturers. SETTING: Eighteen primary care clinics from 8 health care organizations in 5 states. The Commonwealth Fund claims a quarter of hospital expenditure, or roughly $215 billion, comes from administrative costs. All of our primary care clinics offer Telemedicine Visits. For the health centres, a possible reason for wide variations in OPD attendance could be due to the variations in population they covered. This includes costs such as overhead expenses and expenses associated with staff turnover. In general, cost efficiency assessment, budgeting and cost effectiveness analysis of health facilities depend largely on the availability of cost information. Additional details about each method are provided below. Much of the staff time at the CHPS facilities was spent on preventive services (51%). PubMed Central Gross-costing methods can be used to conduct retrospective cost analyses of a primary care transformation effort when a good source of aggregate data is available. Tropical Med Int Health. A variety of metrics can be used to adjust estimates for clinic size, staff mix, and PCMH-related practice changes implemented. The study took the health provider perspective and did not include direct patient costs. Manage cookies/Do not sell my data we use in the preference centre. Google Scholar. On average, AHRQ Estimating Costs grantees found that the transformation efforts they studied occurred over a 2- to 4-year period. A sensitivity was also conducted varying personnel cost. 2012;17:951–7. were obtained from market sources. An important first step in estimating the costs of a primary care transformation effort is to describe the transformation effort and the setting in which it is taking place. The average IGF per health facility cost was US$0.21 (median = US$0.21; range = US$0.09 – US$0.41) at CHPS level and US$0.35 (median = US$0.35; range; US$0.25 – US$0.44) at HC level. This information may not reflect the full costs of the primary care transformation effort incurred by clinics, because many of the costs related to practice redesign are not fully covered. The cost per capita at the CHPS and HC were US$5.14 and US$3.51 respectively. As we all know, more and more providers are brushing aside any ambition to start a private practice and instead joining a hospital or large group practice. However, it is still necessary to make effective use of limited budget. These challenges can be mitigated by offering flexible options for data collection, developing easy-to-use data collection instruments designed to facilitate recall, providing technical assistance to participants, and allowing for ample time to estimate costs. The MOH coordinates the implementation of primary health care policy with other ministerial agencies whiles the GHS is the implementing arm of the MOH that is responsible for health service delivery in the country. Both HCs and CHPS facilities are required to only provide Out Patient Department (OPD) services. Researchers should consider whether the costs of implementing an EHR system are relevant for inclusion, and may want to keep these costs separate from other costs. Carvalho LH, editor. Respondents may have limited expertise in cost data collection and a lack of familiarity with practice costs. The NHIS accredits both public and private health facilities in the country to provide medical care at the point of service for those enrolled into the scheme . Costs may be affected by co-occurring quality improvement or other initiatives whose activities overlap with transformation efforts. Cite this article. A discount rate of 3% was chosen, which is usually the rate used in most economic evaluation studies conducted in developing countries [17,18,19,20,21]. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana. Article Is home management of fevers a cost-effective way of reducing under-five mortality in Africa? Tawiah T, Hansen KS, Baiden F, Bruce J, Tivura M, Delimini R, et al. Based on expert opinion and literature review a useful life of 5 years was used for equipment and vehicles [17, 19, 21,22,23]. Clinical impact and cost-effectiveness of antiretroviral therapy in India: starting criteria and second-line therapy. Data were captured and analysed using Microsoft excel. AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund. By using this website, you agree to our In this study, capital costs were annualized using a discount rate with their respective useful life years. One complete year data were collected to cater for seasonal variation of diseases and utilization. PW and CM contributed to the concept and design of the study, the acquisition of data, data analysis, interpretation of the data, and drafting of the manuscript. Total costs can also be classified into fixed and variable costs. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. For instance, the government spent 58% of its full-year budget for state-worker pay in the first 6 months of 2016. Even half of that $3,500 was for my computer, which you may have already. Overall, it appears the organization’s worksite clinic provides employee health care services 2 to 3 times more cost-effec-tively than do off-site health care services. Available from: https://data.worldbank.org/indicator/SH.XPD.PCAP. Data sources can include insurance claims data, general ledger data (e.g., from a staff model health maintenance organization [HMO] with many primary care clinics), or general ledger data from a grant program funding a primary care transformation effort. Administrative Costs Outstrip Other Nations. Key Characteristics of Estimating Costs Grants, Appendix B. Cost of delivering child health care through community level health workers: how much extra does IMNCI program cost? In order to determine the financial sustainability of the health facilities, information on revenue generated for the period at the health facilities were collected through review of records and interviews of key staff. Available from: https://doi.org/10.1186/s40545-016-0055-9. Health, population, and nutrition office health systems baseline survey report 2015. The good news is, funding is availabl… The life span of equipment and vehicle was also varied from 5 years to 10 years. The major ethnic groups in the region are the Dagaati, Sissala, and Wala . PubMed The Dagaati districts are made up of Daffiama Bussie Issa (DBI), Jirapa, Lambussie, Lawra, Nadowli, Nandom; Wala districts are made up of Wa East, Wa Municipality, Wa West; and the Sissala districts comprised of Sissala East and Sissala West. The health facility cost per capita per year at CHPS and HC were US$5.14(median = US$5.18; range = US$ 3.94 – US$6.67) and US$3.51(median = US$3.52; range = US$3.52 – US$3.67) respectively. Cost estimation methods can be divided into two main categories: micro-costing methods, also known as activity-based costing (ABC), which are based on a detailed analysis of resource use and unit costs of each resource; and gross-costing methods, which are based on aggregate data.9 Most AHRQ Estimating Costs grantees used an ABC method. Qadiyr Anderson says: April 25, … Krumholz AR, Stone AE, Dalaba MA, Phillips JF, Adongo PB. The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Example Data Collection Tools, Appendix B. Permission was also sought from the regional health directorate of the Upper West Region, district health directorate of Wa West, Nadowli and Sissala East as well as the heads of the health facilities included in the study. The cost components included in the analysis were: personnel cost, administrative cost, medicine and consumables cost (representing recurrent cost), cost of equipment and vehicles (representing capital cost). Estimating the cost of healthcare delivery in three hospitals in southern Ghana. PLoS One. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. These include: Another way to standardize results is to report them in standardized dollars (e.g., 2012 dollars). 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