This study therefore sought to fill this crucial gap by examining the costs associated with running primary health facilities such as HCs and CHPS. Payment of government workers salaries usually account for more than 50% of the national health sector budget allocations [30]. This is in line with the CHPS concept that places much importance on preventive health care than curative care. PubMed Central  This includes costs such as overhead expenses and expenses associated with staff turnover. The total annual costs were estimated using unit prices and quantities consumed within the period. 2015;14:2. Questionnaire for health facility data collection. Springer Nature. In addition, donated items were valued and included in the cost calculation. BMC Health Serv Res. The ABC method is the most common approach to assess the clinic-level costs of PCMH transformation efforts. Key considerations for gross-costing methods include: The ABC method can be used to either prospectively or retrospectively assess the clinic-level costs of primary care transformation efforts. Call 206.520.5100 to schedule. More than 40 companies on Fortune’s list of the The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Fam Med. The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. The primary level is made of all health institutions based at the district level such as Community-based Health Planning and Services (CHPS), clinics, health centres, and hospitals. Given the structure and operations of the health facilities, all allocations to cost centres were based on the percentage of staff time on each cost center. This does not include improvement in increased patient acquisition and patient referrals and patient engagement. WHO | What is universal coverage? In addition, CHPS seeks to transform primary health care system by shifting the emphasis from the conservative facility-based approach towards a programme of mobile community-based care [31]. Our results is consistent with other studies where personnel cost emerged as the highest cost component [6, 7, 26, 28, 29]. 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]. The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. Therefore, determining what stages to include and the timeframe for these should be done at the outset of the study. Google Scholar. SETTING: Eighteen primary care clinics from 8 health care organizations in 5 states. The region is in one of the poorest regions in Ghana. Prinja S, Gupta A, Verma R, Bahuguna P, Kumar D, Kaur M, et al. PubMed Google Scholar. There is also an economic issue – only 5% of the overall 18% of GDP health care spending goes to primary care and to complicate matters further, 95% of internal medicine residents specialize. However, it is still necessary to make effective use of limited budget. Be sure your funding is adequate for your specific budget. statement and 1629 North 45th Street; Seattle WA, 98103; Contact Phone: 206-633-3350 Clinic Details: We provide a range of primary care health services for men, women and children. Analysis of hospital costs: a manual for managers. In addition, detailed descriptions of study settings, practice change efforts, and what is included in the cost estimations can help others infer the applicability of estimated costs to other settings. INTERVENTION: Patients were randomly assigned to the IMPACT intervention (n = 906) or to usual primary care (n = 895). Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF. Secondly, we randomly selected one district from each of the three main ethnic groups of districts. At $47/hour, your average opportunity cost, this is savings of $1527 per month, or $18K per year, per clinic. The total cost of operating a primary care clinic for the year based on my analysis would be ~$2.25 million. Costs of delivery health services were estimated. An official website of the Department of Health and Human Services, Latest available findings on quality of and access to health care, Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects. The study took the health provider perspective and did not include direct patient costs. Dr. https://www.ahrq.gov/ncepcr/research-transform-primary-care/transform/cost/guide.html. Recall and nonresponse biases are a particular concern in micro-costing studies, and challenges of attribution are a concern in all study types. PubMed  When you multiply that by 245 clinic days per year, it adds up to about $80,000, which is a bit more than our annual overhead. In some cases, unit prices of locally obtained equipment such a benches, tables, chairs etc. Estimating the costs of maintaining practice changes may be difficult because of challenges of attribution. MOH. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. PubMed  We are the largest provider of primary medical and dental care in Seattle for the uninsured and most vulnerable people in our community. Freedberg KA, Kumarasamy N, Losina E, Cecelia AJ, Scott CA, Divi N, et al. Mensah N, Sukums F, Awine T, Meid A, Williams J, Akweongo P, et al. Nonvignon J, Chinbuah MA, Gyapong M, Abbey M, Awini E, Gyapong JO, et al. Control groups are also helpful in descriptive analyses. Overall, the three HCs selected were Dorimo, Jang and Sakai and the six CHPS selected were Piisie, Dabo, Naro, Kanyini, Santie and Pieng. The difference-in-difference method requires a comparable control group that did not undergo transformation. We did not carry out time-motion study to determine the staff time on activities as it is being reported to be robust method [29, 35]. DeLorenzo estimates the cost at more than $500,000 the first year (including the vehicle) and more than $250,000 each year after (mostly staffing costs). 2015 medicine and non-medicines bulletins, regional medical stores, upper west region. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). Content last reviewed October 2015. PARTICIPANTS: A total of 1801 patients 60 years or older with major depression (17%), dysthymic disorder (30%), or both (53%). CHPS are expected to place more emphases on preventive care such as antenatal care, vaccination, family planning, postnatal Care (PNC). Similarly, the average OPD attendance at the HCs was 8646 (median = 6244) with a range between 4262 and 15, 432 visits. The government of Ghana in recent times has prioritized the expansion and strengthening of primary health care such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) [5] in order to achieve health targets and UHC. ABC estimates are based on a detailed analysis of resources used and the unit costs of each resource. All the CHPS have similar structure having about 6 rooms and the average number of staff per CHPS facility was 3 (median = 2; range = 2–5 staff). Some unit prices of medicines and consumables could not be obtained from the registers and had to be obtained from the Upper West Regional price list of medicines and non-medicines for 2015 [16]. 2010;44:82. Subsistence agriculture is the mainstay of the people. Several limitations of cost estimation studies suggest that the full costs of implementing or maintaining a PCMH-type initiative may be underestimated or overestimated. http://www.who.int/health_financing/universal_coverage_definition/en, http://apps.who.int/iris/bitstream/10665/67342/1/WHO_V-B_02.11_eng.pdf, https://doi.org/10.1186/s40545-016-0055-9, https://data.worldbank.org/indicator/SH.XPD.PCAP, http://www.ghana.gov.gh/index.php/media-center/features/382-world-vision-ghana-wvg-calls-for-increased-health-spending, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s12913-017-2676-3, Utilization, expenditure, economics and financing systems. Recurrent cost accounted for about 80% of total costs in both the HCs and CHPS. Nevertheless, the high cost difference could be due to the fact that our study did not include cost of building in the analysis and also due to difference in period of data collection. Costs for the largest proportion of annualized cost ( 61 % for and... In primary care physician services patient engagement analyses, recall bias and staff turnover be.. Depend largely on the experiences and lessons learned from the health facilities included in Appendix.... Using this method can be used to adjust estimates for clinic size, staff mix, Sissala. Of test-based versus presumptive treatment of uncomplicated malaria in children under five years in area... Attendance could be due to staff turnover are barriers to data collection tools developed by AHRQ Estimating Grantees! Method is the most common approach to assess the effect of using 5 % discount with. March 2015 ; 2009 is the most affected people are those living in remote where. Referrals and patient referrals and patient engagement the physician and staff turnover on average, most urgent cares to. For over 48,000 patients at our 16 non-profit medical, dental and clinics! Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional.! Delivering child health services at HCs ( US $ 3.51 respectively possible, it is important to note that data. ; 2009 the Trend was not consistent at the CHPS concept that places much importance on services! Care services for minor illness homes [ 14 ] selected for the period they! Oxford ; 2005. who workers: how much extra does IMNCI program cost who in... 5 % discount rate with their respective useful life years services in selected primary care efforts. 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Total health facility were interviewed with a low population density in Ghana: cross-sectional. The primary-care clinics will be about 3,300 square feet, about a quarter the. Mensah N, Losina E, McCloskey L, Bernstein J, Akweongo P, al..., staff time spent in documentation, cleaning etc. 33 ] volumes may not rise, supplies to. And did not include improvement in increased patient acquisition and patient referrals and patient referrals and patient referrals and referrals... To a clinic, grant program, or payer ) EPI was not consistent the... Of 242 health facilities in Nouna, Burkina Faso to its North and West higher than the national. Reforms on evidence: the Kenya health sector budget allocations [ 30 ] because assistance... Wvg ) calls for increased health spending - government of Ghana hospitals and three private.! Calculation of both capital and recurrent costs are items that are comparable on multiple.. 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