Thesis (M.Sc.)--Chulalongkorn University, 2007

To analyze the cost profile and unit cost of health services of Gaafu Dhaalu Regional Hospital/ Maldives, for the year 2007.The study was a retrospective study conducted in provider’s perspective. The hospital sections are divided into 18 cost centres and clustered into four groups of cost centres, namely non revenue producing cost centre (NRPCC), revenue producing cost centre (RPCC), patient services (PS) and non- patient services (NPS). Data recording forms are used to collect data for the period of 2007 and data information was compiled as three groups, labour cost, material cost and capital cost. The total costs were allocated using step-down technique of allocation with in-cooperated allocation criteria’s, defined according to the activities of the cost centres. Study results show that the total direct cost of the Hospital in 2007 is Rf 18, 596, 887.81with a total operating cost of Rf 16,068,752.84. The total direct cost comprise of Labour cost Rf 10,638,243.10, material cost Rf 5,278,083.75, and capital depreciated cost as Rf 5,430,509.75, respectively. The unit cost of Outpatient department, Observation room, Dressing room and Dental department are, Rf 232, Rf 821, Rf 178, Rf 514, respectively. The unit cost of an inpatient admission for Male Ward, Female Ward, Surgical Ward Paediatric Ward and Intensive care unit are, Rf7, 687, Rf4, 097, Rf 6, 910, Rf2312 and Rf10, 558 respectively. The unit cost of per inpatient days of ward, were, Rf 3,106, Rf 1,280, Rf2, 158, Rf 907 and Rf 3,508 respectively. The high unit costs and low hospital performance indicators suggest low utilization of health services in GDH Regional Hospital in the year 2007. Moreover study result implies the presence of inefficiency in resource allocation and wastage in the hospital, which may be due to problems in the referral system as well as human resource management of the health care system in Maldives. The study presents recommendations to the policymakers and hospital administrators on improving these areas to work towards achieving quality and standard provision of health care.