Cost estimation of inpatient trauma units in specialized hospitals

Abstract

Background: The incidence of death and illness due to external causes among the population of Mongolia has increased dramatically in recent years, and accidents are the 5th cause of illness and the 3rd cause of death as of 2020. In 2020, 142.761 new accidents and 2736 deaths were registered in Mongolia. It is important to determine the base rate of the hospitals to be financed from the health insurance and the state budget at the industry level by determining the percentage of the costs of accident care services, wages per unit cost, medicine, transportation, fuel, etc. Aim: To calculate the average cost per day of each inpatient ward of the National Trauma and Orthopedic Research Center Materials and Methods: In conducting the research, quantitative research data was collected using a descriptive model. In the study, based on the 2020 financial reports and statistical reports of the National Health Service, a cost analysis was performed and the cost of each inpatient ward was calculated using the traditional method of costing or the top-down method. Results: The total number of inpatient care beds at the National Trauma and Orthopedic Research Center was 121.605 with an average of 8.6 bed days. 14 percent of the total number of beds in inpatient care are occupied by the microsurgery department for hand and paw rehabilitation, 12 percent by the burn rehabilitation department, and the cranial brain injury department. Determining the total costs of the organization’s 2020 financial report and classifying the costs into direct and indirect costs, 52 percent of the total costs are direct costs and 48 percent are indirect costs. When direct costs are directly assigned to cost centers and indirect costs are allocated to cost centers using a cost guide, the main service cost center accounts for 33.3 percent of direct costs and 76.5 percent of indirect costs. The average cost per day of inpatient wards ranges from 147.098 MNT to 918.931 MNT. Conclusion: When calculating the cost of departments using the top-down costing method, the intensive care unit has the highest cost, and the average cost of all departments is 272.583 MNT. Direct labor costs account for 18 percent of the average cost, and drug costs account for 11 percent.