Introducing QI Tools and Approaches Cost-Analysis Tool

1. Introducing QI Tools and ApproachesCost-Analysis Tool APPENDIX FSession E Facilitative Supervision for Quality Improvement Curriculum 2008

2. Cost-Analysis Tool (CAT) Simplifying cost analysis for managers and staff of health care services

3. What CAT Measures • Direct costs • Cost of staff time directly used to provide a service or clinical procedure • Cost of commodities, expendable supplies, and medications for a particular service or clinical procedure

4. What CAT Does Not Measure • Start-up costs (equipment, preservice training, etc.) • Depreciation • Opportunity costs to clients (cost to clients for seeking services—e.g., transportation, lost wages, etc.) • Quality of services provided • Demand for the service • Clients’ willingness and ability to pay

5. CAT Can Be Used to: • Set user fees for different services • Negotiate subsidies • Compare costs of changes in type of procedure and provider (Such decisions must be based on good medical practice, client’s situation, etc.)

6. CAT: Sample Results for IUD Insertion • Total cost of staff time = 6.85 Rupees • Cost of expendable supplies = 7.5 Rupees • Cost of IUD = 100 Rupees • Total direct costs = 114.35 Rupees • Fee the client is charged for the service = 6 Rupees

7. Who Benefits from Using CAT? • Headquarters, donor organizations • Site administrators • Service providers and staff • Clients

8. How Often Should CAT Be Used? One or two times a year, when there are changes in: • Cost of supplies (due to inflation, availability, etc.) • Staff salaries (due to salary increases, changes in staffing, etc.) • Services offered (due to services being reorganized or new services begun) • Client load

9. Action Plans COPE® Action Plan District Supervisor’s Plan INFO Site Training Plan Community Action Plan INFO Cost Analysis Plan

10. The QI Process Information gathering and analysis Follow-up/ evaluation Action plan development and prioritization Implementation