1 / 24

Costing disease management in the state sector Policy implications

Learn how to cost the management of specific diseases in state sector hospitals to improve efficiency and containment. Compare cost components for Lower Segment Cesarean Section in Sri Lankan hospitals. Explore the importance of standardizing treatment processes for accountability and good governance.

nkang
Download Presentation

Costing disease management in the state sector Policy implications

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Costing disease management in the state sector Policy implications JICA EBM STUDY GROUP

  2. Introduction • State borne cost of healthcare substantial • Rise in healthcare costs due to health transition • Sustainability of the health system is a challenge amidst growing alternative demands

  3. Objective • To describe and demonstrate the methodology of costing the management of specific diseases in the state sector hospitals • To develop a framework for cost analysis to improve efficiency and cost containment in the health sector

  4. Introduction • Diseases have wide clinical spectrums • Protocols should cover each level of severity of the disease • Protocol based management of diseases and health events - a cornerstone of accountability

  5. Introduction • Efforts to streamline disease management lead to concerns among medical practitioners and patients • Protocol development need to be a priority of our curative sector

  6. Standardization of the treatment process helps in cost estimation • Possibility of cost estimation is a basis for accountability – a mark of good governance

  7. Objective • To compare the cost components in the management of Lower Segment Cesarean Section (LSCS) in three state sector hospitals in Sri Lanka

  8. Methods • Descriptive cross sectional study • September-December 2006 • Three hospitals • BH, Kuliyapitiya • TH Kurunegala • CNTH, Ragama

  9. Methods • Five diseases/ interventions • Lower Segment Cesarean Section • Ischaemic Heart Disease • Bronchial Asthma • Acute Myocardial Infarction • Excision of Breast Lump

  10. LSCS • Inclusion criteria • Elective LSCS after 36/52 POA • For: • Foetal complications • Maternal complications not needing special care • No post operative complications

  11. Methods • In the absence of protocols identification of cost items involved studying details of the disease management process • Data extraction forms – developed and pre-tested • Retrospective/ prospective data collection • Using Bed Head Tickets • Time study - observation

  12. Methods • Time study • Observation of procedures and interventions in the ward setting • Timing of activities • Recording the personnel involved

  13. Results • Sample size = 120 • 99.2% had spinal anaesthesia • 100% had IV antibiotics and oxytocin (to prevent bleeding) during the surgery

  14. ResultsCardiotocogram (CTG)

  15. Duration of hospital stay

  16. Length of pre-operative stay

  17. Time spent in the OP theatre

  18. Duration of post-operative observation

  19. Length of post-operative stay

  20. Discussion • The variation in these components may be due to resource related reasons or individual decisions • Disease management protocols can standardise the treatment maintaining quality of care and improving efficiency

  21. Discussion • Methodological issues of protocol development • Covering the entire disease spectrum • Evidence from other settings for comparable treatment choices • Research in our healthcare setting

  22. Discussion • Policy issues related to protocol development • Development of protocols by medical professionals through respective colleges • Acceptance of protocols • Adherence to protocols in practice

  23. Acknowledgements • Members of the JICA EBM team • Administrative authorities of the three hospitals • Dr Amala de Silva • Prof Rajitha Wickremasinghe

More Related