Estimate unit cost of curative services at primary health care level in Vietnam

Abstract

Strengthening the primary health care (PHC) system in Vietnam requires insignful evaluation of resource utility and the cost reflecting all actual components those partly did not include in service charges. A study was conducted to estimate unit costs for PHC services and compared the fee-for-service (FFS) reimbursed by health insurance fund (HI). Top-down and bottom-up approaches incoporated with stepdown technique were used to analyse the unit cost for curative services only, excluded the preventive services. The unit cost for outpatient visit, inpatient bed day, surgery, laboratory test,
and image diagnosis were là 287.000VNĐ, 301.000VNĐ, 374.000VNĐ, 40.000VNĐ và 94.000VNĐ, respectively at the district hospital (DH) and the unit cost of outpatient visit, inpatient bed day, surgery at commune health centers (CHCs) were 320.000VNĐ,
776.000VNĐ, 592.000VNĐ, respectively. All unit costs were higher than FFS and the personel cost accounted for the highest share of the unit cost structure for the most clinical services, exception for inpatient bed day and surgery at CHCs. The study findings provide reliable evidence on actual unit cost of curative services of PHC for policy makers to generate the most approriate financial planning, estimation of the relevant base rate to formulate provider payment mechanism, and effective management at PHC level in Vietnam.