ต้นทุนฐานกิจกรรมของการบริการแพทย์ทางไกลโรงพยาบาลบ้านโคก จังหวัดอุตรดิตถ์

Abstract

Activity-based costing (ABC) data is valuable for hospital administrators for achieving a balance between costs and revenues generated by telemedicine services. This study aims to analyze the ABC of telemedicine services at Bankhok Hospital, Uttaradit Province, and compare it with the budget allocated by the National Health Security Office (NHSO). The sample group consisted of telemedicine activities for new and old patients with diabetes or hypertension in the outpatient department of the hospital. Sample size was estimated using time-study principles. The research instruments included: 1) a dictionary of telemedicine activities at Bankhok Hospital, Uttaradit Province, 2) a time recording form, and 3) a cost recording form. The instruments were validated for content validity by three experts and tested for inter-rater reliability by the data collectors. The inter-rater reliability coefficient was 1.00. The accuracy of the cost data recording was verified by having the hospital finance and supplies staff recheck the data. The data was analyzed using descriptive statistics.

The results of the study found the following. 1. The unit cost of telemedicine services for a patient with chronic non-communicable diseases is 264.37 baht, which can be divided into a direct cost of 222.96 baht (84.34%) and an indirect cost of 41.41 baht (15.66%). This also includes labor costs of 191.48 baht (72.43%), material costs of 51.54 baht (19.50%), utility costs of 16.14 baht (6.10%), and capital costs of 5.21 baht (1.97%). 2. The unit cost of telemedicine services for a new patient with non-communicable diseases is higher than the unit cost for an old patient by 63.26 baht. The unit cost of telemedicine services for a new patient is 264.37 baht and the unit cost for an old patient is 201.11 baht. When compared to the reimbursement rate of 100 baht for telemedicine services from the National Health Insurance Office (NHI), the total cost of telemedicine services for new patients is 164.37 baht higher than the NHI reimbursement rate, and the total cost for old patients is 101.11 baht higher than the NHI reimbursement rate. The results of this study provide valuable information for hospital administrators which can be used to develop strategies to reduce the cost of telemedicine services at Bankhok Hospital, Uttaradit Province. These findings may also be used in negotiations with the NHSO to increase reimbursement rates for telemedicine services.