A practical guide to the principles and methods of cost analysis as
a managerial tool for improving the efficiency of hospitals.
Addressed to managers and administrators, the manual aims to equip
its readers with the knowledge and skills needed to calculate the
costs of different activities or departments, analyze their
significance, and use this information to manage resources wisely.
Throughout, recommendations and advice are specific to the
different purposes of cost analysis and the different types of
decisions commonly facing managers. The manual, which is intended
for use as a training tool, was finalized following extensive
field- testing in workshops in Bangladesh, Egypt, and Zimbabwe.
Methods of cost-finding and cost analysis are thoroughly explained
and illustrated with practical examples and model step-by-step
procedures for performing calculations. Since hospital accounting
systems in developing countries may have gaps or inaccuracies, the
manual gives particular attention to reliable methods for
estimating costs when existing data are problematic. The manual
opens with an explanation of the many advantages of using
cost-finding and cost analysis as managerial tools. These include
the provision of data needed for informed decisions on operations
and infrastructure, investment, the planning of future budgets, the
establishment of charges for patient services, and the development
of mechanisms for ensuring that costs do not exceed available
revenues and subsidies. Against this background, the core of the
manual is presented in three chapters. The first, and most
extensive, chapter explains how to allocate costs to cost centers
and how to compute unit costs. Information and examples are
presented according to seven steps. Each is discussed in terms of
the types of data needed, how component cost items should be
treated, and how costs can be computed in particular situations or
cases. Practical examples are used to illustrate the types of
questions addressed in cost analysis and the value of this
information in guiding decisions. Chapter two explains how cost
data can be used to improve the management of an individual
hospital. Information is intended to guide decisions at both the
cost center, or department, level and the hospital level.
Managerial tasks covered include: budgeting; profitability;
efficiency improvements; contracting outside services or producing
in-house; and assessing fiscal solvency. Chapter three considers
the use of cost data in managing national and regional hospital
systems. Specific applications include improvements in the referral
system, the appropriate use of different providers of services, and
the comparison of similar hospitals to identify inefficiencies or
sources of waste. The manual concludes with a series of practical
exercises, followed by explanations of their answers.
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