Unit cost analysis of medical service in asia: A systematic review

Abstract

Nowadays, WHO encourages all nations to employ universal health coverage (UHC). In order to achieve this goal, many things should be considered, since healthcare financing methods and efficiency management are pivotal. The reimbursement rate setting is essential for this matter since it should cover the healthcare cost of beneficial package under the UHC. For the providers (hospitals), financial sustainability depends on a balance of income/ revenue and expenditure/cost, since income is based on budgeting/ financing system, if it is performance-based system. Cost per performance or unit cost is a principal for estimating the budget or payment in case of fee-for-service. This study aimed to explore situation and methodologies of cost analysis of hospital medical services in Asia. This study was designed as a systematic review following the PRISMA guidelines covering research reports during 1997–2016 in the PubMed database. Based on the selection criteria, from 426 records, 18 articles were included to this study, 7 articles were excluded because they were published before 1997. The number and quality of the unit of medical service cost analysis in Asia are not as high as expected. The scope of the research that affects the choice of the costing methodology, such as objective, type of cost, perspective, and provider type, could not be found in some articles. While the common used costing methodology is micro costing or activity based costing (ABC), some studies proposed other approaches that need to be developed to find out a better costing methodology.