Introducing QI Tools and Approaches Cost-Analysis Tool APPENDIX F Session E Facilitative Supervision for Quality Improvement Curriculum 2008

Cost-Analysis Tool (CAT) Simplifying cost analysis for managers and staff of health care services

What CAT Measures Direct costs –Cost of staff time directly used to provide a service or clinical procedure – Cost of commodities, expendable supplies, and medications for a particular service or clinical procedure

What CAT Does Not Measure Start-up costs (equipment, preservice training, etc.) Depreciation Opportunity costs to clients (cost to clients for seeking services—e.g., transportation, lost wages, etc.) Quality of services provided Demand for the service Clients’ willingness and ability to pay

CAT Can Be Used to: Set user fees for different services Negotiate subsidies Compare costs of changes in type of procedure and provider (Such decisions must be based on good medical practice, client’s situation, etc.)

CAT: Sample Results for IUD Insertion Total cost of staff time= 6.85 Rupees Cost of expendable supplies = 7.5 Rupees Cost of IUD= 100 Rupees Total direct costs= Rupees Fee the client is charged for the service = 6 Rupees

Who Benefits from Using CAT? Headquarters, donor organizations Site administrators Service providers and staff Clients

How Often Should CAT Be Used? One or two times a year, when there are changes in: Cost of supplies (due to inflation, availability, etc.) Staff salaries (due to salary increases, changes in staffing, etc.) Services offered (due to services being reorganized or new services begun) Client load

Action Plans INFO District Supervisor’s Plan Community Action Plan COPE ® Action Plan Site Training Plan Cost Analysis Plan

The QI Process Information gathering and analysis Action plan development and prioritization Implementation Follow-up/ evaluation