Download presentation
Presentation is loading. Please wait.
Published byValerie Bridges Modified over 9 years ago
1
Costing disease management in the state sector Policy implications JICA EBM STUDY GROUP
2
Introduction State borne cost of healthcare substantial Rise in healthcare costs due to health transition Sustainability of the health system is a challenge amidst growing alternative demands
3
Objective To describe and demonstrate the methodology of costing the management of specific diseases in the state sector hospitals To develop a framework for cost analysis to improve efficiency and cost containment in the health sector
4
Introduction Diseases have wide clinical spectrums Protocols should cover each level of severity of the disease Protocol based management of diseases and health events - a cornerstone of accountability
5
Introduction Efforts to streamline disease management lead to concerns among medical practitioners and patients Protocol development need to be a priority of our curative sector
6
Standardization of the treatment process helps in cost estimation Possibility of cost estimation is a basis for accountability – a mark of good governance
7
Objective To compare the cost components in the management of Lower Segment Cesarean Section (LSCS) in three state sector hospitals in Sri Lanka
9
Methods Descriptive cross sectional study September-December 2006 Three hospitals –BH, Kuliyapitiya –TH Kurunegala –CNTH, Ragama
10
Methods Five diseases/ interventions –Lower Segment Cesarean Section –Ischaemic Heart Disease –Bronchial Asthma –Acute Myocardial Infarction –Excision of Breast Lump
11
LSCS Inclusion criteria –Elective LSCS after 36/52 POA –For: Foetal complications Maternal complications not needing special care –No post operative complications
12
Methods In the absence of protocols identification of cost items involved studying details of the disease management process Data extraction forms – developed and pre-tested Retrospective/ prospective data collection –Using Bed Head Tickets –Time study - observation
13
Methods Time study –Observation of procedures and interventions in the ward setting –Timing of activities –Recording the personnel involved
14
Results Sample size = 120 99.2% had spinal anaesthesia 100% had IV antibiotics and oxytocin (to prevent bleeding) during the surgery
15
Results Cardiotocogram (CTG)
16
Duration of hospital stay
17
Length of pre-operative stay
18
Time spent in the OP theatre
19
Duration of post-operative observation
20
Length of post-operative stay
21
Discussion The variation in these components may be due to resource related reasons or individual decisions Disease management protocols can standardise the treatment maintaining quality of care and improving efficiency
22
Discussion Methodological issues of protocol development –Covering the entire disease spectrum –Evidence from other settings for comparable treatment choices –Research in our healthcare setting
23
Discussion Policy issues related to protocol development –Development of protocols by medical professionals through respective colleges –Acceptance of protocols –Adherence to protocols in practice
24
Acknowledgements Members of the JICA EBM team Administrative authorities of the three hospitals Dr Amala de Silva Prof Rajitha Wickremasinghe
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.