加纳初级卫生设施提供医疗保健服务的成本。
Cost of delivering health care services at primary health facilities in Ghana.
作者信息
Dalaba Maxwell Ayindenaba, Welaga Paul, Matsubara Chieko
机构信息
Navrongo Health Research Centre, Box 114, Navrongo, Ghana.
Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
出版信息
BMC Health Serv Res. 2017 Nov 17;17(1):742. doi: 10.1186/s12913-017-2676-3.
BACKGROUND
There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs) and Community-based Health Planning and Services (CHPS) in Ghana.
METHODS
The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs) from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD) attendance were estimated.
RESULTS
The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC). The cost per OPD attendance was higher at CHPS (US$8.79) than at HCs (US$5.16). The average Internally Generated Funds (IGF) recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS) reimbursement was the main source of revenue accounting for over 90% total IGF.
CONCLUSIONS
The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar studies involving large numbers of primary health facilities in different parts of the country are needed to assess the cost of providing primary health care.
背景
关于加纳初级卫生保健机构提供卫生服务的成本，人们了解有限，这给资源分配带来了挑战。因此，本研究估算了加纳初级卫生保健机构（如健康中心（HCs）和社区卫生规划与服务（CHPS））提供卫生保健的成本。
方法
本研究为横断面研究，从卫生服务提供者的角度收集定量数据。2016年7月至8月期间，在加纳上西部地区的九个初级卫生设施（六个CHPS和三个HCs）收集数据。收集了2015年的所有卫生相关成本以及该期间产生的收入。使用Microsoft excel捕获和分析数据。估算了提供卫生服务的成本。此外，还估算了单位成本，如每个门诊部（OPD）就诊的成本。
结果
通过CHPS和HCs提供卫生服务的平均年度成本分别为10,923美元和44,638美元。人员成本占成本的最大比例（CHPS为61%，HCs为59%）。CHPS的每个OPD就诊成本（8.79美元）高于HCs（5.16美元）。该期间CHPS和HCs记录的平均内部生成资金（IGF）分别为2327美元和15,795美元。在所有设施中，IGF远低于运营卫生设施的成本。此外，在CHPS和HCs，国家健康保险计划（NHIS）报销是主要收入来源，占IGF总额的90%以上。
结论
通过CHPS和HCs提供初级卫生服务的平均年度成本分别为10,923美元和44,638美元，人员成本是主要成本。政府在进行财务规划、决策和资源分配时应参考这些研究结果，以改善该国的初级卫生保健。然而，需要更多涉及该国不同地区大量初级卫生设施的类似研究来评估提供初级卫生保健的成本。
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