Agrawal Nitin, Sharma Nishant, Jamwal Tilotma, Singh Kshitija, Siddharth Vijaydeep, Satpathy Sidhartha
Max Super-Speciality Hospital, Shalimar Bagh, Delhi, India.
Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
PLoS One. 2025 Jan 13;20(1):e0306159. doi: 10.1371/journal.pone.0306159. eCollection 2025.
Establishing and maintaining gamma knife facility incurs significant costs, mandating healthcare institutions to meticulously assess financial implications for sustainability.
This study explores the financial implications of setting up and operating a Gamma Knife facility, with an aim to ascertain user charges for achieving breakeven. The study was conducted from January to June 2019 at the largest neurosurgery centre of an Institute of National Importance (INI), in Delhi, India. Applying both Traditional and Time-Driven Activity-Based Costing (TD-ABC) methodologies, capital and operating expenses were calculated. (1US$ = INR 70.4 -Average value for the year 2019).
The average cost per gamma knife radio surgery procedure was calculated to be US $2,469 (INR 1,73,832), with major costs attributed to machinery & equipment (43.6%), followed by manpower (32.5%), electricity (9.67%), equipment maintenance (8.61%) etc. The initial investment to establish a Gamma Knife facility is significantly higher with an MRI unit (Model A) at US $ 9,836,423 (INR 69,24,84,164) compared to one without (Model B) at US $7,294,986 (INR 51,35,66,988). Currently, the patient has to pay US $1,065 (INR 75,000) for a gamma knife radio surgery, which poses a challenge for achieving breakeven since the variable cost for the same is US $1,367 (INR 96,239) per procedure.
The study serve as a tool for strategic planning, pricing adjustments, and enhancing operational efficiencies, thus ensuring that such high-end technologies can be sustainably integrated into the public healthcare landscape of a developing country like India.
建立和维护伽马刀设备会产生巨大成本，这就要求医疗机构仔细评估财务影响以确保可持续性。
本研究探讨建立和运营伽马刀设备的财务影响，旨在确定实现收支平衡的用户收费标准。该研究于2019年1月至6月在印度德里一所具有国家重要地位的研究所最大的神经外科中心进行。应用传统成本法和时间驱动作业成本法（TD - ABC）计算资本和运营成本。（1美元 = 70.4印度卢比 - 2019年平均价值）。
伽马刀放射外科手术的平均成本计算为2469美元（173832印度卢比），主要成本归因于机械设备（43.6%），其次是人力（32.5%）、电力（9.67%）、设备维护（8.61%）等。与不配备MRI单元的伽马刀设备（B型）相比，配备MRI单元（A型）的伽马刀设备初始投资显著更高，分别为9836423美元（692484164印度卢比）和7294986美元（513566988印度卢比）。目前，患者进行一次伽马刀放射外科手术需支付1065美元（75000印度卢比），但由于每次手术的可变成本为1367美元（96239印度卢比），这给实现收支平衡带来了挑战。
该研究可作为战略规划、价格调整和提高运营效率的工具，从而确保此类高端技术能够可持续地融入印度这样的发展中国家的公共医疗体系。
