Gap analysis: Assess unmet need in the community Assess current utilization of Infrastructure and...
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Transcript of Gap analysis: Assess unmet need in the community Assess current utilization of Infrastructure and...
Gap analysis: Assess unmet need in the community Assess current utilization of Infrastructure and
Resources Set Targets:
Based on community need Lead to optimum utilization
Strategic approaches to achieve targets Financial viability: what it takes to provide
services/achieve targets and how to meet the expenditure
Assumptions about the environment Assumptions about the Mission Assumptions about the core
competence
Applying it to the “Present” and “Future”
Relevance Standardisation of processes and
protocols Ensure service uptake levels Quality of diagnosis & treatment Patient comfort Outcome
Helps in: Instrumentation Training Patient flow Quality improvements Patient’s understanding & co-operation
Performance Addressing challenges Monitoring changes & variations Review effectiveness of the strategies
& introduce necessary changes to programme implementation
Cost Containment
Improve Resourc
e Utilizati
on
Implement Low-cost
Technologies
e.g. Surgeries/SurgeonOperations/bed/year
e.g. Surgeries/SurgeonOperations/bed/year
e.g. Sutures, Eye drops, IOL/Specs, Maintenance
e.g. Sutures, Eye drops, IOL/Specs, Maintenance
Fixed Cost
Variable Cost
Revenue Generation
Self Generate
d
Other Sources
Subsidy/Donation
e.g. Rich patients, Support services, Spectacles
e.g. Rich patients, Support services, Spectacles
e.g. Govt, Local NGO, Community
e.g. Govt, Local NGO, CommunityPatient
Generated
Revenue
Subsidy Other
countries
e.g. Multilateral, Bilateral, INGO
e.g. Multilateral, Bilateral, INGO
Subsidy Nationa
l
Self-reliance Ext. Dependence
Continually refine pricing &management processes
Diversify the portfolio
Sustainability Process
Maximize Revenue
Minimize costs
Revenue > Cost of eye care services
Tension: Social obligation
Tension: Quality & Patient Satisfaction
Scale: Investment in infrastructure, size of the facility and staffing are the major determinants
Efficiency Optimum utilization of the
infrastructure Seasonal variations in patient load Staffing & Staff utilization pattern Productivity
Logistics driven good inventory management group purchasing for better price Good materials management (reduce
wastage in storage & pilferage) Cost engineer your clinical protocol
Eliminating unnecessary investigations, procedures & medications
Hospital’s perspective:
Hospital Charges Medication ??
Patients’ perspective:
Cost of care Transportation Food Lost wages Cost of accompanying
person Family visits Follow-up visits Restrictions
Total Beds: 63 + 100 Total Beds: 63 + 100 •PayingPaying : 40 (22 %): 40 (22 %)•Free walk-inFree walk-in : 23: 23•CampCamp : 100: 100
Location: 80 km, west of Madurai 80 km, west of Madurai Service area populationService area population•Theni DistrictTheni District : 1 million: 1 million•City PopulationCity Population : 111,500: 111,500•Kerala districtsKerala districts : 3.2 million : 3.2 million
55% of population in rural area55% of population in rural areaHuman Resources:Human Resources:OphthalmologistsOphthalmologists : 2: 2ResidentsResidents : 7: 7Clinical staffClinical staff : 37: 37Administrative staffAdministrative staff : 29: 29
Services offered:Services offered:Cataract; Refractive Errors; Cataract; Refractive Errors; Glaucoma; Medical Retina & Glaucoma; Medical Retina & LasersLasers
Patient Fee Strucutre (US$): Patient Fee Strucutre (US$): OP Consultation: OP Consultation: Paying: 1.00; Walk-in: FreePaying: 1.00; Walk-in: FreeCataract: Cataract: •Camp: US$ 0 (- US$ 6)Camp: US$ 0 (- US$ 6)•Subsidized: US$ 17Subsidized: US$ 17•Paying: US$ 30 - $ 380Paying: US$ 30 - $ 380
PayingFree Hospital
TotalSubsidised Camp
Cataract Surgeries 2,008 1,841 3,707 7,556Fixed Costs $ 150,630 - $ 150,630Variable Costs $ 40,965 $ 10,958 $ 35,305 $ 87,228Total Cost $ 191,595 $ 10,958 $ 35,305 $ 237,858Unit Cost $ 95 $ 6 $ 10 $ 32Fee/Subsidy per case 122 12 14 Contribution per case $ 27 $ 6 $ 4 Total Surplus $ 54,216 $ 11,046 $ 14,828 $ 80,090
32%
All Financial figures are in US$
Capital cost: Cost of Land, Building, major equipment, etc
Recurring cost: Ongoing cost of providing the services Fixed Cost: Costs that have to be incurred
regardless of the level of activity Variable cost: Costs that vary directly with
the level of activity Unit cost: (Fixed cost + variable cost) per
unit of service