UNIT COST ANALYSIS AND APPLICATION OF UNIT COST ANALYSIS ON CURATIVE SERVICES AT PRIMARY HEALTH CARE LEVEL
Main Article Content
Abstract
The systematic review research analyzed the overall system by gathering documents from various
sources from January 2010 to June 2022 to describe the accounting methods for the unit cost of
curative services at health facilities and its application at the primary healthcare level. Unit cost
analysis applied to medical facilities has been widely deployed in many countries around the world.
The bottom-up cost analysis study provided more accurate results but was not widely applied. The
combination of both top-down and bottom-up methods has been curently a solution to overcome the
limitations of these methods. In Vietnam, unit cost analysis applied at primary health care was still
limited in number of issues and mainly focus on setting of service prices and costs of diseases.
Article Details
Keywords
Medical costs, unit cost, medical examination and treatment service, primary healthcare level.
References
[1] R. K. Buccheri and C. Sharifi, “Critical Appraisal
Tools and Reporting Guidelines for EvidenceBased Practice,” Worldviews Evid Based Nurs,
vol. 14, no. 6, pp. 463–472, 2017, doi: https://doi.
org/10.1111/wvn.12258.
[2] S. Mayer, C. Fischer, I. Zechmeister-Koss,
H. Ostermann, and J. Simon, “Are Unit Costs
the Same? A Case Study Comparing Different
Valuation Methods for Unit Cost Calculation of
General Practitioner Consultations,” Value in
Health, vol. 23, no. 9, pp. 1142–1148, Sep. 2020,
doi: 10.1016/j.jval.2020.06.001.
[3] B. Fautrel, A. Boonen, M. de Wit, S. Grimm, M.
Joore, and F. Guillemin, “Cost assessment of health
interventions and diseases,” RMD Open, vol. 6,
no. 3, 2020, doi: 10.1136/rmdopen-2020-001287.
[4] O. B. Acheampong et al., “Costing of Health
Services for Provider Payment: A Practical
Manual Based on Country Costing Challenges,
Trade-offs, and Solutions,” Joint Learning
Network for Universal Health Coverage, p. 93,
2014, doi: http://www.jointlearningnetwork.org/
resources/costing-manual-tool-kit.
[5] T. Q. Vo, U. Chaikledkaew, M. van Hoang, and
A. Riewpaiboon, “Healthcare costing studies in
developing countries: A systematic review in
Vietnam,” Int. J Pharm Sci Rev Res, vol. 39, no.
2, pp. 295–299, 2016.
[6] M. F. Drummond, M. J. Sculpher, K. Claxton, G.
L. Stoddart, and G. W. Torrance, Methods for the
economic evaluation of health care programmes.
Oxford university press, 2015.
[7] M. Z. Younis, S. Jaber, A. R. Mawson, and M.
P.N. Ha, D.T. Nam. / Vietnam Journal of Community Medicine, Vol 63, No 5 (2022) 1-109
Hartmann, “Estimating the unit costs of public
hospitals and primary healthcare centers,” Int J
Health Plann Manage, vol. 28, no. 4, pp. 320–
332, 2013.
[8] G. Porter Purvis, H. T. H. Nguyen, and X. T.
Nguyen, “Chương 4: Quản lý tài chính bệnh
viện,” in Một số kiến thức cơ bản về quản lý bệnh
viện, Hà Nội: Nhà xuất bản y học Hà Nội, 2011.
[9] S. Mayer, C. Fischer, I. Zechmeister-Koss,
H. Ostermann, and J. Simon, “Are Unit Costs
the Same? A Case Study Comparing Different
Valuation Methods for Unit Cost Calculation of
General Practitioner Consultations,” Value in
Health, vol. 23, no. 9, pp. 1142–1148, 2020, doi:
10.1016/j.jval.2020.06.001.
[10] Đại học Y Hà Nội, Bài giảng Tài chính Y tế. Hà
Nội: Bộ môn Kinh tế Y tế, 2010.
[11] D. Cohen and C. Flood, “Health economics,” in
Health Studies, Springer, 2022, pp. 269–294.
[12] E. Martin, R. Blythe, S. Kularatna, and H.
Carter, “The role of health economics,” in Health
Promotion in the 21st Century: New approaches
to achieving health for all, Routledge Oxford,
2020.
[13] A. Leidner, H. W. Chesson, M. I. Meltzer, M.
L. Messonnier, G. M. Lee, and L. A. Prosser,
“Guidance for health economics studies presented
to the Advisory Committee on Immunization
Practices (ACIP), 2019 update,” Atlanta: Centers
for Disease Control and Prevention, 2019.
[14] A. E. Attema, W. B. F. Brouwer, and K.
Claxton, “Discounting in economic evaluations,”
Pharmacoeconomics, vol. 36, no. 7, pp. 745–758,
2018.
[15] A. Torbica, R. Tarricone, and M. Drummond,
“Does the approach to economic evaluation
in health care depend on culture, values, and
institutional context?,” The European Journal of
Health Economics, vol. 19, no. 6. Springer, pp.
769–774, 2018.
[16] H. Raghfar, N. Sargazi, S. Mehraban, M. A.
Akbarzadeh, M. R. Vaez Mahdavi, and Z. Vahdati
Manesh, “The economic burden of coronary heart
disease in Iran: a bottom-up approach in 2014,”
J Ardabil Univ Med Sci, vol. 18, no. 3, pp. 341–
356, 2018.
[17] Z. Špacírová, D. Epstein, L. García-Mochón, J.
Rovira, A. Olry de Labry Lima, and J. Espín,
“A general framework for classifying costing
methods for economic evaluation of health care,”
The European Journal of Health Economics, vol.
21, no. 4, pp. 529–542, 2020.
[18] S. Prinja, M. P. Singh, L. Guinness, K. Rajsekar,
and B. Bhargava, “Establishing reference costs
for the health benefit packages under universal
health coverage in India: cost of health services
in India (CHSI) protocol,” BMJ Open, vol. 10,
no. 7, p. e035170, 2020.
[19] S. Smith, J. Jiang, C. Normand, and C. O’Neill,
“Unit costs for non-acute care in Ireland 2016-
2019,” HRB Open Res, vol. 4, p. 39, Apr. 2021,
doi: 10.12688/hrbopenres.13256.1.
[20] R. S. Dianingati and A. Riewpaiboon, “Unit cost
analysis of medical service in asia: A systematic
review,” Pharmaceutical Sciences Asia, vol. 48,
no. 2, pp. 185–193, 2021.
[21] F. Hafidz, T. Ensor, and S. Tubeuf, “Assessing
health facility performance in Indonesia using
the Pabón-Lasso model and unit cost analysis of
health services,” Int J Health Plann Manage, vol.
33, no. 2, pp. e541–e556, Apr. 2018, doi: https://
doi.org/10.1002/hpm.2497.
[22] R. M. Haqim and F. Pribadi, “Unit Cost Analysis
of Sectio Caesarean with Activity Based Costing
in Yogyakarta Hospital,” Jurnal Medicoeticolegal
Manajemen Rumah Sakit, vol. 8, no. 1, 2019.
[23] A. Agarwal, C. Mann, E. Abdella, W. Mitiku,
A. Alebachew, and P. Berman, “Recurrent costs
in primary health care in Ethiopia: facility and
disease specific unit costs and their components
in government primary hospitals and health
centers,” BMC Health Serv Res, vol. 20, no. 1,
p. 389, 2020, doi: 10.1186/s12913-020-05218-1.
[24] M. Z. Younis, S. Jaber, A. R. Mawson, and M.
Hartmann, “Estimating the unit costs of public
hospitals and primary healthcare centers,” Int J
Health Plann Manage, vol. 28, no. 4, pp. 320–
332, 2013.
[25] B. C. Alkire, J. R. Vincent, and J. G. Meara,
“Benefit-cost analysis for selected surgical
P.N. Ha, D.T. Nam. / Vietnam Journal of Community Medicine, Vol 63, No 5 (2022) 1-1010
interventions in low-and middle-income
countries,” Essential Surgery. Disease Control
Priorities. 3rd edn. Washington DC: World Bank,
pp. 361–377, 2015.
[26] M. A. Dalaba, P. Welaga, and C. Matsubara,
“Cost of delivering health care services at primary
health facilities in Ghana,” BMC Health Serv
Res, vol. 17, no. 1, pp. 1–11, 2017, doi: 10.1186/
s12913-017-2676-3.
[27] S. Prinja et al., “Cost of Delivering Health Care
Services in Public Sector Primary and Community
Health Centres in North India.,” PLoS One, vol.
11, no. 8, p. e0160986, 2016, doi: 10.1371/
journal.pone.0160986.
[28] W. Zeng, Y. A. Halasa, M. Cros, H. Akhter,
A. K. Nandakumar, and D. S. Shepard,
“Costing essential services package provided
by a non-governmental organization network in
Bangladesh,” Health Policy Plan, vol. 32, no.
10, pp. 1375–1385, 2017, doi: 10.1093/heapol/
czx105.
[29] A. Agarwal, C. Mann, E. Abdella, W. Mitiku,
A. Alebachew, and P. Berman, “Recurrent costs
in primary health care in Ethiopia: facility and
disease specific unit costs and their components
in government primary hospitals and health
centers.,” BMC Health Serv Res, vol. 20, no.
1, p. 389, Oct. 2020, doi: 10.1186/s12913-020-
05218-1.
[30] Nguyễn Khắc Lập, “Thực trạng thu chi tài chính
và chi phí đầy đủ một số dịch vụ khám bệnh chữa
bệnh tại Bệnh viện đa khoa thị xã Phúc Yên, tỉnh
Vĩnh Phúc”, Luận văn CKII, YTCC, Trường Đại
học Y Hà Nội, 2017.
[31] Viện chiến lược và Chính sách y tế, “Nghiên cứu
xây dựng gói dịch vụ y tế cơ bản hướng tới bao
phủ chăm sóc sức khỏe toàn dân dựa trên bảo
hiểm y tế tại Việt Nam,” 2019.
[32] Lê Chí Khải, “Thanh toán chi phí khám chữa
bệnh bảo hiểm y tế theo định suất tại một số trạm
y tế xã thuộc huyện Đăk tô tỉnh Kon Tum”, Luận
án tiến sỹ y tế công cộng, Viện Vệ sinh dịch tễ
trung ương, 2014.
[33] Hoàng Văn Minh and Nguyen Thị Mai An, “Phân
tích chi phí điều trị một số bệnh thường gặp tại
bệnh viện Thanh Oai, Hà Nội,” Tạp chí y học
thực hành, 2013.
[34] V. M. Hoang, K. P. Nguyen, A. ÖZaltın,
and C. Cashin, “Costing of commune health
station visits for provider payment reform
in Vietnam,” Glob Public Health, 2015, doi:
10.1080/17441692.2014.944929.
[35] Đỗ Trà My, “Xác định chi phí dịch vụ y tế tại các
bệnh viện huyện thuộc 4 tỉnh Việt Nam,” Tạp chí
Chính sách Y tế, vol. 20, 2017.
[36] H. Van Minh, N. K. Phuong, A. ÖZaltın,
and C. Cashin, “Costing of commune health
station visits for provider payment reform
in Vietnam,” Glob Public Health, 2015, doi:
10.1080/17441692.2014.944929.
Tools and Reporting Guidelines for EvidenceBased Practice,” Worldviews Evid Based Nurs,
vol. 14, no. 6, pp. 463–472, 2017, doi: https://doi.
org/10.1111/wvn.12258.
[2] S. Mayer, C. Fischer, I. Zechmeister-Koss,
H. Ostermann, and J. Simon, “Are Unit Costs
the Same? A Case Study Comparing Different
Valuation Methods for Unit Cost Calculation of
General Practitioner Consultations,” Value in
Health, vol. 23, no. 9, pp. 1142–1148, Sep. 2020,
doi: 10.1016/j.jval.2020.06.001.
[3] B. Fautrel, A. Boonen, M. de Wit, S. Grimm, M.
Joore, and F. Guillemin, “Cost assessment of health
interventions and diseases,” RMD Open, vol. 6,
no. 3, 2020, doi: 10.1136/rmdopen-2020-001287.
[4] O. B. Acheampong et al., “Costing of Health
Services for Provider Payment: A Practical
Manual Based on Country Costing Challenges,
Trade-offs, and Solutions,” Joint Learning
Network for Universal Health Coverage, p. 93,
2014, doi: http://www.jointlearningnetwork.org/
resources/costing-manual-tool-kit.
[5] T. Q. Vo, U. Chaikledkaew, M. van Hoang, and
A. Riewpaiboon, “Healthcare costing studies in
developing countries: A systematic review in
Vietnam,” Int. J Pharm Sci Rev Res, vol. 39, no.
2, pp. 295–299, 2016.
[6] M. F. Drummond, M. J. Sculpher, K. Claxton, G.
L. Stoddart, and G. W. Torrance, Methods for the
economic evaluation of health care programmes.
Oxford university press, 2015.
[7] M. Z. Younis, S. Jaber, A. R. Mawson, and M.
P.N. Ha, D.T. Nam. / Vietnam Journal of Community Medicine, Vol 63, No 5 (2022) 1-109
Hartmann, “Estimating the unit costs of public
hospitals and primary healthcare centers,” Int J
Health Plann Manage, vol. 28, no. 4, pp. 320–
332, 2013.
[8] G. Porter Purvis, H. T. H. Nguyen, and X. T.
Nguyen, “Chương 4: Quản lý tài chính bệnh
viện,” in Một số kiến thức cơ bản về quản lý bệnh
viện, Hà Nội: Nhà xuất bản y học Hà Nội, 2011.
[9] S. Mayer, C. Fischer, I. Zechmeister-Koss,
H. Ostermann, and J. Simon, “Are Unit Costs
the Same? A Case Study Comparing Different
Valuation Methods for Unit Cost Calculation of
General Practitioner Consultations,” Value in
Health, vol. 23, no. 9, pp. 1142–1148, 2020, doi:
10.1016/j.jval.2020.06.001.
[10] Đại học Y Hà Nội, Bài giảng Tài chính Y tế. Hà
Nội: Bộ môn Kinh tế Y tế, 2010.
[11] D. Cohen and C. Flood, “Health economics,” in
Health Studies, Springer, 2022, pp. 269–294.
[12] E. Martin, R. Blythe, S. Kularatna, and H.
Carter, “The role of health economics,” in Health
Promotion in the 21st Century: New approaches
to achieving health for all, Routledge Oxford,
2020.
[13] A. Leidner, H. W. Chesson, M. I. Meltzer, M.
L. Messonnier, G. M. Lee, and L. A. Prosser,
“Guidance for health economics studies presented
to the Advisory Committee on Immunization
Practices (ACIP), 2019 update,” Atlanta: Centers
for Disease Control and Prevention, 2019.
[14] A. E. Attema, W. B. F. Brouwer, and K.
Claxton, “Discounting in economic evaluations,”
Pharmacoeconomics, vol. 36, no. 7, pp. 745–758,
2018.
[15] A. Torbica, R. Tarricone, and M. Drummond,
“Does the approach to economic evaluation
in health care depend on culture, values, and
institutional context?,” The European Journal of
Health Economics, vol. 19, no. 6. Springer, pp.
769–774, 2018.
[16] H. Raghfar, N. Sargazi, S. Mehraban, M. A.
Akbarzadeh, M. R. Vaez Mahdavi, and Z. Vahdati
Manesh, “The economic burden of coronary heart
disease in Iran: a bottom-up approach in 2014,”
J Ardabil Univ Med Sci, vol. 18, no. 3, pp. 341–
356, 2018.
[17] Z. Špacírová, D. Epstein, L. García-Mochón, J.
Rovira, A. Olry de Labry Lima, and J. Espín,
“A general framework for classifying costing
methods for economic evaluation of health care,”
The European Journal of Health Economics, vol.
21, no. 4, pp. 529–542, 2020.
[18] S. Prinja, M. P. Singh, L. Guinness, K. Rajsekar,
and B. Bhargava, “Establishing reference costs
for the health benefit packages under universal
health coverage in India: cost of health services
in India (CHSI) protocol,” BMJ Open, vol. 10,
no. 7, p. e035170, 2020.
[19] S. Smith, J. Jiang, C. Normand, and C. O’Neill,
“Unit costs for non-acute care in Ireland 2016-
2019,” HRB Open Res, vol. 4, p. 39, Apr. 2021,
doi: 10.12688/hrbopenres.13256.1.
[20] R. S. Dianingati and A. Riewpaiboon, “Unit cost
analysis of medical service in asia: A systematic
review,” Pharmaceutical Sciences Asia, vol. 48,
no. 2, pp. 185–193, 2021.
[21] F. Hafidz, T. Ensor, and S. Tubeuf, “Assessing
health facility performance in Indonesia using
the Pabón-Lasso model and unit cost analysis of
health services,” Int J Health Plann Manage, vol.
33, no. 2, pp. e541–e556, Apr. 2018, doi: https://
doi.org/10.1002/hpm.2497.
[22] R. M. Haqim and F. Pribadi, “Unit Cost Analysis
of Sectio Caesarean with Activity Based Costing
in Yogyakarta Hospital,” Jurnal Medicoeticolegal
Manajemen Rumah Sakit, vol. 8, no. 1, 2019.
[23] A. Agarwal, C. Mann, E. Abdella, W. Mitiku,
A. Alebachew, and P. Berman, “Recurrent costs
in primary health care in Ethiopia: facility and
disease specific unit costs and their components
in government primary hospitals and health
centers,” BMC Health Serv Res, vol. 20, no. 1,
p. 389, 2020, doi: 10.1186/s12913-020-05218-1.
[24] M. Z. Younis, S. Jaber, A. R. Mawson, and M.
Hartmann, “Estimating the unit costs of public
hospitals and primary healthcare centers,” Int J
Health Plann Manage, vol. 28, no. 4, pp. 320–
332, 2013.
[25] B. C. Alkire, J. R. Vincent, and J. G. Meara,
“Benefit-cost analysis for selected surgical
P.N. Ha, D.T. Nam. / Vietnam Journal of Community Medicine, Vol 63, No 5 (2022) 1-1010
interventions in low-and middle-income
countries,” Essential Surgery. Disease Control
Priorities. 3rd edn. Washington DC: World Bank,
pp. 361–377, 2015.
[26] M. A. Dalaba, P. Welaga, and C. Matsubara,
“Cost of delivering health care services at primary
health facilities in Ghana,” BMC Health Serv
Res, vol. 17, no. 1, pp. 1–11, 2017, doi: 10.1186/
s12913-017-2676-3.
[27] S. Prinja et al., “Cost of Delivering Health Care
Services in Public Sector Primary and Community
Health Centres in North India.,” PLoS One, vol.
11, no. 8, p. e0160986, 2016, doi: 10.1371/
journal.pone.0160986.
[28] W. Zeng, Y. A. Halasa, M. Cros, H. Akhter,
A. K. Nandakumar, and D. S. Shepard,
“Costing essential services package provided
by a non-governmental organization network in
Bangladesh,” Health Policy Plan, vol. 32, no.
10, pp. 1375–1385, 2017, doi: 10.1093/heapol/
czx105.
[29] A. Agarwal, C. Mann, E. Abdella, W. Mitiku,
A. Alebachew, and P. Berman, “Recurrent costs
in primary health care in Ethiopia: facility and
disease specific unit costs and their components
in government primary hospitals and health
centers.,” BMC Health Serv Res, vol. 20, no.
1, p. 389, Oct. 2020, doi: 10.1186/s12913-020-
05218-1.
[30] Nguyễn Khắc Lập, “Thực trạng thu chi tài chính
và chi phí đầy đủ một số dịch vụ khám bệnh chữa
bệnh tại Bệnh viện đa khoa thị xã Phúc Yên, tỉnh
Vĩnh Phúc”, Luận văn CKII, YTCC, Trường Đại
học Y Hà Nội, 2017.
[31] Viện chiến lược và Chính sách y tế, “Nghiên cứu
xây dựng gói dịch vụ y tế cơ bản hướng tới bao
phủ chăm sóc sức khỏe toàn dân dựa trên bảo
hiểm y tế tại Việt Nam,” 2019.
[32] Lê Chí Khải, “Thanh toán chi phí khám chữa
bệnh bảo hiểm y tế theo định suất tại một số trạm
y tế xã thuộc huyện Đăk tô tỉnh Kon Tum”, Luận
án tiến sỹ y tế công cộng, Viện Vệ sinh dịch tễ
trung ương, 2014.
[33] Hoàng Văn Minh and Nguyen Thị Mai An, “Phân
tích chi phí điều trị một số bệnh thường gặp tại
bệnh viện Thanh Oai, Hà Nội,” Tạp chí y học
thực hành, 2013.
[34] V. M. Hoang, K. P. Nguyen, A. ÖZaltın,
and C. Cashin, “Costing of commune health
station visits for provider payment reform
in Vietnam,” Glob Public Health, 2015, doi:
10.1080/17441692.2014.944929.
[35] Đỗ Trà My, “Xác định chi phí dịch vụ y tế tại các
bệnh viện huyện thuộc 4 tỉnh Việt Nam,” Tạp chí
Chính sách Y tế, vol. 20, 2017.
[36] H. Van Minh, N. K. Phuong, A. ÖZaltın,
and C. Cashin, “Costing of commune health
station visits for provider payment reform
in Vietnam,” Glob Public Health, 2015, doi:
10.1080/17441692.2014.944929.