Analysis of costs of providing maxillofacial surgical services at the operating theatre of the University of Nairobi dental hospital in the year 2005/2006.

Abstract

Objective: To determine the costs and sustainability of providing surgical services at an operating theatre of a teaching hospital providing maxillofacial surgical services. Study Design: Retrospective top-down cost analysis. Study Area: The operating theatre of the University of Nairobi Dental Hospital (UNDH). Study population: All surgical procedures carried out in the financial year 2005 - 2006. Methodology: With reference to financial year 2005 - 2006 (lrt June 2005 - 31st may 2006) the major costs incurred by the University of Nairobi to conduct surgical procedures at the operating theatre of the UNDH were sought. The costs were grouped into two broad categories: fixed costs and variable costs Fixed costs were those costs that did not vary with output. Variable costs were those that varied with output The fixed costs that were analyzed included medical equipment, recurrent items, full-time theatre personnel, buildings and maintenance. The variable costs that were analysed included consumable items, utilities and variable labour costs. The main sources of information were the existing hospital records. Updating of inventories of capital items was done. Computations were based on current prices. The data were entered into a computer and the analysis done using the MS-Excel and the SPSS Version 12.0 programs. The costs that were computed included the actual full costs (AFC), the actual sustainable local costs (ASLC), the actual minimum costs (AMC), the unit cost (UC) of a surgical procedure and the UC of a procedure-hour. Results: The AFC was KSh 5,659,638 The ASLC was KSh 4,826,488 while the AMC was KSh 4,017,124 Based on the AFC the UC of an operation was KSh 51,923 and the UC of an operating-hour was KSh 18,417. The total revenue generated was KSh 1,177,400 representing 29.3% of the AMC. Conclusion It was concluded that the establishment did not meet the criteria for sustainability. Factors that appeared to contribute to this situation included low utilization of the available resources and low levels of revenue generation.