Cost Projections for the Complementary Package of Activities - basics

3. METHODOLOGYThe main source document used for information on the CPA was the CPA Guidelines 3 . Thecosting was conducted in two steps. The first step was to estimate the actual costs of a smallsample of hospitals and to estimate the costs of any additional resources needed by thosehospitals 4 . The second step was to develop normative cost models using the informationgathered from the sample of hospitals and norms from the GPA Guidelines. The results werethen compared with the findings of other costing studies.SAMPLE OF HOSPITALSDue to the limited time available for the study, only a small sample of hospitals was used.Hospitals that are under contracting schemes were used since the data are generally morecomplete and the costs are more likely to reflect the resources needed to run the hospitals at agood level of quality. For example, staff remuneration levels are higher and includeperformance incentive payments.The sample comprised 4 hospitals in Takeo and Kampong Cham provinces. In Takeo we usedAng Roka Hospital, a district-level CPA 1 hospital, and Kirivong Hospital, a district-level CPA 2hospital. These are both supported under the contracting programme managed by Swiss RedCross (SRC). In Kampong Cham we used Kampong Cham Provincial Hospital, a provinciallevelCPA 3 hospital, and Prey Chhor, a district-level CPA 1 hospital. These are both supportedunder the contracting programme managed by Belgian Technical Cooperation (BTC).Kampong Cham Hospital was given a good rating by University Research Corporation (URC) in2007 in areas such as infrastructure and management 5 . An evaluation of Ang Roka Hospitaland Kirivong Hospital by Swiss Red Cross concluded that both hospitals were “of higherstandard than normally encountered in Cambodia with 24 hours coverage and routinemonitoring of patient condition”. The evaluation reported that surveys indicated close to 100%client satisfaction in both hospitals 6 .We made several visits to the hospitals and also collected data at the national level. The datacollected were as follows:3 National Guidelines on Complementary Package of Activities for Referral Hospital Development from 2006 to 2010.Second Version, 15 December 2006. Ministry of Health, Kingdom of Cambodia.4 Former District Hospitals (FDHs), which are large health centres with some inpatient services other than deliverieswere not included under this study due to the lack of time.5 The assessment covered Hospital Management, Administration, infrastructure and equipment, organization ofwards and departments, documentation and recording of information, referral system, staff satisfaction and generalhygiene.6 Contracting of Health Services: Ang Rokar and Kirivong Operational Districts, Takeo Province, Cambodia. FinalEvaluation Report. Sheryl Keller, Jean-Marc Thome and Jean-Yves Dekestier. April 2008. Swiss Red Cross.3