How Much Does It Cost for a Surgical ICU Bed in a Public Hospital in India

Abstract

Introduction: Activity-based costing (ABC) is a costing technique that identifies the activities in an organization and assigns the cost to the activities based on the actual resources consumed for each activity. The method was used to ascertain the cost of surgical intensive care unit (SICU) bed in an institute of national importance, such as All India Institute of Medical Sciences (AIIMS), Bhubaneswar, from June 2019 to February 2021. Objective: The present study aimed to ascertain the cost of SICU beds per day by the ABC technique. The different elements of cost were analyzed. The cost for selected patients in the SICU unit was calculated by preparing a cost sheet based on the elements of cost and studying the existing charging system. Methods: A total of 38 cases were selected from the departments of General Surgery, Urology, Orthopedics, and Plastic surgery. Based on the ABC technique, the activity map was developed for SICU (cost center), and the time consumed together with resources for each activity was calculated with respect to human resources, consumables, medicines, and overheads. Thus, the total cost incurred by the hospital for SICU beds per day was estimated using the cost sheet analysis. Results: The cost was calculated to be Rs. 11,241/-per day (155 USD) against the hospital charge of Rs. 35/-(<0.5 USD) for general patients and Rs. 1000/-for private ward patients. Exchange Conversion Rate used is 1 USD = 72.60 INR (2020-21). Conclusion:The public sector hospitals in India provide health-care services for free and at a subsidized rate; hence, ascertaining the cost incurred by the hospital is necessary for policy decisions.

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“…1,000 ($14) for a private ward. 25 A similar study from an ICU in a private hospital reported average overall ICU charges per day of Rs. 15,556 ($208).…”

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“…So, the daily cost of an ICU bed is three times that of a general bed [ 4 , 18 ]. This unit has the highest cost of equipment depreciation, the highest cost of consumables and special materials, the highest variable costs, the highest cost per service unit, the lowest amount of income per service unit, the highest operating loss per service unit, and the pharmaceutical cost is higher than to other treatment departments of the hospital [ 30 , 31 , 34 ]. One of the main reasons for the high cost of ICU is the follow-up of patients with complex and serious diseases, the number of personnel, the use of expensive tools and equipment, and the high consumption of drugs, laboratory tests, and imaging [ 35 ].…”