กลยุทธ์การบริหารการเงินโรงพยาบาล

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FINANCIAL VITAL SIGNS

Human, technical and financial resources available for health

care delivery are limited, and must therefore be managed

efficiently.

213,664,052 211,044,438 254,122,535 377,410,553 306,541,134 383,125,176

503,760,818506,974,518 561,171,071 665,636,246 630,402,323

713,896,961

359,335,312

359,914,504 391,617,475 391,338,145 419,421,665439,518,585

340,845,367 340,687,475 371,518,378 374,341,746 404,005,162 422,196,822

1,005,818,293

998,994,4961,072,150,978

1,191,887,346 1,142,611,7041,238,743,086

572,999,364 570,958,941645,740,009

768,748,698 725,962,799822,643,761

52,063,269

305,993,789

763,716,638

1,037,812,844

1,507,565,326

60,068,501

277,982,530

617,677,933

963,664,380

1,361,327,090

-8,005,23228,011,258

146,038,705

74,148,465146,238,23652,063,269

300,262,924

747,347,993

1,015,028,458

1,464,407,222

54,784,243

262,001,735

586,503,143

916,420,387

1,296,623,075

-2,720,974 38,261,189

160,844,850

98,608,071167,784,148

1,464,407,222

1,448,814,860

1,323,694,976

1,296,623,075

1,274,377,427

1,378,709,722

167,784,148

174,437,433

-55,014,747

-60,000,000 340,000,000 740,000,000 1,140,000,000 1,540,000,000

2555

2554

2553

:

XXX

54 55

1.7%

:

XXX –

344,990

323,873

368,950

59,5

13

27,7

32

62,1

81

104,574

101,633

61,679

24,9

92

73,3

56

43,0

52

257,084

296,458

295,381

43,0

23

45

,76

258

,109

68,664

70,057

72,874

425,676

392,026

373,571

93,473

66,589

65,978

0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000

2555

2554

2553

UC UC

UC - AE/HC/DMI UC-

EMS

UC-CF

UC .5%

UC AE/HC/

DMI

311,401

336,668

363,145

173,430

151,891

167,492

373,758

353,984

336,676

55,0

50

50,8

37

47,2

29

142,023

147,116

142,466

26,7

30

22,8

70

24,7

93

32,8

68

32,2

26

33,3

72

37,0

78

37,2

64

36,8

39

43,6

61

39,0

99

46,5

04

35,5

69

30,5

61

33,9

49

0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000

2555

2554

2553

:

front office

back office

XXX –

Improving Financial Performance

Health Care Services

Plan and implement strategy

1. Grow market share and revenue

2. Improve operational efficiency

3. Invest or Optimize use of capital resources

1. GROW MARKET SHARE

AND REVENUE

Clinical Service Strategies

Contracting Strategies

Affiliate Clinic Strategies


• Emphasize convenience delivery one

stop)

• Identify and meet distinct local market

needs Variables that define a sub-market

include drive times between providers, the

age of the population, income levels and

disease states, among other demographic

factors


• Be proactive in patient outreach

"customer service" by providing services

like care navigators, web-based

appointment scheduling and

transportation

• Adopt a customer opportunity perspective

from a patient perspective to a customer

opportunity perspective

• Disrupt the notion of "patient loyalty A

patient's choice of a health system can be

driven by a bigger set of economics

1. Grow market share

• Segmentation

–

–

– International

Grow market share

• Cost Center Profit Center , Revenue Center

–

–

– Convenience care clinic

Grow revenue

•

–

–

•

– Affiliate “business”

–

–

Grow revenue

• Niches markets

– Time spend management

– Advance scheduling

• Alternative Revenue

– Market segmentation

– Hospital International

–

1.

2.

3.

4.

5.

•

•

•, DRG profile

•

Case mix index

0.0000

0.5000

1.0000

1.5000

2.0000

2.5000

3.0000

3.5000

2547 2548 2549 2550 2551 2552 2553 2554 2555 2556

CMI 2547-2556

•

•

•

• ,

• ,PP

• DMIS – , –,

• , ,

• on top

2. IMPROVE OPERATIONAL

EFFICIENCY

Typically the resources in any hospital are:

doctors, nurses, operating rooms, waiting rooms,

number of beds, laboratory, etc.

Managing Demand

• Demand partitioning (walk-in vs. appointments)

• Promoting off-peak demand

• Developing complementary services : NON-

CLINICAL SERVICES

Managing Sunk cost

• Quality

• Safety

• A new paradigm advocates making more and better use of existing assets and by pursuing improvements incrementally and at the bedside. – flexing intensive care unit beds

– improving operating room efficiencies

– rationalizing health care capacity

A randomised trial comparing the cost effectiveness of different emergency

department healthcare professionals in soft tissue injury management. BMJ Open

2013;3:e001116 doi:10.1136/bmjopen-2012-001116

Managing Sunk cost

•

•

• Generic Drug

-

• Gen Y Gen Y

•

–

–

Cost management

3. INVEST OR OPTIMIZE USE

OF CAPITAL RESOURCES

Feasibility study

เกณฑ์ XXX เกณฑ์ MMM Mmm Mm เกณฑ์ SSS SSs Sss Ss

>500

เตียง90 เตียง 60 เตียง

11

การหมุนเวียนของ

สินทรัพยบ์ริการเฉล่ีย(

รอบต่อปี )≥ 2 1.6 ≥ 2 2.4 2.6 2.9 ≥ 2 2.5 2.3 3.2 1.7

1

อัตราก าไรขั้นต้นไม่รวม

ค่าเส่ือมราคาและค่าตัด

จ าหนา่ย

≥ 0.0% 16.7% ≥ 0.0% 18.1% 15.9% 25.2% ≥ 0.0% 20.0% 14.3% 9.1% 15.5%

2

อัตราก าไรจากการ

ด าเนนิงานและโครงการ

ไม่รวมค่าเส่ือมราคาและ

ค่าตัดจ าหนา่ย

≥ 0.0% 5.8% ≥ 0.0% 1.8% 5.1% 10.3% ≥ 0.0% 2.6% 1.5% -3.9% 6.0%

3

อัตราก าไรสุทธิไม่รวมค่า

เส่ือมราคาและค่าตัด

จ าหนา่ย

≥ 0.30% 11.5%≥

0.17%7.1% 6.4% 10.9% ≥ 0.19% 3.1% 3.4% -3.5% 3.9%

1ต้นทนุด าเนนิการ

ทัง้หมดต่อ RW

ค่าเฉล่ีย

Percent ile

15 , 0 3 410,513


Percent ile

14 , 8 2 819,160 12,363 18,882


Percent ile

14 , 8 2 814,160 16,611 13,384 11,483

2ต้นทนุด าเนนิการ

ทัง้หมดต่อ OPD Visit


Percent ile

9 4 0

876ค่าเฉล่ีย

Percent ile

6 9 1

610 377 474ค่าเฉล่ีย

Percent ile

6 9 1

400 572 432 516

2 ทนุส ารองสุทธิพอเพียง

ต่อค่าใช่จ่าย (เดือน)≥ 3.0 5.2 ≥ 3.0 0.9 4.6 5.0 ≥ 3.0 2.6 7.4 0.9 1.2

Operating analysis

ดัชนี

Estimated Cost analysis

Profitability Ratio

Managing Capacity

• Labor

– Availability

– : Gen Y

• Technologies

– Availability

– Maximize utility

– Space – flow management

Standard attributes for capital evaluation

Blue ocean strategy : value innovation

Blue ocean strategy : Optimize Hard

Resources

Eliminate factors

* Out patient registration desk

Reduce factors

* Bystander dependency* High value inventory / cost

Blue ocean strategy : Optimize Soft

Resources

Raised factors

* Patient education* Nursing care* Room hygiene

* Billing procedures

Which factors should be created that has never offered

* Spacious seating arrangements* Patient friendly workflow* Avenues of relaxation for bystanders* Health food courts

• Nova Medical centre : 24

– ambulatory surgery

• Mayo Clinic Health Manager :

– a free tool that creates the ability for people to easily manage their families health online.

• HelloHealth :

– mixing office and online visits to give people personal attention from their neighborhood doctor when and how they want it.

• Parrish Medical Center :

– improve their culture and the engagement of its employees (who worked together to eliminate over million in hospital costs)

• InstyMeds™ :

– fully automated ATM-style dispenser of prescription medications.

Increase

Reduce

Assets

[email protected]

[email protected]

กลยุทธ์การบริหารการเงินโรงพยาบาล

Health & Medicine