Calculation of costs of different medical and surgical services has
numerous uses, which include monitor-ing the performance of
service-delivery, setting the efficiency target, benchmarking of
services across all sectors, considering investment decisions,
commissioning to meet health needs, and negotiating revised levels of
funding. The role of private-sector healthcare facilities has been
increasing rapidly over the last decade. Despite the overall
improvement in the public and private healthcare sectors in Bangladesh,
lack of price benchmarking leads to patients facing unexplained price
discrimination when receiving healthcare services. The aim of the study
was to calculate the hospital-care cost of disease-specific cases,
specifically pregnancy- and puerperium-related cases, and to indentify
the practical challenges of conducting costing studies in the hospital
setting in Bangladesh. A combination of micro-costing and step-down
cost alloca-tion was used for collecting information on the cost items
and, ultimately, for calculating the unit cost for each diagnostic
case. Data were collected from the hospital records of 162 patients
having 11 different clinical diagnoses. Caesarean section due to
maternal and foetal complications was the most expensive type of case
whereas the length of stay due to complications was the major driver of
cost. Some constraints in keeping hospital medical records and
accounting practices were observed. Despite these constraints, the
findings of the study indicate that it is feasible to carry out a
large-scale study to further explore the costs of different
hospital-care services