Data Requirements for Costing Primary Care Components of the Universal Health Care Program of St. Lucia

Lucia. The document was produced for review by the United States Agency for International Development. The purpose of the document is to provide an overview of the data needed to conduct a costing analysis that would address the requests of the Ministry of Health of St. Lucia. The Ministry of Health of St. Lucia identified several key questions aligned with their plans for implementing the Universal Health Care program, including the cost of providing secondary care at the New National Hospital and the cost of providing a primary health care package to the population of St. Lucia. The document provides guidance on the kind of data needed to determine the cost of the primary health care package once defined. A micro-costing methodology is recommended for the costing analysis, which involves measuring costs of service as accurately as possible by including all the fixed and variable costs of inputs required to deliver the unit of care. The costing analysis is comprised of identifying all the inputs (labor, supplies, drugs, diagnostic tests, capital costs, transportation, etc.) required to produce each output, and then multiplying these costs by the predicted number of times the services will be used for the upcoming year. Table 1 presents the data types and specific data required to conduct this kind of analysis. The data specified assumes that the consultant would develop costing spreadsheets that use a top-down costing approach, such as was used for the Victoria Hospital costing. The data includes recurrent costs such as salary and allowances, medicine and medical supplies, diagnostic and laboratory test supplies, non-medical materials and office supplies, utility costs, transport operating costs, and maintenance costs for building, equipment, furniture, etc. The data also includes capital costs such as building and construction, which includes total floor space/surface area of the health center, average construction cost of per unit area, year of construction or approximate age of the building/construction, economic life of the building and construction, and percentage of consumption of the above item/services, by key services/outputs. The document provides guidance on the typical sources of data for each of these categories, including facility staff log, interviews with facility manager, health office records, patient records, pharmacy records, procurement office records, and facility or Ministry records. The document also mentions the OneHealth Tool, a costing tool promoted by the World Health Organization for costing an essential health package, which is available online at http://www.futuresinstitute.org/onehealth.aspx. The document is intended to provide guidance to the Ministry of Health on what to expect for a costing analysis of this type.