Case 5: Hospital Jose Maria Cabral y Baez

Case Analysis

FULLANTE, Ma. Khristine Abelinde February 7, 2011

11088230 Health Economics

The case of Hospital Jose Maria Cabral y Baez demonstrates the importance of
good hospital management in a health-care service provider facing financial problems.
Public hospitals in developing countries are more likely to experience difficulties in
achieving equitable and quality health service. These facilities are characterized with
limited health resources and funds for the procurement of pharmaceutical needs,
medical facilities, doctors, and infrastructure to serve the interest of the people (Wei-Hu
& Hsieh, 2002).

Public hospitals exist to promote sustainable health care, not exclusively to profit.
In order to achieve this, they must continue to lower health-care cost, not disregarding
or sacrificing the quality of health care (Neun & Santerre, 2007). Cost management
aspects of the Hospital Jose Maria Cabral y Baez must carefully be given
considerations. Several books will say that cost control, such as increasing the cost of
medical services and hospital operating costs, will improve the level of economic
management of hospitals. However, this may not be applied at all times, especially
when the cost of purchase of medical drugs increases, and when there are a great
number of poor people in the community. Increasing medical service fees will just
aggravate the lack of access of the poor to quality health care. The management of
public hospitals should remember that they should not charge the patient or pay than
standard values just to have access to quality health care. The director should therefore
think of other ways on how to strengthen this aspect to still achieve cost-effective
treatment to the patients of the Dominican Republic.

There are still other ways on how to manage financial problems. First is the
promotion of the development of local health systems of the region. Community
hospitals, rural clinics, and provincial health facilities should cooperate with one another
and share costs among the local government units in each respective health zone or
catchment area. The second step is to prioritize programs that can eliminate public
health threats. Looking at the items presented in the case, we have exhibits 3, 4 and 5
that give us knowledge on the common diseases and mortality causes and reasons for
seeking ambulatory cases in the SESPA region. Through these, we can think of good
ways on how to manage the financial problem faced by the director of Hospital Jose
Maria Cabral y Baez. Most of the diseases can be preventive. The director can design a
framework that will give the hospital the capacity for disease prevention and control, and
at the same time, enhancing the effectiveness of local public health delivery system.
Through prioritizing disease prevention and control program, the hospital can sustain
funding for other expenses that is sufficient for a long period of time. Such expenses
include maintenance of health facilities to minimize budget in purchasing new ones.
Disease prevention and control will also help to reduce health demands of the
community.

Fund-raising activities can also help the hospital. The director can facilitate and
launch fund-raising campaigns through different techniques and methods. He can do
face-to-face solicitation from other kind-hearted physicians. This can be done through
involving himself in meetings of public associations that have a vision and mission to
provide quality health care to the poorest of the poor in the community. He can also
organize medical missions sponsored by other non-government organizations.
Encouraging participation from other community organizations may reduce the
expenses of the hospital. Their participation may not just include financial support. They
can participate through involving themselves in advocacies promoting good health.

Reading the case gives us knowledge on how to manage a public health facility
amidst global crisis. A long-term survival plan of action must be carefully done in order
to standardize financial management, improve economic efficiency, and enhance the
competitiveness of the hospital (Folland & et.al, 1993).

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References:
Folland, Goodman, Stano. (1993). The Economics of Health and Health Care. New York: Macmillan Publishing Company.
Hu & Hseih. (2002). The Economics of Health Care in Asia-Pacific Countries. Massachusettes, USA: Edward Elgar Publishing
Limited.
Overholt & Saunders. (1996). Policy Choices & Practical Problems in Health Economics. World Bank.
Santerre & Neun. (2006). Health Economics: Theories, Insights & Industry Studies. Thomas Learning Asia.