Cost of establishing and maintaining a bed in a tertiary care hospital in Pakistan

The study sought to determine the direct and indirect costs of hospitalization incurred by the provider and consumer in a public funded tertiary care hospital in Islamabad, Pakistan. The cost per hospital bed per day in both medical and mixed specialty wards was determined in terms of infrastructure, manpower, diagnostic investigations, drugs and utilities, and the cost to the hospitalized individual in terms of transport, food, drugs, investigations, and indirect costs such as time and material requirements of relatives or friends resulting from and associated with the hospitalization. The average daily cost per occupied bed to the institution amounted to Rs. 777 (US $ 18.95) per day. The average cost borne by the patient was Rs. 1,071 (US $ 26.10) per day or 58 percent of the total daily cost of a (medical) bed. A disproportionate share of this expense was under specific subheadings, namely purchase of medicines, laboratory services, transportation and food. Study findings confirm that in contrast to stated national policy, stationary health care is not only not free but that the consumer may end up directly paying more than the state for the services she/he receives.