Current problems in national hospitals of Phnom Penh: finance and health care.
The current problems in Cambodia's national hospitals subsist in a geographic imbalance in the location of staff and health facilities, and low staff motivation largely due to inadequate payment. This paper aims to investigate the associations among hospital performance, hospital finances, and other related issues in five national hospitals in Phnom Penh, using annual reports of the five hospitals and annual statistics of the Ministry of Health, from 2000 to 2004. The bed occupancy rates (BOR), average lengths of stay (ALS), hospital mortality rates (HMR), maternal and neonatal mortality rates, numbers of patients, main health problems of inpatients, numbers of health personnel, staff incentives, and annual hospital income were used in this study as indicators of five hospitals in Phnom Penh city. The ALS varied from 3.8 to 9 days. The numbers of health personnel (physician, medical assistant, secondary nurses, primary nurses, secondary midwives, and primary midwives) per 100 beds were from 114 to 282. Supplemental salary per staff also differed greatly among these hospitals; the salaries were the highest at Calmette hospital (US$ 212.8) and the lowest at Preah Kossamak (US$ 12.4). In the five hospitals, the average BOR was 58.8%, and the mean of total annual income was US$ 1,427,852 per year. Although not significant, there was a tendency for higher supplemental salaries to be associated with higher BOR (Spearman rank correlation coefficient 0.70, p = 0.188). This study showed the differences in the hospital indicators among five national hospitals in Phnom Penh city, and the tendency of higher BOR in the hospitals paying higher supplemental salaries to the staff. Higher supplemental salary to the staff seemed to contribute the better hospital performance.
Uy
Sophoat
S
Human Resource Development Department, Ministry of Health, Kingdom of Cambodia. No 151-153 Kampuchea Krom Blvd., Phnom Penh. uysophoat@yahoo.com
Akashi
Hidechika
H
Taki
Kazumi
K
Ito
Katsuki
K
D001509:Bed Occupancy / Q000191:economics / Q000706:statistics & numerical data; D002160:Cambodia; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D006282:Health Personnel / Q000191:economics / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D012456:Salaries and Fringe Benefits / Q000191:economics / Q000706:statistics & numerical data; D000078329:Workforce