How much the quality of healthcare costs? A challenging question!

To meet the economic challenges faced in the healthcare industry and to continue to provide low cost and high quality services; healthcare organizations and private hospitals in particular are striving to control operational costs. Thus, considering cost is essential in order to accomplish this. Costing should promote cost effectiveness of medical practice, maximize the resources available to the healthcare provider by managing the services offered to patients, and explore opportunities for further improvements.1 Traditionally, the cost of quality was considered from the production oriented point of view where the quality costing process takes into account only the cost of deviation from the specifications intended. In services such as healthcare; quality costing is more challenging due to the complexity of the processes and the fact that such processes contain a wide range of costs, a lot of which are intangible and hidden, particularly in not for profit organizations. Although the clinical practice in healthcare organizations of the public sector is evidence based with consideration to cost effectiveness. However, the exercise of quality costing has not been taken seriously. Quality costing is given less attention in public healthcare for several reasons such as the complexity of some of the costing methods and the limited resources to run such an exercise. This is because health managers continue to separate finance when quality programs are introduced or because public healthcare providers perceive themselves sufficiently sheltered from competition.2-4 The three key challenges in producing rigorous cost information about healthcare activities are the heterogeneity in the nature of the cost objectives between and within health organizations, and problems of information quality and variations in costing practices such as allocation of indirect costs.3 These challenges are related to the complexity of the processes and the fact that such processes contain a wide range of costs, a lot of which are intangible and hidden. Defining quality is one of the challenges facing today’s healthcare. Healthcare quality is described as having “uniquely intangible, variable and inseparable characteristics.”5,6 Thus measuring patient satisfaction (when cost of dissatisfaction to be measured) is more important but also very complex.