An Assessment of the Economic Feasibility of Selected Surgeries in the Obstetrics and Gynaecology Department under Community-Based Health Insurance (CBHI) in a Tertiary Care Hospital in South India

Table 4

Costing for calculation of contribution, total variable, and fixed cost and profit or loss%.

		Abdominal hysterectomy		Caesarean section			Vaginal hysterectomy
Sl. no.	Particulars	Arogya Bhagya	ESI	Arogya Bhagya	Arogya Karnataka	ESI	ESI
A	Hospital price	34,338	38,752	26,517	36,399	30,370	35,817
	Less: variable costs
1	Consumables	814	1,676	2,014	1,665	1,562	2,056
2	Medicine	7,355	6,002	3,459	4,982	4,804	4,874
3	Electricity and AC	188	188	163	163	163	150
4	Diagnostics	1,359	1,463	144	1,364	303	1,089
5	BB materials	0	298	0	943	—	876
6	Doctor’s fee	933	971	816	944	855	951
7	Package difference	21,322	24,821	13,429	27,399	13,129	20,012
8	Other variable costs (₹)	320	1,130	1,630	1,217	1,677	743
B	Total variable cost (₹)	32,291	36,549	21,655	38,677	22,493	30,751
C	Contribution margin ( A−B )	2,047	2,203	4,862	−2,278	7,877	5,066
	Contribution margin % (C/A)	6%	6%	18%	−6%	26%	14%
	Less: fixed costs
1	Bed cost	2,675	2,675	2,229	2,229	2,229	2,675
2	Equipment cost	1,821	1,821	1,156	1,156	1,156	1,244
3	Manpower cost-OT	1,529	1,529	1,274	1,274	1,274	1,052
4	Manpower cost-nursing	1,549	1,549	1,549	1,549	1,549	1,549
5	Allocated indirect costs	4,361	4,922	3,368	4,623	3,857	4,549
D	Total fixed costs (₹)	11,935	12,496	9,576	10,831	10,065	11,069
E	Operating profit/loss ( C−D )	−9,888	−10,293	−4,714	−13,109	−2,188	−6,003
	Operating profit/loss % (E/A)	−29%	−27%	−18%	−36%	−7%	−17%