Operating Manifold Services in Hospitals: A costly affair?

Abstract

Manifold services form an important cost centre in hospitals. Most public sector hospitals do not have standard cost accounting system and therefore budget allocation is often difficult for support services such as the manifold. The study was conducted in a 1045 bedded tertiary care hospital in New Delhi, India with the objective of identifying the cost incurred in delivery of manifold services. This traditional costing exercise was conducted from 01 July to 30 Sept 2010 and included classification of costs, identification of the cost centres in the hospital, cost allocation and apportioning. Direct and indirect costs as well as capital and operational costs were calculated. The process of manifold services from delivery to the operational aspects was studied. Tender documents and supply orders were perused to arrive at expenditure on manifold gas pipeline system, equipment & accessories. Total annual cost of manifold services at the hospital was calculated to be $ 333,676 and per day cost was calculated to be $ 941 .Annual cost per manifold terminal unit was $ 207.3. The daily cost of manifold system was calculated to be $ 0.56. The annual and daily cost per bed was deduced to be $ 320 and $ 0.87 respectively. While manifold is a vital support service, the fact remains that it is cost intensive and underutilized and often poorly planned in terms of cost effectiveness. The focus on technology in manifold services needs to be sustained.