1. Comparative Study on Cost Analysis of Interventional Cardio Thoracic services in Sri Lanka- 2016
K. M. Sriyani Padmalatha( RN, RM)
( BSc (Nursing) , EMSc ( health Admin).
Visiting lecture( IIHS)
Cardiothoracic Operating Theater
The National Hospital of Sri Lanka
Colombo, Sri Lanka

2. Introduction
Sri Lanka provides free universal healthcare, from the state sector
Escalating of healthcare Cost is the biggest issue facing most countries in 2015
The ageing population and rise in non communicable diseases (NCDs) will increase the burden on the healthcare system
The government spends Rs 3.5 Billion per year to treat heart patients
Over 5,000 patients are waiting for Heart Surgery in the Government Hospital

3. Burden of Disease NCDs; Mortality from Cardiac Disease

4. Objectives General : Specific
To study the Cost of Interventional Cardio Thoracic Services in Sri Lanka , 2016
Specific
To study the Unit cost of Open hear surgery (CABG) in Sri Lanka , 2016
to study the unit cost of Stent and balloon therapy in Sri Lanka , 2016
To compare the government and private sector Cardiac interventional cost, 2016

5. Methods Design: Cost contributors:
Descriptive, Cross sectional study with an analytical component.
Comparative study on Cost Analysis of Interventional Cardio Thoracic Services in Sri Lanka.
Cost contributors:
Human Resource, Equipment, Space, and Supply

6. Methods Process Calculation
Analysis the cost of Government sector interventional cost for cardiac procedure
Analysis the cost of Private sector interventional cost for cardiac procedure
Comparative analysis of Government, Private interventional centers with foreign cost
Calculation
Unit cost of CABG and stinting and balloon therapy

7. Results –Operation Theater Intervention -CABG
Total Number of Surgeries (CABGs) per year
Unit cost Rs:
Cost contributors
Annual cost
( LKR) %
Human Resource
21,060,000.00
6.7%
Equipment
8,724,433.33
2.7%
Space
21,600,000.00
Supplies
267,150,000.00
83.8%

8. Results cont. – Cardiac Cath Lab Stent & Balloon Therapy
Total Number of Stent & balloon therapy per year – 898
Unit cost Rs:
Cost contributors
Annual cost
( LKR) %
Human resource
2,095,333.00
0.4%
Equipment
37,601,643.00
6.4%
Space
21,600,000.00
3.7%
Supplies
89.6%

9. Cost contributors for CABG

10. Supply cost for CABG Supply cost ( 83.8%) Consumable (85.4%)
Medical
Pharmacy (14.3%)
Consumable (85.4%)
Non medical
0.2%

11. Consumables Consumable ( 85.4%) Total consumable for surgery ( 95%)
Cost of the Pump
64%
Other surgical consumable
36%
For Anesthesia 5%

12. The CABG and Stent & Balloon Therapy
State sector :
The cost contribution of the CABG and Stent & Balloon Therapy take a similar percentages
The unit cost calculated only for the OT and Catheterization Lab
This cost excludes investigation, ward/ ICU , consultation and rehabilitations costs
Supply cost takes up more than 80 % of both interventions
Private sector :
CABG total cost for = Rs. 1000,000 & Stent & Balloon Therapy Rs. 600,000
This is inclusive of Investigation and room charges
This is excluding the Pump charge for CABG and Rehabilitation fees ( with the Pump charge total cost = 1,300,000)

13. International Cost comparison
Country
CABG (USD)
Stent & Balloon Therapy( USD)
Sri Lanka
6,849.30
India
75,000.00
5,700.00
Singapore
22,100.00
11,850.00
USA
35,000.00 2,

14. Discussion
The state sector unit cost for CABG cost seems to be higher than the private sector
Similar costing amounts seen for Stent & Balloon therapy in both Private & Govt Sector
High surgical consumable cost - more than 80 % of both interventions
Sri Lanka’s cost for CABG and Stent & Balloon therapy is lower than the international market
This gives the opportunity for Medical Tourism

15. Recommendation Routine cost analysis; Further study Medial tourism
This cost exclude investigation, ward/ ICU , consultation and rehabilitations costs; needed to be analyzed with a view to calculate the total unit cost for respective interventions .
Further study
High surgical consumable cost needed to be investigated with view to find a cost effective solution
Cost benefit analysis and Outcome analysis in both interventions
Medial tourism

16. References
Dr Kithsiri Edirisinghe(2002) cost analysis of patient care services,
Ibid (2014)Total spending is for the 60 markets that EIU covers. World industry outlook:
Healthcare and pharmaceuticals, Economist Intelligence Unit,
Industry Report,(2014) Healthcare: United States of America, The Economist Intelligence Unit,
Industry Report, (2014)Healthcare: Canada, The Economist Intelligence Unit,
World industry outlook(2014): Healthcare and pharmaceuticals, The Economist Intelligence Unit,
country.eiu.com/article.aspx?articleid= &Country=Sri%20Lanka...
.Emerging Health Challenges in Sri Lanka: More Money for Health and More Health for the Money
samamthi bandara to ‘Talking Economics’, the blog of the Institute of Policy Studies of Sri Lanka (IPS), Sri Lanka’s apex socio-economic policy think tank
Report(2015 )Sri Lanka at high risk of heart diseases: See more at: more at:
Enas A. Enas (2015)Founder President & CEO,CADI Research Foundation1935 Green Trails Dr.Lisle, IL 60532, USA Tel:  Fax: 
Abeywardena (2003) MY. Dietary fats, carbohydrates and vascular disease: Sri Lankan perspectives. Atherosclerosis. ;171(2):
Mendis S.(1998) Coronary risk factors in the Sri Lankan population. Colombo: Ministry of Health, Sri Lanka;
 Mendis S, Ekanayake EM.(1994) Prevalence of coronary heart disease and cardiovascular risk factors in middle aged males in a defined population in central Sri Lanka. Int J Cardiol. 46(2):

17. Questions ?
Thank you