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Dear Readers,
One of the key pillars for an organizational viability is how it plans and manages its finance. In this issue of Sitenews we bring you insights into this important issue. We first bring you a set of articles which throws light on the cost of blindness. This is followed by resources which dwell on the concept of financial sustainability. An understanding of health economics for eye care as well as basics of finance is then brought about for the lay person. Next we provide you a set of tools which can be used for investment analysis. Resources related to costing of different eye care services are provided along with Budgeting and strategies for cost containment. Also check the list of agencies that provide funding for Eye care

Our partner this time is Management Sciences for Health.

We wish you an experience of learning that is very practical. Your feedback will let us know how we can improve. Please write in your feedback at eyesite@aravind.org

We wish our readers an informative reading!

Happy Reading!

Regards,

Vision 2020 e-resource team
The Issue Features...
Financial Planning for Eye Hospital
Vol. 4 No. 1 January 2007
•   Cost of Blindness
•   Financial Sustainability
•   Health Economics
•   Understanding Finance
•   Investment Analysis
•   Costing
•   Budgeting
•   Resource Utilization/Cost Containment
•   Funding Agencies
•   Collaborating Partner
•   Talk To Us

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There have been studies to highlight the cost of blindness to society. This is seen to be alarming as 80 percent of the blindness is avoidable. The articles below highlight burden of blindness to society.
  • UPDATING THE Hu 1981 ESTIMATES OF THE ECONOMIC COSTS OF VISUAL DISORDERS AND DISABILITIES

  • Abstract:
    This is a report submitted to the National Eye Institute (NEI) estimating the economic costs of visual disorders.

  • COST-EFFECTIVENESS ANALYSIS OF CATARACT SURGERY: A GLOBAL AND REGIONAL ANALYSIS

  • Abstract:
    This study was conducted to estimate the population health effects, costs and cost effectiveness of selected cataract surgery interventions in the areas of the world with different epidemiology profiles.

  • SOCIOECONOMIC BARRIERS TO CATARACT SURGERY IN NEPAL: THE SOUTH ASIAN CATARACT MANAGEMENT STUDY

  • Abstract:
    This study was conducted to determine the utilization of cataract surgery and the level of physical and psychosocial impairment and the socioeconomic barriers to cataract surgery in a group of non-acceptors of surgery in Nepal region.

  • IMPORTANCE OF AFFORDABLE EYE CARE

  • Abstract:
    This article focus primarily on the supply issues of service delivery, looking particularly at how increasing operational and manufacturing efficiencies can reduce costs to an affordable level to reach the goal of Vision2020.

  • HOSPITAL PLANNING

  • Abstract:
    This article focuses on Feasibility study for the hospital to be located in a particular area and the Actual planning of the buildings, equipments etc.

  • DEVELOPING PLANS AND PROCEDURES NEW INITIATIVE

  • Abstract:
    This article provides a framework for developing a plan for a new programme initiative. It then suggests how to turn this plan into a proposal for funding. In addition to providing basic guidelines on writing each section of a plan, it gives advice on how to create proposals that will improve an Organizations chances of securing funding for their new program initiatives.

  • PROJECTS TO PROGRAMMES: AN INTERNATIONAL PERSPECTIVE

  • Abstract:
    This article tells in detail how to take effective decision to move from a successful project outcome to large-scale programme operations in the prevention of vitamin A deficiency involves detailed consideration of technical, managerial, and financial implications. It also gives a keen idea on the comparative analysis of the project and programme.

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When the paying capacity of patients is analysed, it can be seen that some patients are willing to pay any amount for good quality ophthalmic services, a significant segment of patients are able to pay reasonable market rates, there is another category that can scrape together enough money to afford a subsidised rate. Apart from the spectrum of those who can pay something to those who can pay anything, there are those who cannot pay, regardless of how low the fee is. In fact, they would need additional support from the programme to provide food and transportation.

Given this economic profile of eye patients, community-oriented programmes that have the social responsibility of reducing needless blindness should attract paying patients with a pricing structure that produces a surplus to support the services for poor patients. The price, the quality of surgery, and the level of comfort influences the demand from paying patients. There could be different prices with varying accommodation and comfort levels, to cater to the different categories of patients and their expectations, including a free ward for the poor patients.

Financial sustainability is difficult for some nongovernmental organisations(NGO) to adopt because of their historical dependence on donations or the charity of others to sustain field programmes. This kind of support often lacks any true incentive for development that leads to sustainability. When an organisation is tied into the charitable mentality for their fund raising appeals, they often lack the skills and attitudes necessary to earn money from the sale of a service or product. They might also lack basic business planning skills necessary for development of cost recovery models.

Collaboration, empowerment and ownership are key factors in enabling change. Organisational structure, management, and pre-existing bureaucratic imperatives can promote or inhibit movement toward economical, large volume, high quality eye care. The key issue is: what already exists in the present approach that might act as incentive (or disincentive) toward excellence? And how can motivating forces be built into the current operating structure?
  • QUALITY CATARACT SERIES - FINANCIAL SUSTAINABILITY

  • Abstract:
    Financial Sustainability consists of examples and models, cost recovery issues, and cost recovery principles such as pricing, accountability etc. and also a cost recovery exercise to record lessons learned in the achievement of cost recovery in eye care programmes, to describe the factors and principles to consider when implementing cost recovery measures for financial sustainability, and to remind those responsible for economic development, costing decisions and financial decisions to ask the right questions to the right people at the right time in the planning process.

  • AN EVALUATION OF THE FACTORS OF SUSTAINABILITY IN THE LESOTHO RURAL HEALTH DEVELOPMENT PROJECT

  • Abstract:
    This article describes in detail about the evaluation study that identified a number of factors that were important in building a sustainable health program in Lesotho. The identified factors include economic and financial factors, project design and implementation, organization and management structure, political and sociocultural context in which the project will operate.

  • FINANCIAL SUSTAINABILITY

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Health economics is the branch of economics concerned with the application of economic theory to phenomena and problems associated typically with the second and third health market. Typically, however, it pertains to cost-benefit analysis of pharmaceutical products and cost-effectiveness of various medical treatments. Medical economics often uses mathematical models to synthesise data from biostatistics and epidemiology for support of medical decision making, both for individuals and for wider health policy.
  • GLOBAL INITIATIVE THE ECONOMIC CASE

  • Abstract:
    This article tells about the economic analysis of health projects conducted for preventing blindness. It also suggests some cost effective measures that could be considered during the projects.

  • HOW TO INTERPRET A HEALTHCARE ECONOMIC ANALYSIS

  • Abstract:
    This article provides in detail the various types of Health Care Analysis, Cost-utility analyses associated with ophthalmic interventions, Quality of life with prevalence about eye care

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For many people, the world of financial jargon is a complete mystery. The truth is that it's all reasonably straightforward, but like many professions, the financial sector does like to deal in a mysterious code. These articles focus on the financial statements. Influence strategic business decisions with a deepened understanding of financial concepts, and feel confident to challenge financial specialists and dictate strategic direction.
  • UNDERSTANDING AND USING FINANCIAL MANAGEMENT SYSTEMS TO MAKE DECISIONS

  • Abstract:
    This article is a guide for Financial Management in Health care organization. Its purpose is to provide information and assist the Programme Managers to make the organization short and long term plans respectively. It also stresses the importance of financial management in hospitals.

  • INTRODUCTION ON FINANCIAL REPORTS ITS NEED AND IMPORTANCE

  • Abstract:
    This article gives a detailed overview of accounting system, the users of accounting system, the financial statements that have to be generated, maintained while monitoring the accounts and also the objectives of maintaining the financial reports.

  • BASICS OF ACCOUNTING

  • Abstract:
    This article provides a guideline for basics of accounting, types of accounting and the rules involved in maintaining accounts.

  • FINANCIAL REPORTS

  • Abstract:
    This presentation gives a brief overview on the need and the importance of generating and maintaining and monitoring the Organizations financial reports. It also speaks about the accounting systems and its need .It also lists out the different modes of accounting, the objective of maintaining accounts in an Organization.

  • AUDITING INTERNAL VS EXTERNAL

  • Abstract:
    This presentation discusses briefly about the Internal and External auditing. It also describes in detail whom and how to conduct the audit, also the vital responsibilities and the role of conducting internal and external audits and to have a full control and monitoring over the Organizational activities.

  • FINANCIAL & ACCOUNTS DEPARTMENT

  • Abstract:
    This presentation gives a brief overview on the objectives of having Finance and accounts Department in the Organization, the Departmental framework and also the general functions that have to be performed by the department.

  • CREDITORS/DEBITORS TREATMENT IN ACCOUNTS

  • Abstract:
    This article is a guideline for how to maintain the credit and the debits in accounts. It also notice how to maintain the accounts cash flow and how to maintain the profit and loss accounts.

  • FINANCIAL RATIOS MANAGEMENT TOOL

  • Abstract:
    This article describes how the financial ratios helps as Management tool to measure the strengthen and the weakness of the Organization.

  • AUDITING

  • Abstract:
    This presentation gives a brief overview on auditing, its purpose. It also tells about the different types of auditing and its advantages. It also tells how to monitor the current organizational activities and to have an internal Organizational control, Account control and also the vital responsibilities of the auditor.

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It is not enough to make an investment, but it is equally important to monitor it closely. This is especially relevant for those investors who make large investments. They need to do an investment analysis before they invest, and also after they have invested money. Such an analysis protects their investments from shrinking.

The investor needs to do two kinds of analyses. The first is the macro analysis. This requires an investor to gauge the health of the economy because the stock markets grow when the economy is growing. On the micro front, the investor needs to analyze a company's fundamentals like profit/earnings ratio, track record of management team, acceptance of the company's products in the market etc.
  • INVESTMENT ANALYSIS FOR GENERAL EQUIPMENTS

  • Abstract:
    With the advent of modern technology, in order to provide quality eye care the hospitals are forced to purchase several equipments. Purchasing of equipments not only involves capital cost of the equipment but also the cost for supporting facilities like air-conditioning, special foundations and construction. It also involves some recurring costs like salaries to technicians, annual service contract charges, cost of spares, consumables, interest and depreciation charges. Due to all these costs many of the charity hospitals find it difficult to invest in new technology. In this context, the hospitals face a situation as to how to mobilize resources (money) to procure the necessary equipments and also whether to charge patients and if so what would be the amount they would charge?

  • INVESTMENT ANALYSIS FOR PHACO & YAG LASER

  • Abstract:
    With the advent of modern technology, in order to provide quality eye care the hospitals are forced to purchase several equipments. Purchasing of equipments not only involves capital cost of the equipment but also the cost for supporting facilities like air-conditioning, special foundations and construction. It also involves some recurring costs like salaries to technicians, annual service contract charges, cost of spares, consumables, interest and depreciation charges. Due to all these costs many of the charity hospitals find it difficult to invest in new technology. In this context, the hospitals face a situation as to how to mobilize resources (money) to procure the necessary equipments and also whether to charge patients and if so what would be the amount they would charge?

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Costing is a continuous organisational process. A narrow and too simple approach will not necessarily be of benefit. It is a complex interaction of technical, organisational and human factors, which needs committed leadership, good attitudes of staff and a system approach. Higher expenses per surgery do not necessarily mean higher quality. Hospitals that provide quality service, and in large volume relative to their size, tend to have lower unit costs through better systems. On the whole, cost containment should be viewed as one of the strategies to enhance efficiency in eye care delivery.

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Many eye care professionals find budgeting very tedious. Nevertheless, to run the programme successfully, programme managers will have to acquire some basic skills in budgeting. As a prerequisite for monitoring and evaluation, financial management can help improve the quality of various activities of the hospital. The budgeted and the actuals are compared, and reasons can be given for variances. These are some article which gives you some basic idea of budget.
  • BUDGETING FOR A DISTRICT VISION 2020 PROGRAMME

  • Abstract:
    This article highlights some of the core concepts of a strong, practical VISION 2020 programme to be considered when preparing a budget. This article also describes in detail about budgeting the variable cost needed for the infrastructure and healthcare requirements for the planned service population.

  • BUDGETING AND CAPITAL INVESTMENT COST CONTROL AND REDUCTION

  • Abstract:
    This presentation gives a brief overview on the importance of budgeting and plan a new capital investment cost control. It also suggests the necessary steps that could be followed while performing budgeting. It also tells about the role of the finance and accounts while preparing the new budget for the Organizational upliftment.

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Eye care services, like other health care services, often face demands for services which fluctuate monthly, daily, or even by the hour. The services cant be produced and stored for later delivery. Neither can the resources be increased at very short notice. Hence maximum utilization of the existing resources (human, social and financial) should be adopted so that it leads to a significant improvement in eye care.

Cost containment requires linking expenditures with outputs, and making that linkage clear to those who can affect either or both. Thus current and accurate records are integral to cost containment. Control will need to be exercised at the micro level, looking at each transaction. Purchase and payment procedures should ensure that what is needed is purchased at the right time, price, quantity and quality.
  • MOBILISING RESOURCES WITHIN THE COMMUNITY: 'MOBILISING THE UNMOBILISED'

  • Abstract:
    This article tells in detail how to mobilize various heath care resource amongst the community by creating awareness about the health care utilities.

  • COST CONTROL IN HOSPITALS

  • Abstract:
    This presentation gives a brief overview of cost control in medical care in the hospitals. It also tells about the objectives of medical care in hospitals, strategies involves in the cost control for improving the Organizations efficiency.

  • COST CONTAINMENT IN EYE CARE

  • Abstract:
    This article mainly focuses on the factors that affect the cost containment in eye care. It also describes the strategies that have to be considered while fixing variable cost in eye care.

  • COST EFFECTIVENESS STRATEGY WORKSHEET AND CHECKLIST

  • Abstract:
    This is a worksheet for providing services on a sustainable basis. This consists of the worksheet for designing the action plan and also a checklist for guiding the action plan design. It directs you to deliver services on a financially viable basis.

  • PURCHASING AND STOCK CONTROL FOR EYE CARE UNITS

  • Abstract:
    This article aims to provide guidelines in support of the Infrastructure and Technology component of VISION 2020. It describes in detail how to purchase and maintain stocks according to the healthcare needs. It also suggests a stock control system by which we can identify the stocks, purchasing the stock by prioritizing its need.

  • HOW TO GET THE MOST FROM YOUR OPTICAL DISPENSARY

  • Abstract:
    This article discusses in detail about the key areas where the ophthalmologists, technicians follow to management the optical dispensary. This article also deals about how to manage the opticians effectively.

  • RETURN ON INVESTMENT - WEB BASED FINANCIAL PLANNING TOOL FOR PAEDIATRIC DEPARTMENT

  • Abstract:
    To find out the pay back period for the investment made on the paediatric eye department based on its workload and also helps you to estimate the annual patient load required to sustain the project.

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Fund raising is a valuable part of strengthening of NGOs and communities. Cash and non cash contributions are needed by them to carry out their desired and planned activities. The obtaining of resources is therefore a desired and honorable task. Kindly check these websites who provide funding for Eye care.
  • FUNDING AGENCIES

  • Abstract:
    This Document contains the list of Funding agencies with their address.

  • EXTRA FUNDS ARE NEEDED FOR VISION 2020: THE RIGHT TO SIGHT

  • Abstract:
    This article describes in detail about the necessity for fund raising in India and it describes in detail how to identify the funding agencies, the ways to approach to get funds from them to meet the goal of vision also and thereby increasing quality eye care.

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Management Sciences for Health

MSH works collaboratively with health care policymakers, managers, providers, and consumers to help close the gap between what is known about public health problems and what is done to solve them. MSH seeks to increase the effectiveness, efficiency, and sustainability of health services by improving management systems, promoting access to services, and influencing public policy.

Visit MSH at Management Sciences for Health

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Vision 2020 e-resource team,
Lions Aravind Institute of Community Ophthalmology,
1, Annanagar, Madurai - 625 020,
Tamil Nadu, India,
E-mail:eyesite@aravind.org
Phone: 91-452-2537580