HEALTH ECONOMICS: COST-BENEFIT ANALYSIS OF AN INVESTMENT PROJECT TO FINANCE THE PROCUREMENT OF A MAGNETIC RESONANCE IMAGING DEVICE
Introduction: Chronic lack of funds in Bosnia-Herzegovina’s (BH) healthcare system is a fact. A permanent way to overcome the current state is throught fundamental healthcare system reform at the national level which would be a long-lasting process. The only could currently be done are just temporary solutions. One of them is finding temporary, alternative solutions to the inflow into health funds. Aim: To point the necessity of intensifying the impact of economic profession in the healthcare system such as practice in developed healthcare systems. Respecting the unification of Evidence Based Medicine (EBM) and economic evaluation principles, would be easier to overcome important dubts about decision making and maximize the ability to choose more favorable business options. Once the ultimate goal of economic evaluation be accepted- achieving the maximum amount of health per unit of money invested, it would be avoided the misconception that it represents a simple cut in healthcare costs. Material and methods: Market data were used to provide the cost of new Magnetic Resonance Imaging device (MRI), including University Clinical Center’s (UCC) Tuzla prices of Computer Tomofraphy (CT) and MRI procedures and the amount of expenses for this purpose approved by Health Insurance Institute (HII) of Tuzla’s Canton (TC) for 2017 year. For the purpose of economic evaluation were used Cost-Benefit Analysis (CBA) and two methods of investment projects evaluation- Net Present Value (NPV) and Discounted Payback Period (DPP). Results: After considering optional ways to raise funds for an investment project of providing a new MRI device, two options proved most favorable. The first one- project in 50% co-financed by European Bank of Reconstruction and Development (EBRD) grant and the rest by some domestic banks at an interest rate of 5%. Next in acceptability was by EBRD financing option with 4 years grace period. Depending on the viewing angle of current needs of the institution, it should be considered which of these options to give priority. Conclusion: After accounting treatment of options we were given an order of funding by eligibility, the complete analisys should be considered in terms of economic evaluation role- as an advisory or as finding options, should not be ever understood as final or binding. The most important thing is to understand the economic evaluation message in healthcare- the ultimate decision which of the offered finantial option to choose should be left to healthcare profession.
Key words: economic evaluation, procurement of MRI device, CBA.