背景:母乳喂养是喂养婴儿和幼儿的生物学规范。当母亲没有母乳时,来自人乳库(HMB)的供体人乳(DHM)成为小型脆弱新生儿的下一个选择。全面的成本分析对于了解建立所需的投资至关重要,操作,并扩大HMB。本研究旨在估算和分析在越南建立的第一家工厂的此类成本。
方法:采用了基于活动的成本核算成分(ABC-I)方法,从服务提供机构的成本角度来看(具体来说,该项目在岘港妇女和儿童及发展伙伴医院进行)。估计财务费用,根据实际支出,以2023年当地货币计量,然后换算为2023年美元(USD)。我们考察了三种情况:1)直接启动成本+间接启动成本+实施成本,2)直接启动成本+实施成本,3)运营6.5年的资金成本+实施成本。
结果:总启动费用为616,263美元,直接活动的总支出为228,131美元,间接活动的总支出为388,132美元。设备投资所占比例最大(84,213美元)。DaNangHMB的每月费用为25,217、14,565和9,326美元,分别对应于方案1、2和3。在HMB运营6.5年的时间里,平均而言,收到的DHM的单位成本为166美元、96美元和62美元,巴氏灭菌的DHM的单位成本为201美元、116美元和74美元,符合相应方案中的指定标准。最初六个月的单位成本最高,减少,一年后达到最低水平。然后,单位成本在2020年底和2021年初经历了增长。
结论:尽管在岘港HMB的DHM单位成本与某些邻国相当,降低处置率的有意措施,提高HMB效率,激励更多基于社区的捐助者,建立HMB服务网络以降低成本。
BACKGROUND: Breastfeeding is the biological norm for feeding infants and young children. When mothers\' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This
study aims to estimate and analyze such costs at the first facility established in Vietnam.
METHODS: An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation.
RESULTS: The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB\'s 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021.
CONCLUSIONS: Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs.