Comparing the Results of two Cost Sharing Approaches in Calculating the Cost of Hospital Services: a case study

Background & Objectives: Calculation of hospital services costs, especially the allocated costs, is a complicated process due to the great number of hospital services, as well as the interdependence between different centers. Considering the interrelationships between all departments in the hospital, cost analysis is possible only through the mutul sharing approach, which can provide more accurate information for researchers and managers in order to decide on a costs analysis. Methods: The present study was a descriptive study that was conducted in 2017 in a selected educational hospital affiliated to Iran University of Medical Sciences. Data collection was done through observation, interview and investigating financial documents. After identifying the active centers and the appropriate cost drivers, the cost of important services in final sectors was calculated by using two methods of one-way sharing and mutual sharing through simultaneous equations. Results: In comparison of one-way and mutaul sharing approach, all overhead, intermediate and total costs showed deviation. The greatest deviation between these two approaches was found in the parturition and ophthalmology departments and related to the cesarean with 16 million rials and the lacrimal duct cathetering with 13 million rials, respectively. Conclusion: The findings of this study showed that if hospitals managers calculate their services costs by activity-based cost and through mutual cost sharing approach, they can benefit from the correct costreportings and by having a clear image can make management decisions appropriately. Key¬words: Activity-based costing, One-way sharing, Mutual sharing, Teaching hospital Citation: Alipour V , Rezapour A , Meshkani Z, Farabi H, Mazdaki A, Hakimi N. Comparing the Results of two Cost Sharing Approaches in Calculating the Cost of Hospital Services: a case study. Journal of Health Based Research 2018; 4(3): 273-87. [In Persian

Actual Costs of Residency Training in Teaching Hospitals: A Case of Iran

Background: There was a challenge for teaching hospitals to accept residents for educational goals due to their training costs. Objectives: The present study aimed to estimate the actual costs of residency training in hospitals for policymaking, budgetary impact, and negotiation. Methods: This retrospective study was performed in eight teaching hospitals affiliated with the Iran University of Medical Sciences, Tehran, Iran, in 2018. Two scenarios were designed to estimate the costs of education per resident. All of the resources used by residents in the hospitals were identified. Cost items attributed to the training goals were allocated to the internal medicine and surgical fields; however, for cost items that were used for treatment and education, such as disposables and consumables and equipment, the cost drivers were used. Therefore, the difference between the scenarios was related to the cost drivers. Results: Overall, the selected hospitals had spent $586,720.35 and$ 572,358.10 based on scenarios 1 and 2, respectively. The residency training per surgical resident in the hospitals was about 1.2 times higher than an internal medicine resident. Surgery, neurology, urology, and anesthesiology were the f ields with the highest costs in the hospitals. Conclusion: Although residency training accounts for a large proportion of hospital costs, employing residents reduces the costs of human resources. Monitoring and controlling costs, as well as resource quotas for resident training, can be a way to reduce educational course costs in hospitals. Universities can cover some parts of the educational costs to motivate hospitals to make an appropriate setting for residents. Keywords: Cost Analyses, Academic Medical Centers, Internship and Residenc

Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population

Background: Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection. Methods: This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach. Results: In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively. Conclusion: There was no significant and considerable dominancy between the alternatives and the diagnostic tests