Analysis of Cost Price and Net Profit of Laboratory: Case Study of Iran

Diagnostic services are regarded as important hospital services, which are very costly due to the use of advanced technologies and facilities, and it seems so necessary to calculate and analyze the costs thereof. Understanding the profitability of lab services by traditional and ABC method that provided by military units is the purpose of the study. This study was an applied retrospective study that conducted in a lab of Iran in a hospital of military unit in 2015. After identifying the overhead and final centers, costs related topics were collected, and cost price of the final services was calculated using Activity-Based Costing method. Calculated cost of services had been consequently compared average tariff of common services using the principles of sharing. According to the results, there were deviations between average service tariff and per admission, and most services provided to armed forces were losing. The lab was no profitable in both methods but losses in ABC were more estimated. For Pathology, Blood Bank, Biochemistry, and Hematology tests, we were witnessing the greatest deviation from the tariff but Immunology, Serology and Microbiology tests were profitable

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

The first stages of liberalization of public hospitals in Iran: Establishment of autonomous hospitals and the barriers

Background: Liberalization and decentralization of public sector has been triggered in some developing countries and in Iran by the Ministry of Health and Medical Education (MOHME) that granted autonomy to 54 public hospitals. However, establishment of such a complex organizational reform was rather unsuccessful. We aimed to explore the obstacles and barriers caused such a failure and their mechanisms.   Methods: Using a qualitative approach in 2013, we consulted key informants at the autonomous hospitals and their affiliating universities. Data collection was done within two phases: (i) 276 unstructured questionnaires asking respondents of barriers, and (ii) 23 semi-structured interviews from the first phase’s key respondents. The first phase data were analyzed using thematic analysis and the second’s by framework approach based on the frame shaped at the first phase.   Results: Nine obstacles were recognized including “autonomous hospitals’ board composition”, “delay in announcing autonomous hospitals’ charges by the MOHME”, “lack of financing by the committed organizations”, “poor follow up for implementation of the reform”, “irregular board meetings”, “lack of an external overseer”, “shortage of full-time physicians”, “lack of management stability”, and “health insurance organizations’ delayed payments”.   Conclusion: The MOHME and insurance organizations did not pay the reform expenses. There were some competing motives as well to slow the reform or to shut it down. The stages of policy formulation and implementation were done separately in Iran, so this big organizational reform encountered serious obstacles

Brain metastasis from esophageal carcinoma

Brain metastasis from esophageal carcinoma is rare. In our center, among 301 cases of esophageal cancer referred for radiotherapy during a 14-year period, brain metastasis from esophageal carcinoma was detected in one case. An unusual case of esophageal carcinoma that presented with brain metastasis is reported

Cost-benefit analysis of Intensive Care Unit with Activity-Based Costing approach in the era COVID-19 pandemic: A case study from Iran.

BackgroundProviding intensive care to acute patients is a vital part of health systems. However, the high cost of Intensive Care Units (ICU) has limited their development, especially in low-income countries. Due to the increasing need for intensive care and limited resources, ICU cost management is important. This study aimed to analyze the cost-benefit of ICU during COVID-19 in Tehran, Iran.MethodsThis cross-sectional study is an economic evaluation of health interventions. The study was conducted in the COVID-19 dedicated ICU, from the provider's point of view and within one-year horizon. Costs were calculated using a top-down approach and the Activity-Based Costing technique. Benefits were extracted from the hospital's HIS system. Benefit Cost ratio (BCR) and Net Present Value (NPV) indexes were used for cost-benefit analysis (CBA). A sensitivity analysis was performed to evaluate the dependence of the CBA results on the uncertainties in the cost data. Analysis was performed with Excel and STATA software.ResultsThe studied ICU had 43 personnel, 14 active beds, a 77% bed occupancy rate, and 3959 occupied bed days. The total costs were $2,372,125.46 USD, of which 70.3$1,213,314.13 USD. NPV and BCR were obtained as $-1,158,811.32 USD and 0.511 respectively.ConclusionDespite operating with a relatively high capacity, ICU has had high losses during the COVID-19. Proper management and re-planning in the structure of human resources is recommended due to its importance in the hospital economy, provision of resources based on needs assessment, improvement of drugs management, reduction of insurance deductions in order to reduce costs and improve ICU productivity