Journal of

Background: Todays, hospitals are facing with shortage of resources and increasing costs challenges, So, cost information and cost calculation of hospital delivered services can be effective in efficient resources allocation and tariff rates reforming and budget. This study aimed at calculating the cost of services and  physiotherapy department's income of Sina hospital and comparing with approved tariffs in 2013-2014.

Materials and Methods: This study was a cross sectional and retrospective one. The cost price of 13 physiotherapy services calculated using Activity Based Costing method for physiotherapy unit of Sina hospital of Tehran in 2013-2014. Data collection tool included some forms related to services costs of physiotherapy and related activity centers. Also, in order to estimate cost proportion of other wards in physiotherapy unit, the proportional allocation bases was determined, then direct allocation method was utilized.

Results: The most costs of 13 provided services were less than tariffs in 2013. Generally, the costs pertain of physiotherapy services computed 794286777 Rials which workforce costs (48.4 percent) was the most proportion and then energy buildings depreciation and equipment costs. This issue is due to equipment dependency in physiotherapy unit services.

Conclusions: study results revealed there was difference between real cost of services and approved tariffs, therefore, in order to more accurate pricing, exact calculation methods such as Activity Based Costing recommended. Considering high personnel and capital costs pay special attention to these resources, appropriate use, identifying and omitting wasted costs can be effective in increasing efficiency and saving costs.

Background and purpose: Evaluating hospital efficiency serves as a critical tool for assessing the preparedness and responsiveness of health systems in times of crisis. Accordingly, this study examines the performance of hospitals affiliated with Tehran University of Medical Sciences in response to the COVID-19 pandemic during the years 2019 to 2022.
Methods: This analytical study assessed hospital efficiency using the Pabon Lasso model over the period 2019–2022. Additionally, statistical correlation analysis was employed to explore the relationship between changes in COVID-19 admissions and variations in hospital expenditures, revenues, average length of stay, and bed occupancy rates.
Results: The outbreak of COVID-19 led to a temporary improvement in performance indicators and more optimal utilization of hospital resources. However, following the subsidence of the crisis, hospitals reverted to their previous inefficient structures. In 2022, the operational structure of hospitals returned to pre-pandemic conditions, with only 14% of hospitals falling within the efficient zone. Compared to 2019, a 33% increase in hospitals located in Zone 1 and a 17% decrease in those in Zone 4 indicated a lack of progress in enhancing systemic efficiency. Moreover, the rise in COVID-19 admissions was associated with increased expenditures and subsidies, yet had no significant impact on hospitals’ direct income from patients. Functional effects were limited to a slight reduction in average length of stay and a modest increase in bed occupancy rates.
Conclusion: The findings highlight the absence of mechanisms necessary to sustain crisis management achievements and promote long-term efficiency. Health system preparedness for future crises requires continuous integration of crisis experiences, proactive planning, resource allocation, and the establishment of frameworks to maintain and enhance productivity under all conditions. Therefore, crisis management should not be viewed as a temporary response but rather as an integral component of the strategic and permanent structure of healthcare organizations.