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Showing 25 results for Cost

M Arab, M Yousefvand, M Zahavi,
Volume 12, Issue 1 (5-2013)
Abstract

Background: One of the most important advantages of calculating the cost and the bed-day expense is that the government can analyze and compare this cost among different centers and regions of the country and adjust an accurate plan and budget and require governmental units to perform it.
Materials and Methods: this research has been done using a descriptive-analytic with a temporary and retrospective approach. sample selection has been done regarding the question that "whether the orthopedic section is beneficial or not" -based on hospital chief`s demands and with experts
consultation. Related data has been gathered through studying documents, performing interviews and observing related checklists .initially all of the active centers were verified and then each activity`s cost was calculated using the ABC technique.
Results: in the year 1387, cost of each occupied bed for the orthopedic section of Imam Khomeini hospital has been 326818 rials per day. Considering the issue that this sector`s income is provided by selling services based on approved tariffs of ministry of health and medical education which has been 217500 rilas for a double-bed room of first grade hospitals in Tehran in the same year, we could conclude that the occupied Bed-Day cost is 109318 rials more compared to the approved tariff of the targeted year, which shows that the tariff's value is highly less than the bed-day cost.
Conclusion: The enormous variance between Bed-Day cost and the tariff approved by the iranian cabinet will result in forfeit of service providing centers and this could make them serious problems in providing quality services in long term. Therefore, it is essential to set the diagnostic and treatment service's tariffs based on the real cost of these kind of services.
F Azadi, M R Maleki, M Azmal,
Volume 12, Issue 3 (12-2013)
Abstract

Abstract Background: Medical tourism industry as one of the tourism dimensions results in a sustainable development and dynamic economy in countries. This study was conducted to examine performance of Tehran’s selected public and private hospitals in attracting medical tourists from foreign costumers’ points of view. Materials & Methods: This cross - sectional study was conducted in Tehran’s selected public and private hospitals in 2011. The study population included 79 foreign patients who referred to four hospitals in Tehran as medical tourists. Data were collected using a self-made questionnaire which consisted of 23 questions which evaluated eight hospital performance components in attracting medical tourists. Descriptive and analytic statistics was used for data analysis. Results: Overall, the hospitals` performances were evaluated to be in an appropriate level. Through Patients` viewpoint, three components including staff number, staff performance quality and staff`s up to date knowledge and skills were in a proper level. Moreover, Staff’s acquaintance with foreign languages and giving proper notifications were reported to be in a very poor level. There was a significant relationship between all of the performance components in attracting medical tourists and hospital ownership excluding staff’s acquaintance with foreign languages and their familiarity with the facilities. Conclusion: Teaching international languages to key staffs and empowering their communication skills can be effective in attracting medical tourists. Considering this, both public and private hospitals must have a serious plan to achieve this goal.
M Yousefi , A Assari Arani , B Sahabi , A Kazemnejad ,
Volume 12, Issue 4 (3-2014)
Abstract

Background: Today, the lack of financial protection against the health costs is recognized as a major flaw in the health systems. It seems that the first step towards solving this problem is exact identification of household health expenditure`s components which will result in better selection of prevention policies and appropriate procedures to solve the problem. Materials and Methods: This study is a qualitative research conducted in two stages. The first stage consisted of interview with a sample formed by households from eight provinces of the country to identify the different components of household health expenditure. After that, a panel of experts categorized the identified components to direct and indirect costs. Results: In The first stage, 93 kinds of households’ health expenditure were identified. In the next stage, 61 cases of these were categorized as direct costs and the other 32 cases were categorized as indirect costs. Conclusion: The exact identification of the components of health expenditure of households and dividing them into two categories of direct and indirect costs can be useful for a more accurate calculation of the household health expenditure in future studies.
Masoumeh Saeedian, Mohammadmehdi Sepehri, Hassan Aghajani, Toktam Khatibi,
Volume 14, Issue 3 (9-2015)
Abstract

Background: Myocardial Infarction (MI) is the most common cause of death in developed and developing countries. Based on World Health Organization prediction, MI will be the leading cause of death in the world up to 2020. The main goal of acute myocardial infarction therapy is reperfusion which is performed by two treatment approaches, although these two methods use for unique complication treatment but they are different in treatment cost and quality; Since the costs of health care is growing, this study aimed at identifying affected differentiated costs among patients with acute MI with the purpose of providing a framework to compare two treatment methods.

Materials and Methods: In presented model in current study, with the purpose of select affecting cost attributes utilized hybrid of Genetic algorithm and decision tree approach as a new method and compare its result using random method.

Results: Study result presented classifies error reduction up to 0.2 compare with random method error. Then, based on selected attributes, presented a framework comparing two treatment methods. Also, in the majority of direct cost and total cost, Primary Angioplasty was cost effective more than Thrombolytic Therapy, but in indirect cost, we achieved some results dissimilar to physicians' expected results such as kidney failure.

Conclusion: Suggested approach in this research can be a guidance to physicians and insurances institutes in acute myocardial infarction treatment policies.


Reza Goudarzi, Safiye Yaghoubi, Mohsen Barouni, Abbas Etminan, Mohammad Reza Baneshi, Behzad Mohamadi,
Volume 14, Issue 4 (1-2016)
Abstract

Background: Chronic renal failure disease is considered as a health problem . Because of their high prevalence and economic burden on the society, health system managers consider to the disease as a public health concern.  This study aimed at comparing the cost-effectiveness of long-term dialysis treatments and kidney transplant using DALY index.

Materials and Methods:This cross-sectional study was designed to compare the cost-effectiveness of two methods such as long-term hemodialysis and kidney transplant using Disability Adjusted Life Years (DALY) in Afzalipour Hospital of Kerman in 2012. The decision tree model and TreeAge software were used for data analysis. In this research, costs and effects were studied from the patient perspective.

Results: The cost of a kidney transplant was 165 million Rials, effectiveness of a kidney transplant was 4.40 DALY, chronic dialysis cost was 1.283 billion Rials and its effectiveness was 6.52 DALY. Cost-effectiveness ratio for dialysis was 196 million Rials per DALY and this ratio is 37 million Rials per DALY for a kidney transplant respectively. According to the findings, kidney transplant is more cost effective than dialysis.

Conclusion: This study suggests kidney transplant over dialysis due to its better quality of life and more life expectancy. The results can help out the government to decide about the more resource allocation to kidney transplant programs. The method in this research can be applied to measure the cost-effectiveness of other organs transplantation.


Mahmoud Zamandi, Hadi Zamandi, Behzad Raei, Amir Norozi,
Volume 14, Issue 4 (1-2016)
Abstract

Background: First of all, in method of Activity Based Costing (ABC), activities identify and then direct and overhead costs associated with each activity calculate based on allocation methods. This study aimed at estimating cost of Hematology ward based on method of Activity Based Costing in Imam Reza hospital of Tehran city in 2014.

Materials and Methods: This study was an applied and cross-sectional one. Specific and overhead data cost of Hematology ward collected using activity-based costing method in Imam Reza hospital in the first semester of 2014. In order to allocate the costs of Hematology ward services, first, allocation bases were determined and then direct allocation method utilized to estimate the costs.

Results: The study findings indicated that costs of each CBC Test, Malaria slide, Cell Count of Biological Fluids and Reticulocyte count were 72673, 64678, 48509 and 48508 Rials respectively. Among the cost centers, the highest costs belonged to buildings depreciation (overhead) (714117127 Rials), Hematology personneles (4182223581 Rials (and materials and supplies costs (110635349 Rials), respectively.

Conclusions: Based on study results, estimated costs differed from tariffs and only Cell Count of Biological Fluids tariff is greater than the estimated cost, the rest of the tests had fewer tariffs than estimated cost which cause laboratory financial loss. At first, in order to control or increase productivity, it is essential to focus on building depreciation costs (e.g. increasing the number of tests) and then should be plan properly to increase manpower productivity of materials and supplies. All tariffs were estimated higher than the estimated cost without building depreciation cost.


Mohammad Noori, Nader Markazi Moghaddam, Reza Goudarzi, Zahra Meshkani,
Volume 15, Issue 1 (6-2016)
Abstract

Background: Suitable budget allocation of organizational activities can deliver the resources distribution, enabling operational monitoring and providing expected access to the cost results. The aim of this study was to calculate the cost of final units in one of the Armed Forces Hospitals.

Materials and Methods: One of the Armed Forces Hospitals selected in 2013.Data gathered from all cost centers to costs calculation and evaluated based on theory of Activity-Based Costing analysis. General wards and intensive care units, operating rooms, dental, emergency and dialysis were considered as final units. Cost calculation performed using Excel software version 2007.

  • Total cost of hospital was 244,416 million rails in 2013 which direct and indirect allocated costs were 52% and 48%, respectively. The CCU, surgery ward, ICU and operating rooms had the highest and clinics and dental had the lowest in case of costs. More than 50 percent of the direct costs of all the units have been spent on manpower except the operating room. After labor costs, medication costs accounted for the largest percentage of direct spending units.

Conclusion: Paying attention to human resources in terms of number and distribution of all units especially in the final units, also considering medications use particularly in middle units and consumables in overhead ones especially can be result in reduction and adjusting hospital costs.


Raziye Beyranvand, Farbod Ebadi Fard Azar, Sara Emamgholipour, Mohammad Arab,
Volume 15, Issue 2 (6-2016)
Abstract

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.


Dr Bakhtiar Ostadi, Reza Mokhtarian Daloie, Dr Mohamad Mahdi Sepehri,
Volume 17, Issue 4 (2-2019)
Abstract

Background: Today, hospitals have faced many requests for quality services, while their costs are increasingly growing as well. These facts; Therefore, necessitate much more attention from hospital mangers in order to reduce healthcare costs. Moreover, the urgent need for a precise costing approach is more evident. Activity-based costing provides useful information on the activities required to achieve services with desirable quality. However, given that the basic information for ABC system is provided under conditions of certainty, the possibility of using this approach in terms of uncertainty would be greatly decreased. This study aims to propose a new framework called FL-ABC.
Materials and Methods: Since, costing processes environment happen under conditions of uncertainty in the hospital, fuzzy logic in the ABC model was used in order to make more accurate estimates of hospital costs and increase the reliability of the results.
Results: This proposed model was used in a hospital lab unit and the results were compared with the standard ABC system. The results showed that the maximum difference in the prescribed costs was 77708951.89 and 67508112.57 IRR in serology and parasitology tests, respectively, mostly due to uncertainty in the assigned costs to each activity.
Conclusion: The FL-ABC system, in terms of taking into account the uncertainty in the parameters of cost, provides more accurate estimates of the cost of activities under conditions of uncertainty which estimates the costs of health care services more accurately.

Dr Aboulghasem Pourreza, Dr Batoul Ahmadi, Dr Jamil Sadeghifar, Mohsen Mohammadi, Mohammad Veysi,
Volume 17, Issue 4 (2-2019)
Abstract

Background: Femoral fracture surgery is one of the most common and expensive surgical procedures and forearm fracture surgery is common performed by Ilam Imam Khomeini Therapeutic Center. This study conducted to analyze the difference in actual cost and global surgery tariffs in this hospital.Also, the related factors acutal cost of mentioned surgery were identified.
 
Materials and Methods: This cross-sectional and descriptive study was conducted on factors related to the actual costs of femoral and forearm fractures. The Activity-Based Costing approach identifies the related cost  associated with these surgeries in through six steps. Data analysis was performed using Excel 2016 software.
 
Results: The  avarage actual cost of the femur fracturs , the code 2 forearm and  the code 1 forearm were 953 thousand and 700 tomans, 444 thousand and 400 tomans and 337 thousand and 800 tomans , respectively. The actual cost of surgery for femoral fracture per unit surgery was 406,000 and 400 tomans lower than the Ministry of Health's tariff. But ,the real cost of the code 2 forearm was 33 thousand tomans higher, as well as the code 1 forearm 20 thousand tomans higher than the global tariff.
 
Conclusion: Overall,  there are significant differences between hospital costs and the Ministry of Health's global tariff. That can be corrected by improving the hospital's performance, as well as carefully examining the cost of global surgical procedures for amending the system of tariff regulation and make the actual amount closer to the tariff level.
 
Dr Nasrin Shaarbafchi Zade, Dr Alireza Jabbari, Mehri Hashemian,
Volume 18, Issue 2 (8-2019)
Abstract

Background: Calculating the cost of services enables the existing resources to be used in the most efficient and effective way possible. Time- Driven Activity Based Costing is a method that, in addition to costing, also calculates the efficiency and unused capacity of resources. The purpose of this study was to use this method to calculate the costs of radiology and CT scans services in two hospitals.
 
Materials & Methods: The present cross-sectional and retrospective research was done in a descriptive-analytic manner in two hospitals affiliated to Isfahan University of Medical Sciences in 2018. Data were collected in designed Excel forms, and costs of services were calculated using Time- Driven Activity-Based Costing (TDABC) method.
 
 Results: The cost of most radiology services and total CT scan services in the government sector was more than that of the private sector. The unused capacity of resources in the public sector was more than private sector. The time spent for providing the services in the two hospitals was the same except for the technician's career. The average cost of radiology services was 223324 in hospital (A), and 194094 Rials in hospital (B). The average cost of the CT scan services was 600522 in hospital (A), and 485230 Rials in hospital (B).
 
Conclusion: According to the findings of the study, the need for human resources management to reduce unused capacity and increase efficiency, as well as improving service delivery processes in order to reduce the time required to provide services seems necessary. Replacing low-cost resources is another solution that is effective in reducing costs. The standards of the most efficient centers of health services are often worth the benchmarking.


Vahid Alipour, Aziz Rezapour, Ebrahim Hasanzadeh, Saeid Bagheri, Mohammadreza Sheykhi Chaman, Yaghoub Yousefi,
Volume 18, Issue 3 (10-2019)
Abstract

Background: Activity-Based Costing Analyzes the Activities Performed in the Service Delivery Process and Accurately Identifies Costs to Improve The Performance and Efficiency of The Delivery Units and Calculates the Cost of Each Activity by Identifying Services and Activities. The Purpose of This Study Was to Calculate the Cost of Radiology Services Based on Activity Based Costing Method In Firooz Abadi Hospital.
 
Materials and Methods: This is a descriptive retrospective study conducted in 2018. Data were collected through interview with Hospital officials, direct observation and from existing documents in hospital. Data entry was done through Excel software and analyzed Based on activity-based costing system in eight steps.
 
Results: Based on the Findings of this Study, Four Types of Imaging Services Were Commonly Found In Firooz Abadi Hospital. From Total Radiology Costs, 79.3% Were Estimated to Be Related to Direct Costs and 20.7% to Indirect Costs. Finally, the Cost Per CT Scan Service Was 725,133 Rials, Mammography 608,054 Rials, Radiology 809,165 Rials and Ultrasound Service 512,692 Rials.
 
Conclusion: Results of the Study Indicated that Direct Costs accounted for most Costs in Radiology Unit, So Improving Performance and Policies in Health System, Particularly in Human Resource Management, Service Consumption Standardization and Staff Training Suggested to Cost Reduction.
 
Jafar Yahyavi Dizaj, Dr Sara Emamgholipuor Dashti, Faroogh Na'emani, Reza Reza Hashempuor,
Volume 18, Issue 4 (1-2020)
Abstract

Background & Aims of study: Hospital care and paramedical services has become one of the most important and problematic issues in the field of health and critical concern of health planners and policymakers. In current study, contribution of various paramedical services costs were extracted from the total household health expenditure.
Materials and Methods: The current study is a descriptive study that was conducted in a 5-year study period from 2011 to 2015. The annual income-based survey data of the household provided by Statistics Center during 2011-2015 was used to achieve the study aims. Excel_2013 software was used. Contribution of household and paramedical services cost were calculated from household health expenditures per year in urban and rural areas.
Results: Regarding the results of the current study, on average, 20 % of total household health expenditure is allocated to paramedical services in urban and rural areas. The cost of radiology, sonography, radiotherapy, scan, echo cardiac stress test, endoscopy, electrocardiogram (ECG) etc, accounts for the largest contribution of hospital and non-hospital paramedical services costs, which include an averagely about 50 %t of paramedical services costs.
Conclusion: Understanding paramedical services costs can guide policymakers and decision-makers in the field of paramedical services to decide better. Moreover it helps them to reduce direct payments from the pocket of household health expenditures. Therefore, considering the laboratory sector and radiology, sonography, radiotherapy sectors and so on are very important to reduce paramedical services costs.
 
Arash Mofarahzat, Ali Akbar Fazaeli, Yadollah Hamidi,
Volume 19, Issue 1 (4-2020)
Abstract

Background and Objective: Tuberculosis is an infectious disease and is the leading cause of death from single-agent infectious diseases. The purpose of this study was to estimate the economic costs of this disease and its effective factors in Hamadan province.
Methods: This descriptive-analytical study was conducted on a cross-sectional (two-year time scale) study in 2014 and 2015. The population of this study is tuberculosis patients in Hamadan province. Data extraction was performed by examining the file of patients with tuberculosis in urban and rural health centers and patients of hospital in Hamadan. Also, using a logistic model and Stata 15, social factors and households that are more likely to be exposed to this disease were studied.
Results: A total of 173 tuberculosis patients were identified, with an estimated cost of treatment of 8307 million IRR. Also, the results of the Logit model showed that people living in the city over 65, low educated, and people with HIV The order of 22, 14, 18, and 6 percent would be greater than the likelihood of exposure to tuberculosis.
Conclusion: The cost of tuberculosis, in addition to allocating a significant amount of health resources in the province, also imposes a high burden on households. The social and economic consequences of these costs lead to many abnormalities such as the exclusion of women with a family or the abandonment of the children of affected people.
Farhad Lotfi, Erfan Kharazmi, Mohsen Bayati, Hajar Alipour, Saeid Lohivash, Ali Jajarmizadeh,
Volume 19, Issue 2 (8-2020)
Abstract

Background: Estimation of cost functions is an appropriate tool for optimal resource allocation in hospitals. The present study aimed at estimating cost function for hospitals affiliated to Shiraz University of Medical Sciences.
                                    
Materials & Methods: In the current cross-sectional study, inputs, costs and resources data for 28 hospitals were gathered from hospital statistics and information system. Required data were collected monthly for two years (2015-2016). Then, The Cobb-Douglas cost function was estimated using panel data analysis. STATA 14 was used for data analysis.
 
Results: Estimates showed that hospitals' cost elasticity concerning the inpatient and outpatient admission were 0.555 and 0.058 for large hospitals, and 0.769 and 0.099 for small hospitals (P<0.01). Among hospitals inputs, the cost of a physician with coefficient 0.175 in large hospitals and 0.481 in small hospitals (P<0.01) was most cost driver. In studied hospitals, average cost (36,406,480 Rial) was higher than marginal cost (26,548,020). Moreover, scale economies index were in small, large, and all hospitals were 0.868, 0.613 and 0.729, respectively. The number of active bed, length of stay and teaching activity had a positive effect on hospitals cost (P<0.01).
 
Conclusion: According to the findings, to control costs, the hospital should manage most cost drivers, such as physicians and pharmaceutical costs. Moreover, According to the average and final cost and scale economies index, hospitals should expand their service provisions with current inputs and resources in order to reach the optimum point of output.
Hojjat Rahmani, Ghasem Rajabi Vasoukola, Rajabali Daroudi, Mani Yousefvand, Zeinab Fakoorfard,
Volume 19, Issue 4 (12-2020)
Abstract

Background: Considering the importance and position of the health sector in socio-economic development programs, it is necessary to be aware of the current situation and to recognize its issues and problems. Determining costs and the amount of profit or even loss in the health sector helps in managing costs. The purpose of this study was to evaluate the cost of common laboratory services and compare them with the tariffs approved by the Ministry of Health and Medical Education in the selected hospital of Tehran University of Medical Sciences.
Materials and Methods: The present study was a cross-sectional and retrospective study. In this study, activity-based costing technique was used. The study population was the laboratory of the selected hospital of Tehran University of Medical Sciences. Data collection tools were information forms, software, interviews and direct observation. The analysis was performed using Excel 2016 software and finally, the cost price was compared with the approved tariff.
Results: The findings indicated that the highest and lowest costs were related to the cost of manpower and energy carriers, respectively. The highest cost was related to the urine analysis test and the lowest was related to the sodium and potassium tests.
Conclusion: The results of this study showed that the cost of conventional laboratory services in the selected hospital of Tehran University of Medical Sciences and the tariffs approved by the Ministry of Health and Medical Education in 2019 were different.
Sajjad Moshki, Shaghayegh Vahdat, Somayeh Hesam,
Volume 19, Issue 4 (12-2020)
Abstract

Background: The present study aimed to determine the causes of patients' readmission in hospitals affiliated to Bam University of Medical Sciences in 2019.
Materials & Methods: The current study was a descriptive-analytic study and the study population included patients readmitted in Pasteur Hospital in Bam, Javad Al-Aimeh Hospital in Narmashir, and Ayatollah Hashemi Rafsanjani Hospital in Regan in 2019. The samples consisted of 312 patient records which were chosen randomly. Data were collected by a checklist and were analyzed using SPSS software version 23 and descriptive and analytical tests (Chi-square and one-way analysis of variance).
Results: The results showed that the internal medicine department received 34% of readmissions. The average readmission cost was 17,265,353 Rials. The most common reasons for readmissions were having a new disease (46.2 percent) and recurrence of the former disease (39.8 percent). Findings of inferential statistics revealed no significant relationship between the causes of readmissions and gender (P = 0.566), age (P = 0.065), or costs (P = 0.625), but there was a significant relationship between the causes of readmissions and marital status (P = 0.049) and married people had more readmissions than single people.
Conclusion: It is necessary to pay more attention to readmissions caused by disease recurrence. It is also possible to prevent such readmissions and improve the quality of medical services by standardizing hospital processes and tools, standardizing staff training, and employing new diagnostic and treatment methods.
Kamran Irandoust, Jafar Yahyavi Dizaj, Hiwa Mirzaii, Faroogh Na'emani,
Volume 20, Issue 2 (9-2021)
Abstract

Background & Aims of study: Service delivery is known as the most tangible function of the health system and hospitals are the most obvious manifestation of this function. Also, one of the most important factors in creating catastrophic health expenditures is the use of hospital services; therefore, in the present study, an attempt was made to describe the share of hospital service costs from total household health expenditures.
Materials and Methods: The present descriptive study was performed retrospectively for the period of 2011 to 2015. The study was done using the Household Expenditure and Income Survey (HEIS) which is conducted annually by the Statistical Center of Iran (SCI). Based on the designed model, the share of hospital costs from household health expenditure was determined by year and type of services in urban and rural areas.
Results: On average, 18.5% of households used hospital services and about 28.7% of household health expenditure had been spent on receiving health services from hospitals. The average cost of household hospital medical services was 92.4% in urban areas and 91.4% in rural areas. On average, 51% of the cost of household medical services in hospitals was related to public hospitals, and the highest cost spent by households in public hospitals was allocated to surgery.
Conclusion:  The share of hospital services costs and the rate of use of these services among Iranian households are significant, which may lead to poverty and catastrophic health expenditures. Therefore, it is necessary for health decision makers to design and implement evidence-based policies to manage and control this part of health costs.

Elahe Eyshi, Omid Khosravizadeh, Aisa Maleki, Bahman Ahadinezhad,
Volume 21, Issue 2 (9-2022)
Abstract

Aim & Background: Cost management is the most important factor affecting the economic performance of the hospital. Good management of costs in the short term stabilizes and balances the operating balance of the hospital and secures the hospital in terms of liquidity. Also, good management of costs in the long term makes the hospital financially stable. According to the mentioned cases and increasing hospital costs, the present study was conducted with the aim of identifying and investigating the factors, drivers and obstacles to improve cost management.

Methods & Materials: This systematic review was conducted in 2020. Data was collected through  searching keywords in Google scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID and Irandoc databases from 2007 to 2020. The classification of the results of the studies was done by the researchers.

Results: All the components identified and extracted from the articles were divided into four dimensions (increasing factors, prerequisites, obstacles and solutions) to improve hospital cost management.

Conclusion: Reviewing the results of each study showed the importance of each component in managing, improving and controlling hospital costs. In this regard, policy makers at decision-making level and managers at executive level should pay attention to the components and dimensions affecting the control and improvement of hospital costs according to the structure, process and expected consequences, and then decide on their implementation.
 
Sanaz Zargar Balaye Jame, Nader Markazi Moghaddam, Hesam Sharifnia, Mehrdad Khoshian,
Volume 22, Issue 3 (12-2023)
Abstract

Background and Purpose: Medical imaging is one of the most expensive sections of a hospital due to the use of superior technology, specialized personnel, and adherence to special protective regulations, all of which have a direct impact on the diagnosis and treatment of diseases. Time-driven activity-based costing (TDABC) provides an overview of hospital activities, enabling the identification and management of costs and resources with greater accuracy and ease. The purpose of this study is to examine the total costs of services and the unused capacity of resources to provide financial management solutions for hospital administrators.
Materials and Methods: This descriptive and retrospective study was conducted on the statistics and accounting data of a general hospital in Tehran in 2018. The study falls under the category of applied research due to the potential use of the results in financial management and resource consumption. The data collection method included the review of documents and financial statements, timing of all activities in the imaging department, and calculations based on the time-driven activity-based costing method, using Excel software, with the elimination of the cost of unused resources.
Results: The study found that the total cost was mostly below the approved tariffs, with the main cost components being 34% manpower, 23% overhead, 22% equipment, and 15% consumables. The findings indicated that only 58% of resource provisioning expenses played a role in determining the total cost of services.
Conclusion: The findings of this research suggest that reducing the unused capacity of resources and organizational reforms can decrease the total cost of services, increase profitability, and optimize resource usage to enhance the quality of hospital services.

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