IN THE NAME OF GOD

TITLEACCOUNTING OF TOTAL COST OF HEALTH SERVICES TO THE TB INPATIENTS IN IRAN ( IN MASIH DANESHVARI HOSPITAL ,2005 YEAR )

TITLE: ACCOUNTING OF TOTAL COST OF HEALTH SERVICES TO THE TB INPATIENTS IN IRAN ( IN MASIH DANESHVARI HOSPITAL ,2005 YEAR

By : Dr MOJGAN AZADI,As Professor of Shaheed Beheshti University of Medical Science & Health Services,Ph.D in Health Administration

Zohre Etaati , Shamsi Nasiri , Azar Nouraki , Dr. Mohammad Reza Masjedi

Introduction

The hospital is one of the important establishments offering health services which playsan economically significant role. Considering the poor economical status of developing countries when facing changes in ‘money and good’ markets, this role becomes more significant.

The main aim of econometric studies of performance in the hospital costs is to take betteradvantage of the existing physical and technological facilities as well as manpower.

Although the financial survey alone in the field of health and medical care seems useless considering the humanitarian and friendly nature of these services, but when used for evaluating the efficiency and proper usage of these resources it is beneficial .

On the other hand, with cost-control procedures agreater number of people can equity use a higherlevel of health care. At the same time, control andsupervising the financial activities of health centers is possible.

5

Management-Functions

human ressource

6

Consumer

ProviderGovernment

Insurances

Culture EnvironmentEconomy History Law

Paying for the Health Care

System

Planning and Controlling the

System Delivering Services

Financial PressureConsumer

Expectations

Health Care Industry (Roles,

Jobs etc.)

Health Care Manager

ADMINSTRATIVEADMINSTRATIVEPROFESSIONAL PROFESSIONAL BUSINESSBUSINESS

Managerial Systems

Hospital Organization

Hospital Standards

Hospital Management System

Financial Management

Performance Evaluation IT System in Hospital

Reengineering

Physical Resource Management

Human Resource Management

8

Input Process

Feedback

Output

Information subsystem

Decision making

subsystem

Control

subsystem

Evaluation

subsystem

Control

subsystem

Management System ( Peter Deraker)

OBJECTIVES:•Accounting of total cost of health services to TB inpatients.•Accounting of percentage of cost in the health services to TB inpatients.•Propose a plan to control of cost.

METHOD:This cross sectional retrospective experimental Study calculated hospital costs and analyzed the data in forms and tables designed especially for this purpose.Also data in regard to capital, current and overhead costs were collected . After calculation ,the mean of total costs was assessed

Pattern of calculate

Hospital

Direct CostsIndirect Costs

1- General Consumable Materials and Equipments2- Specific Materials and

Equipments3- Manpower

4- Fixed Assets

Inputs

Total Costs

Outputs

Hospitals in IRANconsist of :-Governmental Hospitals-Privet Hospitals -Charity Hospitals -Others

Governmental hospitals divided to :-General hospitals-Uni-speciality Hospitals

Situation of Masih Daneshvari Hospital

-Uni-speciality Hospital in TB and Lung Diseases

-Consist of 254 Inpatients beds-Two Wards for TB Inpatients

RESULTS:

Costs Percentage Amount

Generally Consumable Materials and Equipments

9% 3.87$

Specially Consumable Materials and Equipments

4% 1.72$

Fixed Assets 5% 2.15$

Manpower Costs 69% 29.67$

Overhead Costs 13% 5.59$

Total Costs 100% 43$

-Mean days if admission : 10 days -MDR TB admitted for 2 weeks for good observation -Medications are Free-Mean Average Age :40-60 Years (38%)-67% Male

CONCLUSIONS:As it is observed all over the world ,health care personnel pay less attention to the costs of medical equipment and are less aware of the economical aspect of health care services .

Having knowledge about the costs is not only essential for hospital administrators but also for all medical personnel ,since with more cost reduction , a greater number of people can enjoy medical services.

• Increasing economic pressure on health care systems

• 70% of all health care costs depend on the physician‘s decision making

• Sociodemographic factors and technology drive health care costs

• Health Care is an information business – IT economics drive Health Care

Management

• Ultraspecialisation increases fragmentation and complexity

• Human Resources Management as THE key success factor for erforman

and decrease costs.

• Increasing economic pressure on health care systems

• 70% of all health care costs depend on the physician‘s decision making

• Sociodemographic factors and technology drive health care costs

• Health Care is an information business – IT economics drive Health Care

Management

• Ultraspecialisation increases fragmentation and complexity

• Human Resources Management as THE key success factor for erforman

and decrease costs.