Volume 5, Issue 2 (6-2021)
EBHPME 2021, 5(2): 99-105 |
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Management and Medical Information Sciences Department, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran , A_saber@kmu.ac.ir
Abstract: (1284 Views)
Background: Initiatives to improve the quality of health services and reduce costs currently have centered around payment mechanisms. In Iran, like many other countries, the outpatient visit costs are paid via fee for service, while real-time visits and other details of provided services are not considered in the tariff setting process. This study attempted to calculate the visit costs of various service provider groups and compared them with tariffs.
Methods: In this cross-sectional research, the essential data about different costs were collected from providers' offices, standard time of each visit was achieved from Iran's Ministry of Health and Medical Education, current visit time of service providers was calculated based on health insurance companies' data across the country. After calculating the standard and current visit costs through the activity-based costing technique, main determinants of costs (major cost centers) were specified for use in probably future weighted tariffs in fee for service payment mechanism.
Results: The greatest difference between standard and the current number of visits was found in the Sub-specialist physician group (6784 in a year), and the greatest difference was between standard and current cost of visits in sub-specialist psychiatrists (126703 IRR). Staffing and rental cost centers account for the highest share of total visit cost (87 %).
Conclusion: This study demonstrated a significant difference between the current and standard visit costs with tariffs. Therefore, it is essential that policymakers improve the payment mechanism by modifying the visit tariffs for medical service providers. One suggestion in this way is using domestic relative value units according to costing research results.
Methods: In this cross-sectional research, the essential data about different costs were collected from providers' offices, standard time of each visit was achieved from Iran's Ministry of Health and Medical Education, current visit time of service providers was calculated based on health insurance companies' data across the country. After calculating the standard and current visit costs through the activity-based costing technique, main determinants of costs (major cost centers) were specified for use in probably future weighted tariffs in fee for service payment mechanism.
Results: The greatest difference between standard and the current number of visits was found in the Sub-specialist physician group (6784 in a year), and the greatest difference was between standard and current cost of visits in sub-specialist psychiatrists (126703 IRR). Staffing and rental cost centers account for the highest share of total visit cost (87 %).
Conclusion: This study demonstrated a significant difference between the current and standard visit costs with tariffs. Therefore, it is essential that policymakers improve the payment mechanism by modifying the visit tariffs for medical service providers. One suggestion in this way is using domestic relative value units according to costing research results.
Type of Study: Original article |
Subject:
Health Economics
Received: 2021/01/13 | Accepted: 2021/06/29 | Published: 2021/06/29
Received: 2021/01/13 | Accepted: 2021/06/29 | Published: 2021/06/29
References
1. World Bank. Islamic Republic of Iran Health Sector Review. Available from URL: http://databankworldbankorg/ data.
2. Goeree R, Gafni A, Hannah M, Myhr T, Blackhouse G. Hospital Selection for unit cost estimates in multicentre economic evaluations. Pharmacoeconomics. 1999; 15(6): 561-72. [DOI:10.2165/00019053-199915060-00004]
3. Ghiyasvan H, Zandiyan H, Moghadam TZ, Naghdi S. Cost of radiology services using the activity based costing (ABC) method. Payesh (Health Monitor). 2013; 12(6): 595-605.
4. Jafari Sirizi M, Barouni M, Saber Mahani A. Analysis of cost price and net profit of paraclinic services in private and public sectors: a case study of Kerman city 2014. Journal of Health Management & Informatics. 2015; 2(4): 138-43.
5. Gholami K, Laali E, Abolhassani H, Ahmadvand A, Mohebbi N, Javadi MR, et al. Costs of hospital admission on primary immunodeficiency diseases. Iranian Journal of Public Health. 2017; 46(3): 342-50.
6. Olyaeemanesh A, Manavi A, Monazzam K. Documentation and studies conducted at the Department of Health Economics. Department of Health, Ministry of Health and Medical Education, Iran. 2004.
7. Ayvaci M, Cavusoglu H, Kim Y, Raghunathan S. Designing Payment Contracts for Healthcare Services to Induce Information Sharing: The Adoption and the Value of Health Information Exchanges (HIEs). Available at SSRN 2978862. 2019.
8. Babashahy S, Rashidian A. Payments of physicians employed in public and private hospitals after modification of surgical and invasive services tariffs. Hakim Research Journal. 2012; 15(1): 38-43.
9. Babashahy S, Baghbanian A, Manavi S, Sari AA, Manesh AO, Ghaffari S, et al. Insight into provider payment mechanisms in healthcare industry: A case of Iran. Iranian Journal of Public Health. 2016; 45(5): 693-5. PMID: 27398344.
10. Coberly S. Relative Value Units (RVUs). 2015.
11. Medicare Cf, Services M. How to Use the Searchable Medicare Physician Fee Schedule (MPFS). Baltimore: US Department of Health and Human Services. 2014.
12. Cao P, ToYabe S-I, Akazawa K. Development of a practical costing method for hospitals. The Tohoku Journal of Experimental Medicine. 2006; 208(3): 213-24. [DOI:10.1620/tjem.208.213]
13. Lee H, Manns B, Taub K, Ghali WA, Dean S, Johnson D, et al. Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access. American Journal of Kidney Diseases. 2002; 40(3): 611-22. [DOI:10.1053/ajkd.2002.34924]
14. Ringelstein D. An Activity-Based Costing Assessment Task: Using an Excel Spreadsheet. E-Journal of Business Education & Scholarship of Teaching. 2009; 3(1).
15. Rajabi A. The role of activity based costing (ABC) system in governmental hospital services in Iran. 2008.
16. Cabinet decree, in Fifth Five-Year Development Plan of Islamic Republic of Iran. 2012, Parliament of Iran: Tehran. [In Persian]
17. Fattahpour A, Ebrahimi Dourcheh R, Rahimi M, Rafiee N. Comparison of hoteling cost of global surgery with real cost in Isfahan public hospitals, 2012. Evidence Based Health Policy, Management and Economics. 2017; 1(1): 47-53.
18. Janati A, Khosravi MF, Imani A, Javadzadeh A, Gharamaleki MM. Cost analysis of eye surgeries and comparison with approved governmental tariffs. Health Scope. 2017; 6(2). [DOI:10.5812/jhealthscope.39948]
19. Zarekhormizi E, Bahrami MA. Absolute Cost of Hernia Operation using Activity Based Costing (ABC). Evidence Based Health Policy, Management and Economics. 2017; 1(1): 40-6.
20. Gh G. cost price estimation of emergency ICU services in Imam hospital, [Besthesis]. Tehran: Tehran University of Medical Sciences, School of Public Health. 2003. [In Persian]
21. Ebrahimi Z. Cost price estimation of ICU services in Shafa hospital. [Besthesis]. Kerman. Kerman University of Medical Sciences,health management and informatics faculty. 2008. [In Persian]
22. Maxwell S, Zuckerman S. Impact of resource-based practice expenses on the Medicare physician volume. Health Care Financing Review. 2007; 29(2): 65-79.
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