IN THE NAME OF GOD TITLE ACCOUNTING 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 DANES HVARI 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 plays an 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 better advantage 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 a greater number of people can equity use a higher level of health care. At the same time, control and supervising the financial activities of health centers is possible.

5 Management-Functions human ressource planning & control leadership & organisation

6 Consumer ProviderGovernment Insurances Culture Environment Economy History Law Paying for the Health Care System Planning and Controlling the System Delivering Services Financial Pressure Consumer Expectations Health Care Industry (Roles, Jobs etc.) Health Care Manager

ADMINSTRATIVE PROFESSIONAL BUSINESS 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 InputProcess 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 Costs Indirect Costs 1- General Consumable Materials and Equipments 2- Specific Materials and Equipments 3- Manpower 4- Fixed Assets Inputs Total Costs Outputs

Hospitals in IRAN consist 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: CostsPercentageAmount 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.