ABSTRACT
Background@#Avoidable hospitalizations (AHs) are defined as hospitalizations that could have been prevented through timely and effective services. AHs are, therefore, an indicator used to evaluate the access and effectiveness of primary health care services. @*Methods@#A retrospective time-series study spanning 8 years (2006–2013) was conducted to determine the relationship between AHs and gender, age, and access to primary health care physicians in rural areas in Tehran province, the capital of Iran. The total number of avoidable hospitalizations was 22,570; logistic regression was estimated for each year separately. @*Results@#Total hospitalizations and AHs increased during the study period, especially during the first 3 years of the study. AHs, as a percentage of total hospitalizations, did not change significantly throughout the study years. This value was 22.3% during the first year of study and varied between 17% and 19.6% from 2007 to 2013. No statistically significant relationship was seen between AH occurrence and access to a physician during the study years. @*Conclusion@#Increasing access to primary health care physicians cannot necessarily result in decreased AHs. Considering the factors influencing AHs while designing and implementing the family physicians program is important to achieve the expected results regarding the effectiveness of primary health care services.
ABSTRACT
Introduction: Health policymakers faced with new challenges such as increasing elderly population. This study aimed to investigate the consumption pattern and hospitalization costs of the elderly covered by Iran Health Insurance Organization in teaching hospitals of Sanandaj, Iran
Method: In this descriptive-analytical as a cross sectional one, the samples included 5753 elderly covered by Iran Health Insurance Organization who used hospitalization services in three teaching hospitals of Sanandaj in 2013. Using Chi square and t-test, data analysis was performed
Results: The frequency of elderly hospitalizations was 6703 cases. Mean of hospitalization rate was 1.04 times in men and 1.36 times in women. The elderly hospitalization costs were about 27.8% of the total hospitalization costs. The costs of hospitalization services were statistically different between elderly and non-elderly patients except the rehabilitation services. Although there was statistically significant relationship between the age of elders and their length of stay but no statistically significant relationship between elderly's age and their hospitalization costs was reported. In addition, no significant difference between the mean costs of each hospitalization in men and women was reported
Conclusion: It was concluded that the hospitalization costs are higher in elderly patients compared to the non-elderly patients, so managers and policymakers are required to have a program for funding the elderly's health services costs. Considering the evidences in aged economic area including consumption patterns and services costs seems to be necessary
ABSTRACT
Activity Based Costing [ABC] is a method to illustrate cost of products and is capable to provide non-financial information to improve efficiency of organizations. The Aim of this study is to determine cost of radiology and sonography services and to demonstrate difference between fees and cost in public sector. We analyzed more than 100 different radiology and sonography services using work and time study to determine dedicate time and resource for each service in radiology ward of Hafez hospital. Total cost of overhead centers was allotted to services using concurrent equation method after calculation. Monte Carlo simulation method has been used to calculate confidence interval of each cost price. Estimated cost price has been showed in details that included activities description, kind, amount and cost of material, equipment and energy consumed by each service. Also we calculated building depreciation and amount of total cost allotted to each service from overhead centers such as management, accounting and so on. Fees 36678 and 42038 respectively for radiology and sonography services. Our results indicated that main components of cost were human resource [48%], overhead cost [27%], equipment depreciation cost [14%] and material cost [11%]. Due to low productivity, cost of service was higher then received fees. So, for overhead cutting, the best was is increasig service volume. Finally we must mention that for making fees move realistic and imporoving service level use of ABC system is a necessity