محبوبه شهبازی فرد

The hospital autonomy plan, the biggest decentralization plan to reform the administration structure of public hospitals, has been implemented for about three decades in Iran. In this study, we aimed to examine the effects of the plan on the financial indicators of autonomous public hospitals.

This descriptive cross-sectional study used revenue and cost data associated with all public hospitals affiliated to Bushehr University of Medical Sciences in 2021. The relevant data was extracted from two big databases including health information system (HIS) and accounting system, and after the data quality control, specific financial self-sufficiency balance (the ratio of specific income to the specific cost of the same hospital) and total financial balance (the ratio of specific income to the total cost of the same hospital) were calculated using Excel software.

Results demonstrated that the specific financial self-sufficiency balance and the total financial balance were 61% and 27%, respectively. The highest and the lowest values of the specific financial self- sufficiency index pertained to the Heart Hospital (the only single specialty heart hospital in the province) and Imam Hossein Hospital (a hospital with 29 active beds in Tangestan county with a population of 82502) as 74% and 45%, respectively. The gap index between the specific cost and revenue of each ac-tive bed showed that on average, the cost of each bed was nearly 215 million Tomans higher than its own income in 2021.

The hospital autonomy plan had different effects on the financial indices of public hospitals studied in this research, denoting it is not possible to cover all hospital-specific expenses through its own earned revenues. Accordingly, government subsidies to autonomous hospitals are necessary.