فهرست مطالب mahmoud zamandi

Estimating the total cost of services is crucial for utilizing available resources more efficiently and effectively. By employing the time-driven activity-based costing (TDABC) method, not only can costs be calculated, but also the efficiency and unused capacity of resources can be assessed.

This study aimed to calculate the cost of education for each medical student at one of the AJA Medical sciences Universities in 2022 using the TDABC method.

This quantitative study was conducted cross-sectionally and retrospectively in a descriptive-analytical manner. The data were collected and analyzed through interviews and observations. To analyze and allocate costs, administrative and educational departments were categorized into three levels: Overhead, intermediate, and final activity centers. Then, using the TDABC approach in Microsoft Excel 2013 software costs from the overhead and intermediate activity centers to the final activity center and students.

Thestudy estimated the average cost of educating each medical student tobeapproximately IRR6267 568 065. Additionally, the unused capacity of resources in overhead and intermediate centers was observed to be 30% (range: 4 - 44%) and 33% (range: 26 - 43%), respectively.

The findings indicated that the cost per student is somewhat reasonable; however, there is a high level of unused capacity in the university and faculty activity centers. The effective management of human resources and equipment is necessary to enhance service delivery processes, increase productivity, and reduce unused capacity.

Hypertension is a common public health problem with potentially serious consequences. We aimed to explore the direct costs of hypertension treatment in Iran.

Literature review and STEPS survey were used to estimate the incidence and prevalence of hyperten-sion for Iranian males and females and the proportion of its treatment coverage in 2020. A standard national protocol for hypertension treatment was used to estimate the required medical services including visits, medica-tions, and lab tests. The cost of each service and the total cost of the disease were identified using the national reference costs.

About 23.39 million people suffer from moderate systolic blood pressure (BP of 120 to 139 mm/Hg) and a further 14.6 million people had severe BP (≥140 mm/Hg). Nearby 39.8% of these patients, receive BP treatment. The direct costs of hypertension treatment were 19,006.08 billion IR Rials (USD 87.54 million), of which 16.60% and 83.40% of the costs were related to new and prior cases, respectively. The costs of patient visits, medications, and lab tests were 56%, 35.51%, and 8.49% of the total costs, respectively.

The prevalence and economic burden of hypertension are relatively high in Iran. Early detection and treatment of hypertension might have a significant effect on reducing its complications and costs.

The role of accurate information in decision-making and programs implementation has highlighted the need to design an appropriate costing system. The present study aimed to estimate the cost of student Training in the Department of Health Management and Economics at the School of Public Health, Tehran University of Medical Sciences using activity-based costing.

This research was an applied, descriptive, and cross-sectional study. In this study, all information was collected through interviews with seven officials, financial and administrative staff, and also by using available documents in the faculty. To analyze the costs, the administrative and educational sections were classified into three levels including overhead, middle, and final activity centers, and, using appropriate bases and Microsoft Excel 2013 software, costs of overhead, middle, and final activity centers, and finally, the total cost of each student was calculated.

In this study, the total cost of education for each Ph.D. and master’s student in the department of health management and economics was estimated as 1.95 billion and 376 million IR Rials, respectively. So that the cost of each year of Ph.D. and master’s student education was 433 and 150 million IR Rials, respectively. Out of the total costs of the Department of Health Management and Economics, only 22% of the costs were related to overhead and middle activity centers, and 78% of the costs were exclusive to the final activity center, and the majority of these costs (97%) were related to the personnel, especially the faculty members. 

The cost of training Ph.D. students due to the high coefficient of the degree and thus increasing the importance (cost share) of the field, receiving a scholarship from the Ministry of Health and a longer period of study, was estimated to be about 5 times that of a master’s degree. The Ministry of Health and universities can design and implement targeted research programs with the help of faculty members and graduate students, especially Ph.D. students, to solve problems and improve the health of the community, thus improving resource efficiency and productivity.

Economic evaluation is used for the optimal allocation of resources in the health sector. While a large number of economic evaluation studies have been conducted, there is less critical review of these studies. We critically examined the economic evaluation studies of preventive health interventions.

The study was carried out using critical review method. Seven databases (i.e., PubMed, Cochrane Database of Systematic Reviews, Web of Science, Science Direct, Scopus, Springer Link, and Elsevier) were searched to find articles on economic evaluation of health interventions published from 1985 to 2018. In addition, the references of retrieved studies were hand screened for articles that were not indexed in these databases. Finally, 206 articles, including 33 cost- benefit analysis, 146 cost- effectiveness analysis, and 27 cost- utility analysis were included in this study. These studies were critically evaluated using a checklist of 11 criteria.

Only 20% of the studies met all the methodological criteria of health economic evaluation. The cost perspective, costs type, cost data source, and cost measurement were not explained and discussed in 17%, 20%, 5%, and 33% of studies respectively. Outcome data sources and outcome valuation method were only mentioned in 53% and 69% of studies. The sensitivity analysis and results’ generalizability were not reported in 16% and 46% of studies.

The quality of economic evaluation studies is low, and it can be misleading if resource allocation decisions are made using this evidence. Authors should use valid protocols to conduct and report economic evaluation studies, and journals’ editors should use valid checklists to evaluate these articles.

One of the goals of health systems is to reduce inequality in access to care and promote people's health. Decentralization in the past four decades has aimed at improving management processes and providing appropriate services. The purpose of this study was to investigate the consequences of decentralization by updating systematic review studies. This research is the result of updating the last studies on systematic review of health system's decentralization (March 2016). For this research, all original research papers on the topic were collected by searching in valid databases and qualitative evaluation was performed after removing duplicate and non-related ones. Out of the 640 founded papers, seven study were selected.Decentralization in countries with an organizational structure and appropriate local capacity improves the Governance and active participation of the community, trusts decentralized care, reducing travel distances, increasing access to treatment, achieves universal coverage, and improves all important parameters of service delivery, including quality. It also increase annual visits and reduces infant mortality that can improve access to equity and health outcomes. Decentralization provides an opportunity for community and employee participation in planning, budgeting and providing of justice in resource allocation, and thereby motivates and improves the quality of service delivery. Given that the decentralization implementation in each country depends on the political leadership, socio-economic background, pre-implementation infrastructure and managerial and technical skills at the local level, therefore, key health sector policy makers should have a deep understanding of the country's context in designing and implementing technical strategies

First of all, in method of Activity Based Costing (ABC), activities identify and then direct and overhead costs associated with each activity calculate based on allocation methods. This study aimed at estimating cost of Hematology ward based on method of Activity Based Costing in Imam Reza hospital of Tehran city in 2014. This study was an applied and cross-sectional one. Specific and overhead data cost of Hematology ward collected using activity-based costing method in Imam Reza hospital in the first semester of 2014. In order to allocate the costs of Hematology ward services, first, allocation bases were determined and then direct allocation method utilized to estimate the costs. The study findings indicated that costs of each CBC Test, Malaria slide, Cell Count of Biological Fluids and Reticulocyte count were 72673, 64678, 48509 and 48508 Rials respectively. Among the cost centers, the highest costs belonged to buildings depreciation (overhead) (714117127 Rials), Hematology personneles (4182223581 Rials)and materials and supplies costs (110635349 Rials), respectively. Based on study results, estimated costs differed from tariffs and only Cell Count of Biological Fluids tariff is greater than the estimated cost, the rest of the tests had fewer tariffs than estimated cost which cause laboratory financial loss. At first, in order to control or increase productivity, it is essential to focus on building depreciation costs (e.g. increasing the number of tests) and then should be plan properly to increase manpower productivity of materials and supplies. All tariffs were estimated higher than the estimated cost without building depreciation cost.