Document Type : Original Article

Authors

1 Social Security Organization, Urmia, Iran

2 Department of Public Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran

3 Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran

10.30476/jhsss.2022.95634.1603

Abstract

Background: CT-scan is one of the radiology units in which various services are carried out by injection and without injection to describe the patient’s anatomy better. Given the increasing costs of the CT due to diagnostic equipment, it is necessary to calculate the exact costs of services provided to determine optimal pricing and logical tariff of these services.
Methods: The present study is an applied and cross-sectional research performed by step-down costing method using the data of 2018 at the CT-scan unit of the radiology department of Imam Reza Hospital in Urmia. In this study, standard forms related to direct and indirect costs of CT units and other activity centers have been used to collect the data. Appropriate sharing bases were used to determine the share of the costs of other departments in the services of this unit.
Results: The cost of a brain scan without injection was calculated 66.7$PPP, the brain with injection 143.9$, the chest without injection 84.4$PPP, the chest with injection 163.5$PPP, upper and lower limbs without injection 150.1$PPP, spine (cervical, thoracic, lumbar) 135.6$PPP, abdomen and pelvis without injection 149.2$PPP, abdomen and pelvis with injection 243.9$PPP, sinus 94.1$PPP, carotid CT angiography (extracranial) 287.5$PPP, and thoracic aortic CT angiography 277.8$PPP.
Conclusion: The study results showed a significant difference between the actual price of CT scan services and tariffs. Also, the shorter the service time and the more services in the CT scan department, the lower the unit cost. Comparing the cost of selected CT services in this study, we found that some timeconsuming services, which were mainly related to injection services, imposed higher costs on the centers.

Highlights

Kaveh Houman (Google Scholar)

Hasan Yusefzadeh (Google Scholar)

 

Keywords

  1. Almen A, Tingberg A, Mattsson S, et al. The influence of different technique factors on image quality of lumbar spine radiographs as evaluated by established CEC image criteria. the British journal of radiology. 2000;73(875):1192-9. doi: 1259/bjr.73.875.11144797.
  2. Simpkin DJ. Evaluation of NCRP Report No. 49 assumptions on workloads and use factors in diagnostic radiology facilities. Medical Physics. 1996;23(4):577-84. doi: 10.1118/1.597813.
  3. Stephenson S. Manual on Radiation Protection in Hospitals and General Practice. Taylor & Francis. 1976; PMCID: PMC1008072.
  4. Yaghoubi M, Agharahimi Z, Karimi S, Javadi M. Factors Affecting Patients' Preferences in Choosing a Hospital-Based on the Mix Marketing Components in Isfahan. Hakim Research Journal. 2011;14(2):106.
  5. Nisenbaum HL, Birnbaum BA, Myers MM, Grossman RI, Gefter WB, Langlotz CP. The costs of CT procedures in an academic radiology department determined by an activity-based costing (ABC) method. Journal of computer assisted tomography. 2000;24(5):813-23. doi: 10.1097/00004728-200009000-00026.
  6. Afshari A, Khatib Semnani AM, Rahim RN, Anvari Savojbolaghi S, Yusefi B. Cost Of Services In Medical Imaging Center Of Imam Khomeini Hospital. Payavard Salamat. 2013;7(2). Available at: https://sid.ir/paper/149591/en.
  7. Cinquini L, Mitchell F. Success in management accounting: lessons from the activity‐based costing/management experience. Journal of Accounting & Organizational Change. 2005. doi: 10.1108/18325910510635290.
  8. Namazi M. Study activity based costing in accounting management and its behavior respects. Accounting and Audit Studies. 1999;26:71-106.
  9. Järvenpää M. Making business partners: a case study on how management accounting culture was changed. European Accounting Review. 2007;16(1):99-142. doi: 1080/09638180701265903.
  10. 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.
  11. Beyranvand R, EBADI FAF, Emamgholipour S, Arab M. Unit-Cost Calculation of Delivered Services Based on Activity Based Costing (ABC) Method Compared with Approved Tariffs in Physiotherapy Department of Sina Hospital Affiliated to Tehran University of Medical Sciences in 2013-2014. 2016;15(2):49-58.
  12. Innes J, Mitchell F. ABC: a follow up survey of CIMA members. Management Accounting. 1995;73(7):50-51.
  13. Yusefzadeh H, Hadian M, Abolghasem Gorji H, Ghaderi H. Assessing the Factors Associated With Iran's Intra-Industry Trade in Pharmaceuticals. Glob J Health Sci. 2015;7(5):311-9. doi: 10.5539/gjhs.v7n5p311. PMID: 26156931. PMCID: PMC4803853.
  14. Torabi A, Keshavarz K, Najafpour Z, Mohamadi E. Computing cost price by using activity based costing (abc) method in radiology ward of Golestan hospital in Ahvaz university of medical sciences in 2009. HOSPITAL. 2011;10(2(37)). Available at: https://sid.ir/paper/106665/en.
  15. Saber MA, Barouni M, Bahrami MA, et al. Cost price estimation of radiology services in Shafa Hospital, Kerman, 2010. Toloo-E-Behdasht. 2011;10(1):50-61. Corpus ID: 167454471.
  16. Nikpajouh A, Shariati B, Soheili S. The costs of the radiology ward by step-down method in amir alam hospital, Tehran, Iran. Payesh (Health Monitor). 2009;8(3):235-244.  http://payeshjournal.ir/article-1-608-en.htm.
  17. Aghlmand S, Rahimi B, Farrokh-Eslamlou H, Nabilou B, Yusefzadeh H. Determinants of Iran's BilateralIntra-industry Trade in Pharmaceutical Industry. Iran J Pharm Res. 2018;17(2):822-8. PMID: 29881438. PMCID: PMC5985198.
  18. Lewis MA, La Forgia GM, Sulvetta MB. Measuring public hospital costs: empirical evidence from the Dominican Republic. Social science & medicine. 1996;43(2):221-234. doi: 1016/0277-9536(95)00364-9.
  19. Ahmadi Jahanabad F, Moshrafzadeh K, Davari K, Parisaei Z, Dayanati K, Abravan J. Cost–Analysis in Health& Medication Services in Health Sector of Kohgiluyeh & Boyrahmad Province. Armaghane danesh. 2005;10(3):85-93.
  20. Laurila J, Suramo I, Brommels M, et al. Activity-based costing in radiology: application in a pediatric radiological unit. Acta radiológica. 2000;41(2):189-95. doi: 10.1080/028418500127345037. PMID: 10741796.
  21. Ibrahim R, Nur AM, Zafirah A, Aljunid SM. The Cost of Radiology Procedures Using Activity Based Costing (ABC) for Development of Cost Weights in Implementation of Casemix System in Malaysia. Jurnal Sains Kesihatan Malaysia (Malaysian Journal of Health Sciences). 2018;16(1): 155-62.
  22. Niasti F, Fazaeli AA, Hamidi Y, Viaynchi A. Applying ABC system for calculating cost price of hospital services case study: Beheshti hospital of Hamadan. Clinical epidemiology and global health. 2019;7(3):496-9. doi: 1016/j.cegh.2019.06.001.