Payesh (Apr 2017)
Iran\'s Health System evolution and Tariff change on Cardiovascular Ward Performance of a Big Teaching Hospital
Abstract
Objective (s): A major share of health system financial resources are dedicated to hospitals and any reform in the health system can affect the performance of them. The aim of this study was to determine the effect of Iranchr('39')s health system reform and tariff change on income and expenditure of cardiovascular ward of a big tertiary Hospital in Iran in 2015. Methods: This cross-sectional study was conducted in cardiovascular department of a big tertiary hospital in Mashhad, Iran, using activity based costing. Data relating to performance, revenue and expenditure of the cardiovascular department were collected using a designed form. Results: After both health system evolution and tariff change, total health service related income of cardiovascular department has increased respectively by 31% (real value = 29% increase). The governmental funds which dedicated to this department has also increased by 104% (real value =10% increase). Total income of this department has increased respectively by 39% 26% after health system evolution and tariff change. The highest increase of income has related to operating room after tariff change (203%). After both health system evolution and tariff change, total expenditure of this department has increased respectively by 21% and 31%. The highest increase of expenditure has related to physician wage (97%) after tariff change. Totally, before health system evolution, profit of cardiovascular ward was 135 million rail while has changed after health system evolution and tariff change respectively by 3/452 and 3/257 million rail. Conclusion: Performance and financial indicators of Imam Reza cardiovascular ward have been effected substantially by health system reform; however, has not equally effected all revenue and expenditure items.
