Cost Analysis of Eye Surgeries and Comparison with Approved Governmental Tariffs

Abstract

Background: Cost and cost analysis is a managerial tool that can place needed data at managers' disposal and help them in making informed decisions in investing services and infrastructures. Objectives: The aim of this study was to estimate the cost of eye surgeries and compare them with tariffs approved by the Iranian ministry of health. Methods: The present retrospective-descriptive study was carried out at Nikookari ophthalmic hospital, from April 2013 to April 2014, in Tabriz, Iran. Surgical operations of cataract, strabismus and glaucoma were considered on the grounds that they were global and the most frequent. The required data was collected through conducting interviews with experts and relevant units, direct observation of activities, analysis of documents in the financial department, and hospital information system (HIS) and financial software system of the hospital. The cost of surgical operations was estimated by activity based costing (ABC). Results: According to the findings, the amount and the share of the total costs of the activities identified in the main centers were as following: human resources $2 818 722, depreciation of medical equipment $277 233, consumable medicals and supplies $218,484, building depreciation $138004, depreciation of non-medical equipment $43640, consumable non-medicals and supplies $26804, utility costs $4724, and costs of indirect units $864 455. Ultimately, the costs of different surgeries were estimated to be as follows: strabismus surgery $464, glaucoma $505 and cataract surgery $400, which respectively had $235, $298 and $75 difference with the approved governmental tariffs. Conclusions: This price gap can negatively affect the performance and quality of services provided by hospitals in the long term. Since the costs of personnel, indirect costs and depreciation of medical equipment account for 90% of the total costs of surgery, hospital managers should pay more attention to these issues in order to improve efficiency and reduce costs.