How is the Cost Structure of Hospital in Developing Countries? A Case of Public University Hospitals in Iran

Introduction: The health systems around the world are facing significant pressure to control the costs and improve the health services delivered. A method to address this challenge is to express the potential savings and inefficiencies of hospitals. The hospitals should provide health care services with the acceptable quality and minimum cost. For this purpose, managers should have accurate information about the cost of the services they provide. Methods: This is a cross-sectional retrospective study carried out based on the data of financial year of 2017-2018. In this study, the cost structure of Shafa Hospital was analyzed and its unit cost of the final activity centers was calculated using top-down approach. Results: The total cost of the hospital in the studied period was US$ 265034418.4. The highest and lowest cost share was related to human resources and energy consumption (59.95% and 0.54%, respectively). The human resources, medicines, and consumables account for over 84% of the cost of the final clinical activity centers. The unit cost of the final activity centers varies so that among admission wards the unit cost of ICU is the highest (US$372.45) and the daily bed cost in the neurology ward is the lowest (US$118.9). Conclusion: Clarification of the hospital cost structure can provide a comprehensive analysis of hospital costs for decision making and policy making. The unit cost of the final activity centers also provides insights into the hospital cost management planning.