Articles

Calculating the Costs of the Technical Component of Operating Room in Selected Hospitals in Iran, 2019

Abstract

Introduction: Considering that surgeries have a significant role in treating and improving patients’ health, increasing the efficiency and optimizing the costs in the operating rooms are highly important. Thus, this study aimed to calculate the costs related to the technical component of the operating rooms in selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences in 2019.
Methods: This research is a retrospective, descriptive, and analytical study, which is considered applied in terms of its objective. First, literature reviews and expert panel discussions were held, and calculating the methods and assumptions was defined, followed by performing a quantitative study and using traditional costing methods. Data were collected from forms, hospital documents, and the hospital information system and then recorded in Excel 2016. After performing calculations, cost analysis was conducted in two scenarios.
Results: In all the operating rooms of Tehran and Iran Universities of Medical Sciences, considering depreciation, the highest and lowest unit costs of the technical component were $3.54 and $1.68 based on USD purchasing power parity, respectively. Both values exceeded the technical component rate of $0.87 in 2019,, demonstrating a negative cost-to-revenue balance in all operating rooms. Even without considering depreciation, the unit cost of the technical component in all operating rooms (except one) was higher than the monetary coefficient of the technical component of $0.87 in 2019.
Conclusion: The significant difference between the unit cost of the technical component in the operating room and the technical component rate in 2019 led to increased costs for hospitals. Given the increasing trend of consumable costs, this cost imbalance is likely to widen further. Hospitals are forced to use their own revenues to cover these costs since they are not covered by insurance organizations or patients. Therefore, it is essential to take necessary measures to adjust the percentage of the technical component of the operating room and adopt policies to prevent problems in the continuity of service delivery in public hospitals.

1. Fagih dinvari M, Chamangard N. The Effect of Cost of Hospital Services on the Quality of Services and Acceptance of
Stakeholders in Tabriz Hospitals. Journal of Accounting and Management Vision. 2019;2(11):61-75.
2. Houman K, Yusefzadeh H, Nabilou B. Determining the cost of MRI using the step-down method: A case study. Journal of Health Administration. 2021;24(3):22-31.
3. Shams L, Gharibi F, Poursaki T, Maher A. How Iran’s Hospital Accreditation Program Meets the International Society for Quality in Health Care (ISQua). Health Technology Assessment in Action. 2024;8(3). doi:10.18502/htaa.v8i3.16405
4. Shaarbafchi zade n, jabbari a, hashemian m. Comparing the costs of radiology and CT-scan services in two hospitals
affiliated to Isfahan University of Medical Sciences with approved tariffs and studying resource capacity using TimeDriven Activity Based Costing (TDABC) Method. Hospital. 2019;18(2):75-90.
5. Askari-Majdabadi H, Valinejadi A, Mohammadpour A, Bouraghi H, Abbasy Z, Alaei S. Use of Health Information Technology in Patients Care Management: a Mixed Methods Study in Iran. Acta Inform Med 2019;27(5):311–7. doi:10.5455/aim.2019.27.311-317
6. Mobasheri M, Sami H, Rafiee A. Calculation of the final cost of the services offered in Crusher Unit of Ayatollah Kashani Hospital of Shahrekord using activity-based costing technique. Health Information Management 2015;11(7):889-95. doi:10.22122/him.v11i7.1378
7. Nasiripoor AA, Tabibi J, Maleki MR, Nourozi T. Computation Cost Price of clinical laboratories services in valiasr hospitals in Tehran in 1387 by using of ABC model. jhosp 2010;8(3):5.
8. Alamshah SA. Calculating the cost of services of laboratory in alami herandi clinic of Isfahan Social Security Organization using time-driven activity-based costing and comparing it with the approved tariffs in 2015. Journal of Health Accounting. 2017;6(1):88-110.
9. Javid M, Hadian M, Ghaderi H, Ghaffari S, Salehi M. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital. Glob J Health Sci 2015;8(1):165–72. doi:10.5539/gjhs.v8n1p165
10. Hajighasemi M, Azhdari M. Comparative Examination of the Treatment Costs of Pediatric Digestion Patients Using TimeDriven Activity-Based Costing and Traditional Models (Case Study: Shahid Sadoughi Hospital, Yazd). Journal of Accounting and Social Interests. 2020;10(3):135-56.
11. Kaplan RS. The design of cost management systems: Harvard Business School Press; 2020.
12. Brimson JA, Antos J. Activity-Based Management: for service industries, government entities, and nonprofit organizations: Wiley; 1994.
13. Horngren CT, Bhimani A, Datar SM, Foster G. Management and cost accounting: Financial Times/Prentice Hall Harlow; 2002.
14. Jabbari A. Perception of insurance organization managers on the concept of real tariff of medical services in the health system: A qualitative study. Journal of Qualitative Research in Health Sciences 2015;4(3):304–13.
15. Barber SL, Lorenzoni L, Ong P. Price setting and price regulation in health care lessons for advancing universal health
coverage: lessons for advancing universal health coverage. OECD Publishing; accessed 26 June, 2019. Avaiable from:
https://www.oecd.org/en/publications/price-setting-and-priceregulation-in-health-care_ed3c16ff-en.html
16. Babashahy S, Manavi S, Akbarisari A. Impact of Primary Stage of Targeted Subsidies Scheme on Inflation Growth and Extra Costs of Hoteling in Public Hospitals in Iran. Hakim-Journal 2015;18(1):49.
17. Rahmani H, Rajabi Vasoukola G, Daroudi R, Yousefvand M, Fakoorfard Z. Evaluation of the cost price of conventional
laboratory services in the selected hospital of Tehran University of Medical Sciences and its comparison with the tariffs
approved by the Ministry of Health and Medical Education in 2019. jhosp 2020;19(4):55.
18. Mehrolhassani MH, Heidari M, Rahimi Z, Emami M. Cost price estimation of clinical laboratory services in Shafa Hospital based on Activity-based Costing, Kerman, 2011. Journal of Sabzevar University of Medical Sciences 2014;21(4):587-595.
19. Hajizadeh A, Kakemam E, Arab-Zozani M, Najafpoor Z, Dargahi H, Saeidpour J. Turnover intention among nurses in
Iranian hospitals: a systematic review and meta-analysis. BMC Nurs 2025;24(1):166. doi:10.1186/s12912-025-02801-x
20. Arab M, Ghiasvand H, Darroudi RA, Akbari Sari A, Hamidi M, Moghri J. Determination of radiology services cost in selected hospitals affiliated with Tehran university of medical sciences in 2010, using the activity based costing method. jhosp 2012;11(3):27.
21. Mouseli A, Barouni M, Amiresmaili M, Samiee SM, Vali L. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country. Electron Physician 2017;9(4):4077–83. doi:10.19082/4077
22. Beyranvand R, Ebadi Fard Azar F, 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. jhosp 2016;15(2):49.
23. Aeenparast A, Farzadi F, Maftoon F, Zahirian Moghadam T. Feasibility of estimating cost of diagnostic radiology and
sonography services by using activity based costing. Payesh 2015;14(1):15-23.
24. Azhdari M, Hajighasemi M, Zand V. Calculating the Cost of the Care Cycle for each Patient Undergoing Tonsillectomy
Using Time-Driven Activity-Based Costing Method. Journal of Health Promotion Management. 2021;10(6):151-61.
25. Ebrahimi Pour H, E P, Vafayinezhad R, Badie Aval S, Keyvanlou Z, A. JB. Total Cost of Pre-Hospital Emergency Missions based on the Activity-based Costing Model and its Comparison with the Cost of Private Emergency Pre-Hospital Emergency Services in Mashhad in 2016. Manage Strat Health Syst 2019;4(2):86-96. doi:10.18502/mshsj.v4i2.1405
26. Hadian M, Mohammadzade A, Imani A, Golestani M. Analysis and Unit Cost Estimation of Services using “StepDown Method” in Fatemieh Hospital of Semnan University of Medical Sciences-2006 Iran. Journal of Health Administration. 2009;12(37):39-48.
27. Golmohammad A, EbadifardAzar F, Abutorabi A. The Cost of Services Provided in the Physiotherapy Department of Shafa Yahyaian Hospital. hbrj 2020;5(4):355. doi:10.22062/5.4.355
28. Mohammadi Y, Baghestani E, Bahrami MA, Entezarian Ardekani S, Ahmadi Tehrani G. Calculating the Cost Price of Dialysis in Shahid Sadoughi Hospital Using Activity Based Costing: Yazd, 2011. Journal of Health Accounting
2012;1(1):73–84. doi:10.30476/jha.2012.16588
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Keywords
Technical component Operating room Unit costs Hospital Costing

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1.
Ehsani Chimeh E, Fakoorfard Z, OlyaeeManesh A, Yousefvand M, Ma’navi S, Damiri S, Radin Manesh M, Hasanzadeh E, Akbari Sari A, Mohaghegh Dolat Abadi M, Daroudi R, Barati O. Calculating the Costs of the Technical Component of Operating Room in Selected Hospitals in Iran, 2019. Health Tech Ass Act. 2026;10(1).