Tehran University of Medical Sciences Health Technology Assessment in Action 2645-3835 10 1 2026 05 10 379 379 Elham Ehsani Chimeh National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Zeinab Fakoorfard Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Alireza OlyaeeManesh National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Mani Yousefvand Secretariat of the Supreme Health Insurance Council, Ministry of Health and Medical Education, Tehran, Iran Saeed Ma’navi Secretariat of the Supreme Health Insurance Council, Ministry of Health and Medical Education, Tehran, Iran Soheila Damiri Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maryam Radin Manesh Social Medicine Department, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran Ebrahim Hasanzadeh School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran Ali Akbari Sari National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Mahmoudreza Mohaghegh Dolat Abadi Anesthesiology Department, Shahid Hashemi Nejad Specialized Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Rajabali Daroudi Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Omid Barati School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran 2024 12 30 2025 10 13 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. https://htainaction.tums.ac.ir/index.php/hta/article/view/379 https://htainaction.tums.ac.ir/index.php/hta/article/download/379/218