Survey on Economic and Performance Indicators of a Big Tertiary Hospital: Before and After Health Care Evolution Plan, Tariff Change and Pay for Performance Instruction Implementation
Introduction: The aim of this study was to determine the effect of Iran's health system evolution plan, tariffs change on performance, revenue, and expenditure of a big tertiary hospital in Iran in 2015. Methods: This cross sectional descriptive study was conducted in a big tertiary hospital, (Imam Reza) in 1394 using activity based costing in four time spans: before and after health system evolution, after tariff change, and one year after the inauguration of the evolution. Data relating performance, revenue, and expenditure were gathered and analyzed using descriptive statistics by Excel 2013 Software. Results: Cost, revenue, and profit of hospital were increased by 31% 82% and 4.6% after health system evolution and by 42% 38% and 1.7% after tariff change, respectively. Hospital encountered with 17% loss one year after the inauguration of the evolution, however, cost and revenue of hospital were increased 23% and 3% respectively. The highest change in physician and personnel income with 103% and 91% rise was related to after tariff change. After health system evolution and tariff change, operating room income was increased 33% and 124% respectively. One year after the inauguration of the evolution, the operating room income didn't change and the amount of surgeries decreased by 9% Conclusions: Performance and financial indicators of Imam Reza hospital have been affected substantially by health system evolution; however, it has not equally affected all revenue and expenditure items.