Comparison of Global and Actual Cost of Kidney Transplant in Imam Reza Hospital, Tabriz

Global system was implemented in Iran in 1999. This system is currently used to pay for the second and third level health services. In the global system، patients are classified according to the 60 cases of common surgical procedures including kidney transplantation. Several years after implementing this system، the differences between actual costs and global costs of the operations raised many questions. This study aimed to compare actual cost and global cost of kidney transplantation in Imam Reza hospital in Tabriz. In this cross-sectional study، data on kidney transplant surgery were gathered via hospital HIS and all patients'' medical records undergoing kidney transplantation during 2009-2010 (35 patients). Data were analyzed using descriptive statistics and paired T-test in the SPSS-17. The findings of the study showed that there was a loss of 818،665. 45 thousand Rials in the hospital in 2009-2010 due to implementing global costs system. The mean and standard deviation of global costs was 32927. 14±4040. 66 thousand Rials; and mean and standard deviation of actual costs was 56317. 58±3. 53 thousand Rials. There was a statistically significant relationship between the actual and global costs of kidney transplantation. The real cost (non-global) was significantly larger than the global costs (P <0. 001). Insurance companies are only obligated to pay the approved Tariff. The difference between the costs and the income has been reduced in recent years، which may have a negative impact on efficiency of hospitals. The differences between the global and actual costs of kidney transplantation are due to management issues and insurance organizations performance.