Extra Cost of Granting Autonomy to Public Hospitals

Reform of structure and improvement of healthcare providing system especially in hospitals are among the most important priorities of health systems. Granting autonomy to university hospitals is a recommended in this regard. The aim of this study was to determine the costs and credits imposed to the system by granting autonomy to public hospitals. To calculate the necessary funding, two components of physician fee and hotelling were accounted. The available statistics and documentations including the number of regular and special beds of public hospitals, occupied bed coefficient, the extra cost of hotelling due to granting autonomy, relative value unit, and the annual number of health services in country were extracted from the Ministry of Health and Medical Education and insurance organizations. Then, due to study modeling the amount of increased costs and funding of granting autonomy to hospitals was estimated. The estimated cost of physician fee for procedures was about 7,026 billion IR Rials and cost of hotelling was nearly 8,140 billion IR Rials before granting autonomy to public hospitals. In autonomy condition of hospitals, the annual surplus cost of 27,881 billion IR Rials was required including 15,669 billion IR Rials for physician fees and 12,211 billion IR Rials for hotelling. In the condition of granting autonomy to public hospitals, the extra funding was about 28,000 billion IR Rials which must be paid by the Ministry of Health and Medical Education and insurance organizations.