title: Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.
abstract: BACKGROUND
  Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study.
  
  
  OBJECTIVE
  The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs).
  
  
  METHODS
  We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios.
  
  
  RESULTS
  Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs.
  
  
  CONCLUSIONS
  As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system such as ABC technique, hospitals would be able to generate robust evidences for financial management of their overhead, intermediate and final ACs.
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Bayati
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Iranian Center of Excellence in Healthcare Management, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mahboub Ahari
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Badakhshan
authors.affiliation: Department of Community Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Mahin
authors.initials: M
authors.lastname: Gholipour
authors.affiliation: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Joulaei
keywords: Cost Analysis; Health Economics; Health-Care; Magnetic Resonance Imaging; Pricing Medical Fees