Background Considering the importance of healthcare services costing in resource allocation, the aim of this study is to calculate the cost of rehabilitation services in an outpatient rehabilitation clinic in Tehran, Iran. Methods The data for this study were categorised as financial data and information about the process of rehabilitation services. The first category was extracted from the financial documents and the second was obtained by observation of patient flow and interviews with the clinic staff in 2016. The cost of rehabilitation services has been estimated using the time-driven activity-based costing approach. Results The findings show that the cost of physical occupational therapy in the Asma rehabilitation center was $18.79 per unit of service. This amount for speech therapy services was $17.23 to $19.40, taking into account the difference in the quality of the service delivered. The cost of mental health occupational therapy service was between $19.46 and $23.57. Comparing the cost of these services with the government’s tariffs makes it clear that there is a huge gap. Conclusion The limited number of patients referred to the center makes the cost of one unit of rehabilitation services much higher than the official tariffs. This is true for almost all similar institutions and makes the profitability of small rehabilitation institutions extremely unstable. Therefore, proper marketing for rehabilitation services by promoting patient referral links with larger healthcare centers and reallocation of resources to the formation of integrated rehabilitation complexes can play a significant role in their profitability.
The article's abstract is not available.
This paper develops an integrated model for flexible job-shop scheduling problem with the maintenance activities. Reliability models are used to perform the maintenance activities. This model involves two objectives: minimization of the maximum completion time for flexible job-shop production part and minimization of system unavailability for the PM (preventive maintenance) part. To aim the objectives, two decisions must be taken at the same time: assigning jobs on machines in order to minimize the maximum completion time and finding the appropriate times to perform PM activities to minimize the system unavailability. These objectives are obtained with considering dependent machine setup times for operations and release times for jobs. In advance, the maintenance activity numbers and PM intervals are not fixed. Two multi objective optimization methods are compared to find the pareto-optimal front in the flexible job-shop problem case. Promising the obtained results, a benchmark with a large number of test instances is employed.
Bachground: Considering the necessity of health services costing, the aim of this study is to calculate the cost of rehabilitation services in an outpatient rehabilitation clinic in Tehran, Iran.Methods: The data for this study were categorized as financial data and information about the process of rehabilitation services. The first category was extracted from the financial documents and the second one is obtained by observation of patient flow and interviewing the clinic staff in 2016. The cost of rehabilitation services has been estimated using the time-driven activity-based costing approach.Results: The findings show that the cost of physical occupational therapy in the Asma rehabilitation center was $18.79 per unit of service. This amount for speech therapy services was $17.23 to $19.40, taking into account the difference in the quality of the service delivered. The cost of mental health occupational therapy service was also between $19.46 and $23.57. Comparing the cost of these services with their government’s tariffs makes it clear that there is a huge gap.Conclusion: The limited number of patients referred to the center has made the cost of one unit of rehabilitation services much higher than their official tariffs. This is true for almost all similar institutions and makes the profitability of small rehabilitation institutions extremely unstable. Therefore, proper marketing for rehabilitation services by promoting patient referral links with larger healthcare centers and the formation of integrated rehabilitation complexes can play a significant role in their profitability.
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