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The effect of COVID-19 on public hospital revenues in Iran: An interrupted time-series analysis

Author

Listed:
  • Masoud Behzadifar
  • Afshin Aalipour
  • Mohammad Kehsvari
  • Banafsheh Darvishi Teli
  • Mahboubeh Khaton Ghanbari
  • Hasan Abolghasem Gorji
  • Alaeddin Sheikhi
  • Samad Azari
  • Mohammad Heydarian
  • Seyed Jafar Ehsanzadeh
  • Jude Dzevela Kong
  • Maryam Ahadi
  • Nicola Luigi Bragazzi

Abstract

Background: The “Coronavirus Disease 2019” (COVID-19) pandemic has become a major challenge for all healthcare systems worldwide, and besides generating a high toll of deaths, it has caused economic losses. Hospitals have played a key role in providing services to patients and the volume of hospital activities has been refocused on COVID-19 patients. Other activities have been limited/repurposed or even suspended and hospitals have been operating with reduced capacity. With the decrease in non-COVID-19 activities, their financial system and sustainability have been threatened, with hospitals facing shortage of financial resources. The aim of this study was to investigate the effects of COVID-19 on the revenues of public hospitals in Lorestan province in western Iran, as a case study. Method: In this quasi-experimental study, we conducted the interrupted time series analysis to evaluate COVID-19 induced changes in monthly revenues of 18 public hospitals, from April 2018 to August 2021, in Lorestan, Iran. In doing so, public hospitals report their earnings to the University of Medical Sciences monthly; then, we collected this data through the finance office. Results: Due to COVID-19, the revenues of public hospitals experienced an average monthly decrease of $172,636 thousand (P-value = 0.01232). For about 13 months, the trend of declining hospital revenues continued. However, after February 2021, a relatively stable increase could be observed, with patient admission and elective surgeries restrictions being lifted. The average monthly income of hospitals increased by $83,574 thousand. Conclusion: COVID-19 has reduced the revenues of public hospitals, which have faced many problems due to the high costs they have incurred. During the crisis, lack of adequate fundings can damage healthcare service delivery, and policymakers should allocate resources to prevent potential shocks.

Suggested Citation

  • Masoud Behzadifar & Afshin Aalipour & Mohammad Kehsvari & Banafsheh Darvishi Teli & Mahboubeh Khaton Ghanbari & Hasan Abolghasem Gorji & Alaeddin Sheikhi & Samad Azari & Mohammad Heydarian & Seyed Jaf, 2022. "The effect of COVID-19 on public hospital revenues in Iran: An interrupted time-series analysis," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0266343
    DOI: 10.1371/journal.pone.0266343
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    References listed on IDEAS

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    1. Thomas Czypionka & Markus Kraus & Susanne Mayer & Gerald Röhrling, 2014. "Efficiency, ownership, and financing of hospitals: The case of Austria," Health Care Management Science, Springer, vol. 17(4), pages 331-347, December.
    2. Reza Goudarzi & Mohammad Tasavon Gholamhoseini & Somayeh Noori Hekmat & Setareh YousefZadeh & Saeed Amini, 2021. "The effect of Iran’s health transformation plan on hospital performance: Kerman province," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-10, February.
    3. Masoud Behzadifar & Meysam Behzadifar & Mandana Saki & Mehrdad Valipour & Roodabeh Omidifar & Fatemeh Iranshahi & Nicola Luigi Bragazzi, 2020. "The impact of the “Health Transformation Plan” and related policies on the prevalence rate of cesarean section in Iran: Insights from an interrupted time series analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(1), pages 339-345, January.
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