Comparison of the Unit Cost of Diagnostic Imaging Services Before and During the COVID-19 Pandemic Using the Activity-Based Costing (ABC) Method

Abstract

Background: The consequences of coronavirus disease (COVID-19) pandemic, especially the financial burden imposed on the healthcare systems and hospitals, have been unpredictable around the world. Radiology wards have been exposed to the highest burden during this pandemic. Objectives: This study aimed to calculate the cost of diagnostic imaging services before and during the COVID-19 pandemic, using the activity-based costing (ABC) method in an important diagnostic center of COVID-19 in Khorramabad, Iran. Patients and Methods: In this retrospective study, data were extracted from the hospital accounting sources in the radiology ward over two years (2019 - 2021). According to the ABC method, four types of cost were defined, including wage, supporting services, Consuming materials, and overhead expenses. Therefore, based on the monthly number of services, the unit cost of each service was calculated. Results: The unit cost of all services during the COVID-19 pandemic was higher than before, except for CT scan (before: 6.1 United States dollar [USD]; during: 5.6 USD) (P = 0.008). The unit cost of MRI service was 5.7 USD before the pandemic and 7.1 USD during the pandemic (P = 0.57); the cost per radiography service was 1.8 USD before the pandemic and 7.1 USD during the pandemic (P = 0.01); and the cost per sonography service was 1.1 USD before the pandemic and 2.8 USD during the pandemic (P = 0.04). Finally, the cost of mammography increased dramatically during the pandemic (before the pandemic: 21.3 USD; during the pandemic: 48.2 USD) (P = 0.004). Conclusion: The COVID-19 pandemic has increased the radiology department expenses. The cost of CT scan services decreased due to the large number of services provided compared to the pre-pandemic period.