Doshmangir L^1,2 (MS), Rashidian A * ^1,3 (MD, PhD), Moaeiri F⁴ (MD, MPH), Akbari Salari A^1,3 (MD, PhD)

  ¹ Department of Health Management and Economics, School of Public Health,

  Tehran University of Medical Sciences, Tehran, Iran

  ² School of Management & Medical Information, Tehran University of Medical Sciences, Tehran, Iran

  ³ Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran

  ⁴ Ministry of Health and Medical Education, Tehran, Iran

  Received : 20 Oct 2010, Accepted: 6 Apr 2011

  Abstract

  Introduction: If relative values for services are not determined correctly, they might have negative consequences on availability of care. In this study, we aimed to compare relative values of medical tariffs determined in 1993 (known as the 'California' book) with proposed changes to relative values in 2005 (clinical and diagnosis relative values) and assess the effects of the proposed changes on payment weights of different clinical specialties and costs of health system.

  Methods: In this descriptive cross-sectional study, we conducted a situational analysis, compared the codes, and assessed the potential effects on costs. We, also, investigated views of different experts on relative value changes of some medical tariffs in the proposed book.

  Results: Findings showed imbalance between different relative values of clinical services in the country. If the proposed relative values were implemented for different clinical services, payment weights for different services would have changed considerably.

  Conclusion: If the proposed relative values were implemented, the present imbalances between the relative values within and between different fields of clinical services would have been reduced however, the total healthcare cost would have been increased.

  Key words: Medical Tariff, Health system costs, Payment weight

  Hakim Research Journal 2011 14(1): 1- 9.

  * Corresponding Author: National Institute of Health Research, No 78, Italia Ave, Tehran, Iran. Tel: +98- 21- 88991112, Fax: +98- 21- 88991113, E-mail: arashidian@tums.ac.ir