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  3. The state of consumption of energy carriers before and after the implementation of the subsidy targeting plan in the hospitals of Ilam University of Medical Sciences in 2008-2019

The state of consumption of energy carriers before and after the implementation of the subsidy targeting plan in the hospitals of Ilam University of Medical Sciences in 2008-2019

Number of pages: 109 File Format: word File Code: 32066
Year: 2013 University Degree: Master's degree Category: Health - Health
Tags/Keywords: Energy carriers - energy consumption, - Energy sources - hospital - Optimizing energy consumption - Targeted subsidy scheme
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  • Summary of The state of consumption of energy carriers before and after the implementation of the subsidy targeting plan in the hospitals of Ilam University of Medical Sciences in 2008-2019

    Dissertation for obtaining a master's degree in healthcare management

    Abstract:

    Introduction: Energy resources are one of the most important sources of service in the hospital. The purpose of this research was to compare the amount of energy consumption before and after the implementation of the targeting plan of subsidies in the hospitals of the Ilam Institute of Medical Sciences in the years 1390-1388.

    Methodology: This is a descriptive-analytical research that was conducted quantitatively and cross-sectionally in 1391. The research population included all the hospitals of Ilam University of Medical Sciences. All hospitals have been studied by census. Referring to the statistics and documents of cost and consumption in the years 2018-2019 was the basis for collecting information. The data obtained by entering Excel and SPSS statistical software were analyzed using descriptive statistics and paired T-test and Pearson's correlation. Findings: The t-student test showed that the average monthly consumption of water and electricity in one year after the targeting of subsidies in the studied hospitals more than one year ago and the amount of gas consumption was significantly lower than before. However, the average monthly amount of water, electricity and gas in the period after the subsidies were targeted was significantly higher than before (p-value ? 0.001). Also, the total energy cost in the studied hospitals (Mustafa Khomeini, Taleghani, Imam Khomeini) increased by 3.7, 6.5, and 6.8 times respectively after the subsidies were targeted.

    Discussion and conclusion: To optimize consumption It is better for energy consumption standards in hospitals to be determined and applied in different sectors according to the latest level of technology and other factors affecting energy consumption. It is also suggested that the government reform the provision of government medical center subsidies so that this heavy burden is removed from the shoulders of hospitals or adjusted to a significant extent. Keywords: hospital, energy consumption, targeting of subsidies 1 Introduction:

    Today, energy is considered as one of the main factors of production in the world, along with capital and human power, and in our country, energy undoubtedly plays a significant role in the progress and development of the country; Therefore, it is very important to formulate appropriate strategies and policies, taking into account future forecasting criteria and formulating programs according to it, in order to use and optimally allocate energy. (Warning statistics of the Minister of Oil, 2019)

    Energy input is considered one of the basic inputs in the macroeconomic production function; In such a way that any change in the price of this input affects the price index of the production of goods and services in the short term through its cost share and in the long term through the mutual effect on the market of other inputs. The importance of the behavior of the energy input compared to other inputs is such that it has dedicated special detailed discussions in the economic literature. (Sharifi et al., 2017) Effective use of energy can be one of the potential and effective ways to solve the global energy problem. (Sabitosi, 2008)

    In order to reduce the negative economic, social and environmental effects of the consumption of energy carriers such as fossil fuels, governments must play their role either individually or in collaboration through strong measures and policies such as market regulatory interventions. So that in the energy replacement scenario of the International Energy Agency (IEA), the policies that governments are currently implementing (such as energy subsidy reforms) seem to reduce the growth of fossil fuel consumption and extraction by half by 2030. (Morgan, 2008) Meanwhile, the production and consumption of energy in Iran is far from the optimal state and the intensity of energy consumption has increased significantly in Iran over the past years. (Jabarvand et al., 1390)

    Although Iran is considered the second country in the Middle East in terms of diverse energy sources and reserves, timely investment in the energy sector and paying sufficient attention to it is necessary even in countries that have technical energy resources and makes it possible to reach international arenas.For example, Iran's gas reserves alone are far more than the total gas reserves of the Middle East countries; But the importance of saving natural gas consumption as a sustainable resource becomes more clear when we know that the consumption of this fuel is increasing day by day due to its many advantages over other fuels. Among these advantages, it can be mentioned that it is cheap, does not pollute the air, the environment, and can be replaced by other fuels as well as by other fuels. (Salehi, 1372)

    Also, by looking at energy consumption statistics and important indicators such as per capita energy consumption, energy intensity and energy efficiency in Iran and comparing it with other countries in the world, we find that in the field of global competition that is moving towards less (optimal) consumption and more production, we see a lot of energy waste in the transportation, household, industry and public-government sectors, especially hospitals. (Ministry of Energy, 2018) Statistics and figures presented in researches related to health care show that energy consumption per square meter in hospitals is much higher than other types of service institutions. (Jabarvand et al., 1390)

    One of the main types of office buildings that has a great potential for energy saving measures is the hospital. Hospitals account for a large share of the consumption of energy carriers for the reasons we mention. Reasons include: the 24-hour operation of this organization, the large size and surface of the structure, the need for hot water, the need for cooling and heating facilities, sterilization equipment, and the existence of all kinds of medical equipment. (EPA Environmental Consultants, 2007)

    It is clear that energy resources are one of the most important sources of service in the hospital, and any problem in their provision and use will directly disrupt the provision of services to patients and even endanger their lives. Energy cost accounts for a significant part of non-personnel costs and directly affects the cost of each unit of service provided to hospitals. (Sedqiani, 1377)

    Energy price is among the variables that are exogenously determined by the government in Iran's economy. Because, on the one hand, energy flows among all economic sectors, and on the other hand, all economic sectors are connected with each other. Therefore, any change in energy prices affects the entire economy and leaves significant consequences. (Qadri et al., 2018) The initial investigation shows that if the price of energy carriers increases, it is possible that the cost of government health and treatment centers will increase up to 700 billion tomans. (Iran Health Information Database, 2019) In this regard, Khabar Online website quoted a member of the Health and Treatment Commission of the Islamic Council as saying that most of the government hospitals are currently facing a budget deficit, and they will not be able to provide services to the people if government support is cut off. Because the lower deciles of the society are the most people who refer to government hospitals, and with the removal of subsidies for energy carriers, which include water, electricity, and gas, these hospitals will not be able to cover their own water and electricity costs, and the people of the lower decile of the society will face many problems. (Hosni Bafrani, 1389)

    The World Health Organization has estimated that almost three-quarters of the total health and treatment budget in developing countries is spent on hospital expenses, and the ever-increasing cost of healthcare and treatment, the unused part of the capacity of hospital beds, the lack of correct and rational use of existing resources, and the lack of attention to hospital bed indicators cause the loss of resources, wastage of financial resources and decrease It has become hospitals. (Bahadri, 1386) What is referred to as a subsidy in our society today, is actually a direct or indirect payment of some kind of financial aid, economic privilege or granting a special advantage to private institutions, households or government units that is done to achieve the desired goals.

  • Contents & References of The state of consumption of energy carriers before and after the implementation of the subsidy targeting plan in the hospitals of Ilam University of Medical Sciences in 2008-2019

    List:

    The first chapter. 12

    1-1 Introduction: 13

    1-2 statement of the problem and importance of the research: 16

    1-2-1 benefits of targeting energy carrier subsidies: 18

    1-3 goals and assumptions. 21

    1-3-1 The main purpose of the plan. 21

    1-3-2 sub-objectives of the plan. 21

    1-3-3 functional purpose. 22

    Aspirational goal: 22

    1-3-4 research questions. 22

    The second chapter. 23

    2-1 Theoretical foundations of research. 25

    2-1 Historical background of the research topic: 26

    The history of subsidies in the world. 26

    2-1-2 History of subsidy in Iran. 26

    2-1-3 Subsidy reforms in recent years (9th and 10th governments) 28

    2-2 Theoretical foundations of the research. 29

    2-2-1: The benefits and advantages of implementing the subsidy targeting program: 30

    2-2-2 Conditions of subsidy reforms. 32

    2-2-3 Objectives of subsidy reforms: 32

    2-2-4 Subsidy payment methods: 33

    2-2-5 Subsidies and their types: 33

    2-2-6 Subsidy targeting methods: 35

    2-2-7 Energy carriers and hospitals: 36

    2-2-8 The status of the three energy carriers studied in Iran (before the implementation of the subsidy targeting plan): 37

    2-2-9 The main energy supply systems in hospitals: 38

    2-2-10 Benefits of saving energy carriers: 38

    2-2-11 Audit and evaluation of subsidy reforms: 38

    2-2-12 Audit and evaluation of energy carrier consumption: 39

    2-2-13 Obstacles and limitations of energy consumption efficiency evaluations: 40

    2-2-15 Definitions of some key terms in the topic of targeting subsidies: 41

    2-2-15-1 Subsidy: 41

    2-2 An overview of studies. 43

    Studies carried out in Iran: 43

    2-3-2 Researches carried out outside Iran: 49

    Chapter three. 53

    3-1 Introduction. 54

    Chapter Four. 57

    4-1 Introduction: 58

    Table 1: Average monthly number of patients and occupied bed days of the studied hospitals one year before and after the implementation of the subsidy targeting plan 59

    Chart 1: Comparison of the average monthly water consumption (in liters) of the studied hospitals one year before and after the implementation of the subsidy targeting plan 60

    Table 2: Comparison of the average consumption Monthly water before and after the targeting of subsidies in the studied hospitals one year before and after the implementation of the targeting of subsidies 60

    Chart 2: Comparison of the average monthly electricity consumption (in kilowatt hours) of the studied hospitals one year before and after the implementation of the targeting of subsidies 61

    Table 3: Comparison of the average monthly electricity consumption before and after the targeting of subsidies in the studied hospitals one year before and after the implementation Subsidy targeting plan 62 Table 4: Comparison of average monthly gas consumption before and after subsidy targeting in the studied hospitals one year before and after the implementation of the subsidy targeting plan 64 Chart 4: Comparison of the average monthly cost of water consumption in the studied hospitals one year before and after the implementation of the subsidy targeting plan 65 Chart 5: Comparison of the average cost of electricity consumption of the studied hospitals one year before and after the implementation of the subsidy targeting plan 66

    Chart 6: Comparison of the average monthly cost of gas consumption of the studied hospitals one year before and after the implementation of the subsidy targeting plan 67

    Chart 7: Comparison of the total cost of water consumption of the studied hospitals one year before and after the implementation of the subsidy targeting plan 68

    Chart 8: Comparison of the total cost The electricity consumption of the studied hospitals one year before and after the implementation of the subsidy targeting plan 69

    Chart 9: Comparison of the total cost of gas consumption of the studied hospitals one year before and after the implementation of the subsidy targeting plan 70

    Chart 10: The total energy cost before and after the subsidy targeting in the studied hospitals one year before and after the implementation of the subsidy targeting plan. 71

    Table No. 5: Comparison of the average monthly consumption of energy carriers in one year before and after the subsidy targeting plan in the research hospitals one year before and after the implementation of the subsidy targeting plan 72

    Table 6: The average per capita water consumption (liters) of the studied hospitals according to the number of patients one year before and after the implementation of the subsidy targeting plan. 73

    Table 7: Average per capita electricity consumption (kWh) of the studied hospitals according to the number of patients one year ago and73

    Table 7: Average per capita electricity consumption (kWh) of the studied hospitals according to the number of patients one year before and after the implementation of the targeted subsidy plan 73

    Table 8: Average per capita gas consumption of the studied hospitals according to the number of patients one year before and after the implementation of the targeted subsidy plan 74

    Table 9: Average per capita water consumption of the studied hospitals according to occupied day beds One year before and after the implementation of the subsidy targeting plan. 75

    Table 10: Average per capita electricity consumption of the studied hospitals according to occupied day beds one year before and after the implementation of the subsidy targeting plan 75

    Table 11: Average per capita gas consumption of the studied hospitals according to occupied day beds one year before and after the implementation of the subsidy targeting plan. 76

    Table 10: Average per capita water consumption (liters) of the studied hospitals according to the number of approved beds one year before and after the implementation of the targeted subsidies plan 76

    Table 11: Average per capita electricity consumption (kWh) of the studied hospitals according to the number of approved beds one year before and after the implementation of the targeted subsidies plan 77

    Table 12: Average per capita gas consumption (cubic meters) the hospitals under study according to the number of beds approved one year before and after the implementation of the targeting plan for subsidies 77

    Table No. 13: Pearson correlation coefficients between the amount and amount of consumption of energy carriers with the number of patients in the hospitals under study one year before and after the implementation of the targeting plan for subsidies 78

    Table No. 14: Correlation coefficients of Pearson between the amount and amount of consumption of energy carriers with occupied day beds in Researched hospitals one year before and after the implementation of the subsidy targeting plan 78 Table 15: Comparison of the water consumption efficiency of the studied hospitals according to the occupied day bed one year before and after the implementation of the subsidy targeting plan Table 16: Comparison of the electricity consumption efficiency of the studied hospitals according to the occupied bed day one year before and after the implementation of the subsidy targeting plan 79

    Table 17: Comparison of the gas consumption efficiency of the studied hospitals in terms of occupied day beds one year before and after the implementation of the subsidy targeting plan 80

    Table 18: The overall efficiency of energy carriers in terms of occupied day beds in the studied hospitals one year before and after the targeting of subsidies 80

    Table 19: Comparison of energy efficiency before and after the targeting of subsidies in One year before and after the targeting of subsidies in the studied hospitals 81. Table 20: The ratio of energy cost to total running costs in the studied hospitals one year before and after the targeting of subsidies. 83

    Table 22: Point-to-point comparison of per capita water consumption according to the number of patients in Taleghani Hospital. 84

    Table 23: point by point comparison of per capita water consumption according to the number of patients in Imam Khomeini Hospital. 85

    Table 24: Point-to-point comparison of per capita electricity consumption according to the number of patients in Mustafa Khomeini Hospital. 86

    Table 25: Point-to-point comparison of per capita electricity consumption according to the number of patients in Taleghani Hospital. 87

    Table 26: Point-to-point comparison of per capita electricity consumption according to the number of patients in Imam Khomeini Hospital. 88

    Table 27: Point-to-point comparison of gas consumption per capita according to the number of patients in Mustafa Khomeini Hospital. 89

    Table 28: Point-to-point comparison of gas consumption per capita according to the number of patients in Taleghani Hospital. 90

    Table 29: Point-to-point comparison of water consumption per capita according to occupied day bed in Mustafa Khomeini Hospital. 91

    Table 30: point-by-point comparison of per capita water consumption according to occupied day beds in Taleghani Hospital. 92

    Table 31: Point-to-point comparison of water consumption per capita according to occupied day bed in Imam Khomeini Hospital. 93

    Table 32: Point-to-point comparison of electricity consumption per capita according to occupied day bed in Mustafa Khomeini Hospital. 94

    Table 33: Point-to-point comparison of per capita electricity consumption according to occupied day beds in Taleghani Hospital. 95

    Table 34: Point-to-point comparison of per capita electricity consumption according to occupied day beds in Imam Khomeini Hospital. 96

    Table 35: Point-to-point comparison of gas consumption per capita according to occupied day bed in Mustafa Khomeini Hospital. 97

    Table 36: Point-to-point comparison of gas consumption per capita according to occupied day beds in Taleghani Hospital. 98

    The fifth chapter.

The state of consumption of energy carriers before and after the implementation of the subsidy targeting plan in the hospitals of Ilam University of Medical Sciences in 2008-2019
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