Open Access Maced J Med Sci. 2022 Nov 07; 10(E):1723-1730. 1723 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2022 Nov 07; 10(E):1723-1730. https://doi.org/10.3889/oamjms.2022.10724 eISSN: 1857-9655 Category: E - Public Health Section: Public Health Education and Training Patient-Level Cost Estimation for Health Services at Secondary Hospital, Saudi Arabia Asim Mehmood 1 * , Zafar Ahmed 2,4 , Fahad Khan Azeez 1 , Sohail Akhtar 3 , Wajiha Rehman 1 , Sumaira Idrees 1 1 Department of Health Informatics, College of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia; 2 Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kota Samarahan, Malaysia; 3 Department of Health Informatics, College of Public Health and Health Informatics, Qassim University, Buraydah, Saudi Arabia; 4 Department of Social Work Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK Abstract BACKGROUND: Cost information can help improve the quality of medical care budgeting and can also improve the efcient allocation of resources and patient outcomes. AIM: This study aimed to estimate the inpatient unit cost of health services in a secondary hospital in Saudi Arabia. Cost information can help improve the quality of medical care budgeting and can also improve the efcient allocation of resources and patient outcomes. This study aimed to estimate the inpatient unit cost of health services in a secondary hospital in Saudi Arabia. METHODOLOGY: A cross-sectional retrospective approach was applied to categorize the inpatients discharged from the hospital from January to December 2018. A top-down costing method for cost estimation was used. RESULTS: We found that the overhead cost center represents 40.17% of the total hospital cost and the intermediate and fnal care cost centers consumed 25.50% and 34.33%, respectively. Among the inpatient wards, the surgical ward had the highest operational cost (39.27%). Human resources consumed the hospital’s highest resources (75%) on salaries. CONCLUSION: The hospital’s cost structure was not remarkable and needed revolutionary changes to adopt the new payment mechanism envisioned in the 2030 Saudi vision. Edited by: Sasho Stoleski Citation: Mehmood A, Ahmed Z, Azeez FK, Akhtar S, Rehman W, Idrees S. Patient-Level Cost Estimation for Health Services at Secondary Hospital, Saudi Arabia. OpenAccessMacedJMedSci.2022Nov07;10(E):1723-1730. https://doi.org/10.3889/oamjms.2022.10724 Keywords: Health services cost; Patient-level costing; Secondary hospital; Saudi Arabia; Top-down costing *Correspondence: Asim Mehmood, Department of Health Informatics, Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia. E-mail: assimrza@gmail.com Received: 23-Jul-2022 Revised: 24-Oct-2022 Accepted: 27-Oct-2022 Copyright: © 2022 Asim Mehmood, Zafar Ahmed, Fahad Khan Azeez, Sohail Akhtar, Wajiha Rehman, Sumaira Idrees Funding: This research did not receive any fnancial support Competing Interests: The authors have declared that no competing interests exist Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction Cost knowledge helps administrators and policymakers improve the quality of medical care and make cost projections. Hospital costing information support improving the efective distribution of resources and patient performance [1]. It also ofers basic information on setting user fees for the community with quality [2]. Hospitals are vital and critical for the healthcare system and are considered the most extensive and expensive operational units that consume a large proportion of the health sector’s budget. They provide primary health services and accept referral cases for complicated diseases. Cost analysis studies in recent years have increased awareness of hospital cost structures that are important to improve the efciency and quality of healthcare services [3]. The World Health Organization (WHO) also introduced diferent projects in member states to provide cost information to policymakers to efectively distribute health expenditures [4]. Many developed and developing countries have performed costing exercises for diferent purposes. South Africa, Myanmar, Ghana, Palestine, and India, where hospital service demand is growing and the health system needs to be strengthened, have conducted cost estimation studies [5], [6], [7], [8]. In Saudi Arabia, the Ministry of Health (MOH) is the primary provider and covers almost 60% of health services. It supervises and regulates 244 hospitals and 2037 primary health-care centers throughout the Kingdom through its 20 regional health directorates [9]. The annual Government budget directly funds the MOH, and the regions are allocated lump-sum budgets distributed among hospitals per capacity and requirement [10]. In Saudi Arabia, the third largest sector of government spending in the fscal year 2019 was healthcare and social services, accounting for 15.6% of the total budget, a slight increase from 15.4% and 14.4% of the total budget in 2018 and 2017, respectively [11]. This increase refects that healthcare costs will probably increase in the coming years. However, allocations in the health care sector were traditionally allocated based on the fgures of the previous year without performing costing exercises at the patient or service level. Recently, a costing exercise was performed in a tertiary hospital [1]. There is a need Since 2002