Introduction: The hospitals is known to be allocated about 70 percent cost of health system in developing countries, This study was aimed to analysis and unit cost estimation of services using “Step-Down Method” in Fatemieh Hospital ( Semnan University of Medical Sciences-2006)

Methods: This is a cross-sectional, study. The study population is the functional departments of Fatemieh Hospital. Data collecting tools were researcher made tables and reviewing of existent documents and evidences. To analyze the data, we used Excel Software and complementing step-down chain. 

Results: Among three functional departments, the final service departments with 47.5 percent allocated the highest share followed by overhead and intermediate service departments with 24.3 and 21.5 percent of total hospital-wide costs respectively. Annual depreciation was 6.7. Expenditures on personnel cost accounts for almost 48 percent, substantially higher proportion of total cost than expenditures on buildings and permanent structures (5 percent), expenditures on utilities(3 percent) or materials and supplies (2 percent).

Conclusion: Special notice to subject of human resource management and labor productivity are visible and the final service department are necessary for organizing the same activity complementing Also making a database of cost recording in hospital, and implementing one comprehensive and integrated operational planning system at hospital system is needed for managers.