Title of article :
Identifying the Causes and Extent of Insurance Deductions in a Hospital: An Interventional Approach to Cost Management
Author/Authors :
Taheri ، Roohangiz Health Services Management Department - School of Public Health - Qazvin University of Medical Sciences , Kalhor ، Rohollah Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases - Qazvin University of Medical Sciences , Ahadinezhad ، Bahman Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases - Qazvin University of Medical Sciences , Kiaei ، Mohammad Zakaria Department of Health Services Management - Islamic Azad University, South Tehran Branch
Abstract :
Background: A significant amount of revenues and deductions exist in the hospitals each year. This study aimed to determine the number of deductions applied and identify its causes. Furthermore, we aimed to provide management strategies to reduce these deductions in Shafa Takestan hospital. Methods: This applied and interventional study was conducted with a crosssectional design. The data collection tool was a checklist from the previous studies. Data were analyzed using descriptive statistics such as mean, percentage, and standard deviation as well as analytical statistics of the Wilcoxon test. Results: Before the intervention, among 405 nonglobal inpatient cases, about 323 (80 %) contained subtractions. After the intervention, among 555 nonglobal hospital admissions, about 264 (47 %) included deductions. Most deductions were related to health services insurance (75.38 %). Concerning each hospital ward, most deductions were related to surgery ward (38 %). Before and after the intervention, service deductions were included in 5.59 % and 4.57 %, respectively. Conclusion: Therefore, medical personnel should pay more attention to documenting patients records and minimizing documentation errors. Moreover, to reduce patient record deductions, the health care staff should be familiarized with proper documentation procedures by conducting training sessions.
Keywords :
Hospital deductions , Cost Management Interventional Approach , Six Sigma , Insurance Organizations
Journal title :
Evidence Based Health Policy, Management and Economics
Journal title :
Evidence Based Health Policy, Management and Economics