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طب و تزکیه، جلد ۲۲، شماره ۲، صفحات ۵۳-۶۰
عنوان فارسی بررسی میزان کسورات اعمال شده سازمانهای بیمه خدمات درمانی و تأمین اجتماعی نسبت به صورت حسابهای ارسالی بیمارستا نهای آموزشی شهر خرم آباد
چکیده فارسی مقاله
کلیدواژه‌های فارسی مقاله جمعیت،سالمندی،هزینه ها،ایران،
عنوان انگلیسی A Survey on Deduction Rate Applied By Medical Services and Social Security Insurance Organizations in Respect to Accounts Receivable of Khoram Abad Teaching Hospitals
چکیده انگلیسی مقاله Introduction: the main source of hospital income is by selling health care services provided to theinsured. Thus, the quality of services and facilities to the insured population and other individuals can beimproved by controlling these resources to make correct and efficient use of them and to avoid the wasting.So the aim of research was survey the amount deduction rate by medical services and social securityinsurance organizations with accounts to be sent to Teaching Hospitals University.Methods: The study was cross-sectional, descriptive and type of it was applied study Researchdocuments included all bills sent by Khorramabad Teaching Hospitals to Medical Services and SocialSecurity organizations. The instrument for data collection was check list. Data by descriptive statistic andSPSS software were analyzed.Results: The Mean of hospitalization and outpatient deductions accounts sent with Medical Servicesinsurance was 4.22%, the highest and the lowest deductions accounts, respectively, were related toShohadaye Ashaeer with 5.46 % and psychiatric hospital with 0.18 %. And so, the anesthesia cost have ahighest percentage of bills deductions (18.46%). the average of hospitalization and outpatient deductionsaccounts sent with Social Security insurance was 4.22%. Shohadaye Ashaeer hospital with 6.24 % of mostdeduction and psychiatric hospital with 0.19 % had the lowest deduction.Conclusion: although deduction was applied to a small percentage of accounts, a significant financialburden was imposes to the hospitals. The major causes of deduction, documentation incomplete records,lack of familiarity with hospital information systems, incomplete and incorrect registration insurance code;up coding, incorrect calculations, lack of adequate training and other factors as is. It is recommended touniversities for reduce the amount of deductions to adopt appropriate policy.
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نشانی اینترنتی http://www.tebvatazkiye.ir/article_79454_65a5e15e1b029e461083de18dd9c1269.pdf
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