Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014
Background: Most of the reforms that have taken place in world health systems are aimed at increasing the efficiency, quality, and control of costs. By implementing the health system reform plan, the actual plan of medical services tariffs by communicating the relative value of health services instr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | fas |
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Shahid Sadoughi University of Medical Sciences
2018-03-01
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| Series: | Rāhburdhā-yi Mudīriyyat dar Niẓām-i Salāmat |
| Subjects: | |
| Online Access: | http://mshsj.ssu.ac.ir/browse.php?a_code=A-10-1-40&slc_lang=en&sid=1 |
| _version_ | 1818173923343204352 |
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| author | Houshang Golzar Saeid Tahmasebi Morad Alizadeh |
| author_facet | Houshang Golzar Saeid Tahmasebi Morad Alizadeh |
| author_sort | Houshang Golzar |
| collection | DOAJ |
| description | Background: Most of the reforms that have taken place in world health systems are aimed at increasing the efficiency, quality, and control of costs. By implementing the health system reform plan, the actual plan of medical services tariffs by communicating the relative value of health services instruction on October 2014 was started. One of the most important goals of the reform plan was to reduce out of pocket payment. This study was conducted to determine the amount of out of pocket payment of insured people covered by the health insurance organization in the selected hospitals in Bushehr province.
Methods: The present analytical study was conducted on insured people hospitalization cases of health insurance organization in selected hospitals affiliated to Bushehr University of Medical Sciences (Persian Gulf Martyrs Hospital, Shahid Ganji Hospital) in July, August, January, and February 2014 as the statistical population and the most common services used as the statistical sample. The data were collected using a researcher-made checklist and investigating the hospital records coded and analyzed by SPSS 20 software.
Results: According to the results of the study, the average cost of the patient's share was 1050835 Rials in July, August to 611631 Rials in January, and February, which decreased by 42.00 %. The results of the study show that by implementing the relative value of services instruction, the share of the health insurance organization increased from 79.00 % to 84.00 % and the share of the patient's payments decreased from 8.00 % to 4.00 %.
Conclusion: The results of the study show that the government has been able to achieve one of the goals of the health reform plan, which is reducing the out of pocket payment, by increasing health resources. |
| first_indexed | 2024-12-11T19:36:13Z |
| format | Article |
| id | doaj.art-7a9f154842344ddaa52d1775091b80c9 |
| institution | Directory Open Access Journal |
| issn | 2476-6879 2538-1563 |
| language | fas |
| last_indexed | 2024-12-11T19:36:13Z |
| publishDate | 2018-03-01 |
| publisher | Shahid Sadoughi University of Medical Sciences |
| record_format | Article |
| series | Rāhburdhā-yi Mudīriyyat dar Niẓām-i Salāmat |
| spelling | doaj.art-7a9f154842344ddaa52d1775091b80c92022-12-22T00:53:09ZfasShahid Sadoughi University of Medical SciencesRāhburdhā-yi Mudīriyyat dar Niẓām-i Salāmat2476-68792538-15632018-03-0124295304Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014Houshang Golzar0Saeid Tahmasebi1Morad Alizadeh2 Student of MPH, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Assistant Professor, Department of Statistics, School of Basic Sciences, Persian Gulf University, Bushehr, Iran Assistant Professor, Department of Statistics, School of Basic Sciences, Persian Gulf University, Bushehr, Iran Background: Most of the reforms that have taken place in world health systems are aimed at increasing the efficiency, quality, and control of costs. By implementing the health system reform plan, the actual plan of medical services tariffs by communicating the relative value of health services instruction on October 2014 was started. One of the most important goals of the reform plan was to reduce out of pocket payment. This study was conducted to determine the amount of out of pocket payment of insured people covered by the health insurance organization in the selected hospitals in Bushehr province. Methods: The present analytical study was conducted on insured people hospitalization cases of health insurance organization in selected hospitals affiliated to Bushehr University of Medical Sciences (Persian Gulf Martyrs Hospital, Shahid Ganji Hospital) in July, August, January, and February 2014 as the statistical population and the most common services used as the statistical sample. The data were collected using a researcher-made checklist and investigating the hospital records coded and analyzed by SPSS 20 software. Results: According to the results of the study, the average cost of the patient's share was 1050835 Rials in July, August to 611631 Rials in January, and February, which decreased by 42.00 %. The results of the study show that by implementing the relative value of services instruction, the share of the health insurance organization increased from 79.00 % to 84.00 % and the share of the patient's payments decreased from 8.00 % to 4.00 %. Conclusion: The results of the study show that the government has been able to achieve one of the goals of the health reform plan, which is reducing the out of pocket payment, by increasing health resources.http://mshsj.ssu.ac.ir/browse.php?a_code=A-10-1-40&slc_lang=en&sid=1Relative value Health cost Out of pocket Boushehr |
| spellingShingle | Houshang Golzar Saeid Tahmasebi Morad Alizadeh Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 Rāhburdhā-yi Mudīriyyat dar Niẓām-i Salāmat Relative value Health cost Out of pocket Boushehr |
| title | Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 |
| title_full | Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 |
| title_fullStr | Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 |
| title_full_unstemmed | Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 |
| title_short | Investigating the Effectiveness of the Health Services Relative Value Implementation on Out of Pocket Payment of Insured People Covered by the Health Insurance Organization in Selected Hospitals of Bushehr Province in 2014 |
| title_sort | investigating the effectiveness of the health services relative value implementation on out of pocket payment of insured people covered by the health insurance organization in selected hospitals of bushehr province in 2014 |
| topic | Relative value Health cost Out of pocket Boushehr |
| url | http://mshsj.ssu.ac.ir/browse.php?a_code=A-10-1-40&slc_lang=en&sid=1 |
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