Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran
Background: Deductions are a part of hospital revenues. However, they mostly remain unpaid due to incorrect documentation. This study focused on the rate and causes of deductions made by hospitals affiliated to Kashan University of medical Sciences, Kashan, Iran, according to available documents. M...
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| Format: | Article |
| Language: | fas |
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Vesnu Publications
2012-03-01
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| Series: | مدیریت اطلاعات سلامت |
| Online Access: | http://him.mui.ac.ir/index.php/him/article/view/567 |
| _version_ | 1828780505038848000 |
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| author | Reza Safdari Mahtab Karami Maryam Moini |
| author_facet | Reza Safdari Mahtab Karami Maryam Moini |
| author_sort | Reza Safdari |
| collection | DOAJ |
| description | Background: Deductions are a part of hospital revenues. However, they mostly remain unpaid due to incorrect documentation. This study focused on the rate and causes of deductions made by hospitals affiliated to Kashan University of medical Sciences, Kashan, Iran, according to available documents.
Methods: This was a descriptive cross-sectional study conducted in the first half of 2009 in hospitals of Kashan University of Medical Sciences. The research population included 7907 medical records covered by the Social Security Insurance. The data was collected by a standard checklist. It was then analyzed through descriptive statistics.
Results: Based on available documents, the most important causes of deductions were lack of a physician's order in drug forms (427), lack of laboratory report in laboratory forms (2195), lack of radiology report in radiology forms (226), incorrect operation report in surgery forms (429), lack of an anesthesiologist's signature in anesthesia forms (322), and lack of consultation order in consultation forms (226). The study also showed that in general, among all evaluated forms, drug forms had the maximum of deductibles.
Conclusion: The most frequent cause of deductions is incorrect documentation. On the other hand, insurance organizations only pay costs according to registered data. Therefore, it is really essential and helpful to pay enough attention to documentation principles. In addition, it is important to use diagnosis related group (DRG) and healthcare information systems.
Keywords: Insurance; Social Security; Hospitals. |
| first_indexed | 2024-12-11T17:19:07Z |
| format | Article |
| id | doaj.art-83bd10b748674f679106b3ab99ebdff3 |
| institution | Directory Open Access Journal |
| issn | 1735-7853 1735-9813 |
| language | fas |
| last_indexed | 2024-12-11T17:19:07Z |
| publishDate | 2012-03-01 |
| publisher | Vesnu Publications |
| record_format | Article |
| series | مدیریت اطلاعات سلامت |
| spelling | doaj.art-83bd10b748674f679106b3ab99ebdff32022-12-22T00:57:13ZfasVesnu Publicationsمدیریت اطلاعات سلامت1735-78531735-98132012-03-0191347Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, IranReza Safdari0Mahtab Karami1Maryam Moini2Associate Professor, Health Information Management, Tehran University of Medical Sciences,Tehran, Iran.PhD Student, Health Information Management, Tehran University of Medical Sciences, Tehran, IranPhD Student, Health Economics, Tehran University of Medical Sciences, Tehran, Iran.Background: Deductions are a part of hospital revenues. However, they mostly remain unpaid due to incorrect documentation. This study focused on the rate and causes of deductions made by hospitals affiliated to Kashan University of medical Sciences, Kashan, Iran, according to available documents. Methods: This was a descriptive cross-sectional study conducted in the first half of 2009 in hospitals of Kashan University of Medical Sciences. The research population included 7907 medical records covered by the Social Security Insurance. The data was collected by a standard checklist. It was then analyzed through descriptive statistics. Results: Based on available documents, the most important causes of deductions were lack of a physician's order in drug forms (427), lack of laboratory report in laboratory forms (2195), lack of radiology report in radiology forms (226), incorrect operation report in surgery forms (429), lack of an anesthesiologist's signature in anesthesia forms (322), and lack of consultation order in consultation forms (226). The study also showed that in general, among all evaluated forms, drug forms had the maximum of deductibles. Conclusion: The most frequent cause of deductions is incorrect documentation. On the other hand, insurance organizations only pay costs according to registered data. Therefore, it is really essential and helpful to pay enough attention to documentation principles. In addition, it is important to use diagnosis related group (DRG) and healthcare information systems. Keywords: Insurance; Social Security; Hospitals.http://him.mui.ac.ir/index.php/him/article/view/567 |
| spellingShingle | Reza Safdari Mahtab Karami Maryam Moini Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran مدیریت اطلاعات سلامت |
| title | Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran |
| title_full | Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran |
| title_fullStr | Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran |
| title_full_unstemmed | Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran |
| title_short | Causes of Deductions Made by the Social Security Insurance in Hospital Affiliated to Kashan University of Medical Sciences, Iran |
| title_sort | causes of deductions made by the social security insurance in hospital affiliated to kashan university of medical sciences iran |
| url | http://him.mui.ac.ir/index.php/him/article/view/567 |
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