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
Journal Title: مجله راهبردهای مدیریت در نظام سلامت - Year 2018, Vol 2, Issue 4
Abstract
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
Authors and Affiliations
Houshang Golzar, Saeid Tahmasebi, Morad Alizadeh
Keywords
Related Articles
- EP ID EP291525
- DOI -
- Views 93
- Downloads 0
The Relationship between the Patient's Safety and Nurses' Team Working in Surgical and Intensive Care Units in Gilan Province Selected Hospitals
Background: Patient safety is one of the most important and vital issues in the health systems of different countries. Team working and communication are very important in preventing and reducing medical errors. This Stu...
Investigating the Factors Affecting Out-of-Pocket in Hospitals Affiliated to Mazandaran University of Medical Sciences
Background: Out-of-pocket is one of the most important payment methods in Iran's health system, which has negative impacts on equity and pushes the vulnerable groups into poverty. Considering the importance of this metho...
Investigating the Relationship of Study and Learning Strategies with the Level of Test Anxiety among Students of Yazd University of Medical Sciences in 2016
Background: Test anxiety is a common problem among students. Applying the learning and studying strategies to deal with anxiety disorder can improve students' academic performance. The purpose of this study was to inves...
Challenges of Clinical Governance in Risk Management: A Qualitative Study of Teaching Hospitals
Background: Clinical governance is a Framework in which health care provider will be responsible for continuous quality improvement. This study aimed to identify implementation challenges of Clinical governance in the ar...
Correlation of Leadership Style with Job Satisfaction and Happiness among the Staff of Petroleum Industry Health Organization
Background: Expert human resources have a key role in development of the community; among the multiple factors influencing this development, the community leaders who are organizing the resources have the most prominent...