Reza Safdari; Mahtab Karami; Maryam Moini
Volume 9, Issue 1 , March and April 2012
Abstract
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: ...
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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.
Mahtab Karami; Mehdi Setayesh Barhaghi
Volume 8, Issue 1 , March and April 2011
Abstract
Diseases management offers the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. The key mechanism used to identify individuals at risk, stratify patients by risk level and track patients’ progress through the disease management is the data warehouse (DW). ...
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Diseases management offers the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. The key mechanism used to identify individuals at risk, stratify patients by risk level and track patients’ progress through the disease management is the data warehouse (DW). This review article describes operational systems, DW features and component and role of it in disease management programs. By data warehouse, healthcare organizations, clinicians and managers can reduce costs generated by process redesign, obtain right information in areas of patient care, budgeting, planning, research, process improvement, external reporting, benchmarking, trend analysis and marketing and make the right decision to prevent the progression or appearance of the illness, thus maintaining the health of the population. Key words: Disease Management; Information Technology; Decision Making; Data.
