Document Type : Original Article
Authors
1 Assistant Professor, Health Services Management, health management and economic research center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Health Services Management, Tehran University of Medical Sciences, Tehran, Iran
3 Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Introduction: Out of pocket payments (OOP) as a kind of financial resources in health systems has regressive effects on health status, equity and both qualitative and quantitative health system performance indicators. Higher health expenditures and higher OOP may lead to more people fall in poverty or decrease their accessibility to health services. Unfortunately this could be found more among poor people whom need more protection. This study aimed to reveal if social security organization (SSO) wants to protect their insured people from higher amounts of OOP (bills more than 100 million Rials) how it would affect cost coverage of other people assuming fixed total cost of all bills for SSO. Methods: That was a cross sectional study on Isfahan hospital bills for inpatients of SSO during 2008. Sampling method was cluster sampling. We studied 2430 hospital bills and copayment paid directly by patient. The data were collected by Finance information form. The form was a standard so it is the reliable and valid. Data analyzed with Excel software and descriptive statistics. Results: Now SSO covers around 90% of hospital bills for its insured patients regardless of bill amount. Our calculations according to before mentioned show that SSO should pay less to low cost bills through one of these scenarios: First: for all bills fewer than 10 million Rials, covering 43% of costs. Second: for all bills fewer than 20 million Rials, covering 77% of costs. Third: for all bills fewer than 100 million Rials, covering 86% of costs. Conclusion: Findings show that social security organization by using Variable Copayment in different manners could protect individuals with high health expenditures and protect households against catastrophic costs.Key words: Hospitals; Social Security; Costs
Keywords
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