Factors Influencing Deduction and its Rate in Selected Hospitals in Tabriz (2015 & 2016) and Providing Appropriate Options

Abstract

Abstract Introduction: Hospital deductions is one of the pivotal financial issues in Iranian health system and is considered as the main challenges in managing costs by the hospital managers. Aim: To determine causes and types of deductions in selected hospitals in 2015 & 2016 and providing options to reduce its prevalence. Materials And Methods: The present study is a multi-method study including a systematic review, a qualitative study and a quantitative study. The statistical population of the study was inpatient hospitalized records in five hospitals of Emam Reza, Shahid Madani, Shams, Shahryar and Amiralmomenin in Tabriz during the first half of 1394 and 1395 years. Data collection was performed through observation and review of documents including electronic patients records by a administrative checklist use of the interview and the Delphi panel findings. Data were analysed by Excel software (2013) and MAXQDA 10. Results: Based on the health insurance bills, the rate of deductions in shams private hospital7815 million Rials in 2016(June until October) was in high rate and in Emam Reza hospital as a public hospital was 24667 million Rials during June until October 2016. In Amiralmomenin hospital, according to the social security insurance bills rate of deductions was 1228 million Rials during June until October 2016. The main type of deductions in social insurance bills were related to surgeon wage, physician visit, anesthesia, hoteling, counseling, operating room and in health services insurance, angiography, operating room, counseling, medicines and consumed goods were high. Conclusions: Based on the results, the major deductions were related to surgeon wage and physician visit induced by doctors. Use of trainng plans and informing them regarding the medical services coding by formation of a technical committee is essential to reduce deductions. Keywords: Deductions, hospital records, hospital, insurance, Tabriz