Volume 8, Issue 1 (Spring 2025)
Iran J Health Insur 2025, 8(1): 73-80 |
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Motaghi M, Gholizade L. Hospital Performance in Reducing Insurance Deductions in the Health Sector. Iran J Health Insur 2025; 8 (1) :73-80
URL: http://journal.ihio.gov.ir/article-1-352-en.html
URL: http://journal.ihio.gov.ir/article-1-352-en.html
1- Department of Health, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
2- Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran ,lida_gholizade@yahoo.com
2- Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran ,
Abstract: (1078 Views)
Introduction: Today, providing household health expenses for health system is an important challenge. The purpose of this study is to investigate effective measures in reducing insurance financial deductions with emphasis on the role of insurance.
Methods: The current research is descriptive-analytical and cross-sectional. 196 patients (families) were selected as research samples. The research population consisted of 400 employees of Shahid Rajaei Hospital in Gachsaran, and a simple random sampling method was employed to select 196 participants, according to Cochran's formula. A researcher-developed questionnaire with 21 questions was used for data collection. The formal and content validity of the questionnaire was confirmed, and its reliability was verified using Cronbach's alpha. The collected data were analyzed using parametric tests by SPSS20 software.
Results: The research data indicated that uncompromised elements such as not distorting the date and prescription, having the stamp and signature on insurance prescriptions, transparent and digitally typed medical orders, proper completion of medical procedures descriptions by physicians, accurate and precise registration of equipment, drugs, and supplies, proper registration and documentation of daily requests, Request for basic care instructions in medical and nursing orders, have an impact on reducing insurance financial deductions at Shahid Rajaei Hospital in Gachsaran, across the inpatient, clinical, and administrative departments.
Conclusion: Based on the obtained results, by implementing effective and transparent measures, identifying and eliminating factors contributing to the increase in insurance deductions, it is possible to reduce the disputes between hospitals and insurance organizations. The finding show that; a significant relationship between health insurance coverage. The correlation between use of preventive care services, adverse health outcomes and reduced performance, preventable health problems, severe disease at the time of diagnosis, and premature mortality showed significance.
Methods: The current research is descriptive-analytical and cross-sectional. 196 patients (families) were selected as research samples. The research population consisted of 400 employees of Shahid Rajaei Hospital in Gachsaran, and a simple random sampling method was employed to select 196 participants, according to Cochran's formula. A researcher-developed questionnaire with 21 questions was used for data collection. The formal and content validity of the questionnaire was confirmed, and its reliability was verified using Cronbach's alpha. The collected data were analyzed using parametric tests by SPSS20 software.
Results: The research data indicated that uncompromised elements such as not distorting the date and prescription, having the stamp and signature on insurance prescriptions, transparent and digitally typed medical orders, proper completion of medical procedures descriptions by physicians, accurate and precise registration of equipment, drugs, and supplies, proper registration and documentation of daily requests, Request for basic care instructions in medical and nursing orders, have an impact on reducing insurance financial deductions at Shahid Rajaei Hospital in Gachsaran, across the inpatient, clinical, and administrative departments.
Conclusion: Based on the obtained results, by implementing effective and transparent measures, identifying and eliminating factors contributing to the increase in insurance deductions, it is possible to reduce the disputes between hospitals and insurance organizations. The finding show that; a significant relationship between health insurance coverage. The correlation between use of preventive care services, adverse health outcomes and reduced performance, preventable health problems, severe disease at the time of diagnosis, and premature mortality showed significance.
Type of Study: Research |
Subject:
Special
Received: 2025/02/23 | Revised: 2025/10/28 | Accepted: 2025/05/20 | ePublished: 2025/06/18
Received: 2025/02/23 | Revised: 2025/10/28 | Accepted: 2025/05/20 | ePublished: 2025/06/18
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