Fatemeh Kavian Telouri, Alireza Heidari, Anis Abbasi, Mohammad Javad Kabir, Abbas Badakhshan, Zahra Khatirnamani,
Volume 3, Issue 4 (12-2020)
Abstract
Introduction: Measuring and monitoring health costs will help health system policy makers choose appropriate policies to protect patients. The purpose of this study was to investigate the referral burden and cost of hospitalized patients covered by the Rural Insurance Fund before and after the implementation of the referral system program in Golestan province, Iran..
Methods: A cross-sectional descriptive study was performed based on the information of the first six months of 2017 and 2018 of all patients admitted to health insurance in all hospitals of Golestan province. The information systems and existing documents of the General Directorate of Health Insurance were used to collect data.
Results: Compared to 2017, the number of hospitalizations of health insurance policyholders in the public sector in 2018 in total funds and rural funds decreased by 13 and 10 percent, respectively, and in the private sector, in all funds and rural funds decreased by 39 and 98 percent, respectively. The cost of hospitalization of health insurance policyholders in the public sector in total funds and rural funds decreased by 13 and 12 percent, respectively, and in the private sector by 24 and 99 percent, respectively. This reduction in referral burden and hospitalization costs in the public and private sectors in rural and public funds and in all funds has been significant (P <0.05).
Conclusion: According to the findings, in order to reduce the demand for hospitalization, it is recommended that the guidelines of the rural family physician program and the referral system at level one be fully implemented. By increasing the facilities and physical capacity of services in level one and providing comprehensive and timely services that continue in level two, the induced demand created in patients' hospitalization should be prevented.
Seyed Reza Hosseini, Bijan Abbasi, Ehsan Aghamohammadaghaee,
Volume 4, Issue 1 (3-2021)
Abstract
Health is one of the most basic needs of all human beings. The main function of the health system of any country is to provide services in this field. The purpose of this research is to find out how services are provided by which institution and according to what principles. After the victory of the Islamic Revolution, the expansion of social security became a public right in Article 29 of the Constitution, relying on the enjoyment of social security benefits by all people. Accordingly, the main institutions, organizations, institutes and funds in the areas of insurance, protection and relief of this system are obliged to carry out their executive affairs and tenure in the field of production and provision of services and related legal obligations in accordance with contracts proposed by the Ministry of Cooperatives. Social welfare and the approval of the High Council of Welfare and Social Security will be determined to be delegated to brokerage firms. In the Iranian legal system, various institutions are responsible for providing health services to different segments of society, but the main institutions providing insurance services are the Health Insurance Organization of Iran and the Social Security Organization. Each of these organizations, according to their duties and responsibilities, provide health services in the community.
Marzieh Salimi Bani, Behjat Taheri, Mohammad Ghari, Ali Ahmadi, Mohammadreza Rezayatmand, Mojtaba Baktashian, Saeed Abbasi,
Volume 4, Issue 4 (3-2022)
Abstract
Introduction: Intermediate Care Unit is for patients who do not need intensive care but cannot be admitted to normal wards. The aim of this study was to evaluate the frequency of patients in need of intermediate care in Al-Zahra Hospital, Isfahan, Iran in 2020.
Methods: This research was applied and descriptive. Patients admitted to some normal wards and intensive care units of Al-Zahra Hospital were considered as the study population. To determine the sample size, 240 samples were obtained, which were randomly distributed in 14 checklists in each section. The data collection tool was a researcher-made checklist that the reliability of the checklist was 0.8 using Cronbach's alpha test. The collected data were analyzed by STST software.
Results: Of the 31 patients who died, 5 patients (2.44%) were admitted to the intensive care unit, 12 patients (12.09%) were admitted to the intensive care unit, and 14 patients (19.23%) were admitted to the intensive care unit. Due to the size of the gamma effect (0.96), the formation of the intermediate care unit in Al-Zahra Medical Center has a strong effectiveness (gamma between 0.8 to 1.19 indicates strong effectiveness).
Conclusion: Examining the demographics of patients in need of transfer to the IMCU ward and also the feasibility of its establishment, the findings indicate the existence of hospitalization criteria for a number of patients in the interstitial care ward and confirm the effectiveness of its establishment. The desired infrastructure will be able to improve care and mortality outcomes while reducing hospitalization costs and overall patient care.
