Zahra Najafi, Vahid Majidi, Naser Safaie, Negar Nezhadabyaz,
Volume 2, Issue 3 (12-2019)
Abstract
Introduction: With the introduction of the book Relative Value, anesthesia has increased, and as prolonged anesthesia time, along with the risks and adverse effects, impose a financial burden on the patient and the hospital, it is essential to review the costs required by this department and to monitor the maintenance of the insurance organization's resources and reduce payments from the insured's pockets. The aim of this study was to determine the incidence of unrealistic anesthesia registrations and their impact on costing in East Azerbaijan.
Methods: This descriptive study was performed by extracting data from 8 selected hospitals by purposeful stratified method based on criteria and indicators (including 182 surgical records). Descriptive statistics and one-way ANOVA and variance test were used to classify the data.
Results: Most of the surgeries were related to health insurance funds (48%). The average unit of anesthesia time elapsed for each operation was similar in different surgeries in different hospitals. The time taken for global action was longer than the average time recorded for each operation in private hospitals and public hospitals. In clinical records, overlap of anesthesia was extracted according to available documentation based on calculation of duration of each physician's activity and concurrent anesthesia management of two patients by physician during office hours. The average overwriting in public hospitals was 26.6% and in private hospitals 54%. In 19% of the time the anesthesia was started before the patient entered the operating room and in 36% of the cases the end of the anesthesia was recorded after the patient had left the operating room and 43% of the total requested hospital units were surplus. Since P-Value<0.05 was considered statistically significant in this study, the result of claiming a significant difference between the average amount of anesthesia for similar operations in private and public hospitals was rejected (p = 0.793).
Conclusion: The amount requested for anesthesia times in both public and private hospitals is higher than the actual amount. Therefore, the cost can be controlled by applying the calculation method of unrealistic registration cases. Also, the unit of anesthesia time considered in the Global Time List is higher than the average unit recorded for each operation in the studied hospitals. Therefore, a review of the list of times of global actions seems necessary.
Sepideh Mirmajidi, Davood Mehrabi, Irvan Masoudi Asl,
Volume 6, Issue 4 (Winter 2024)
Abstract
Introduction: The implementation of the electronic health system on a global scale continues to face various challenges, including legal challenges, after two decades. This research aims to identify the legal principles governing the regulation of the Electronic Health System's Stakeholders Communication in Iran, with emphasis on service providers.
Methods: This qualitative research was conducted using thematic analysis method. Data collected in interviews with 27 experts. Interviewees were selected based on their familiarity with the electronic health system, expertise in legal issues related to it, and communication within this system. Data were analyzed using MAXQDA version 20 software.
Results: Data thematic analysis led to the identification of four global themes and ten organizing themes. Legal challenges of the electronic health system and the legal principles governing the regulation of stakeholders' communication are two organizing themes discussed in this article.
Conclusion: Managing conflict of interest, redesigning the architecture of the electronic health system, mandating contracts for physicians with basic and complementary insurances, and utilizing the potential capacities and capabilities of private sector are among the recommendations of this research.
