Hospital Expenditures of Guardian less Patients in Shiraz Selected Hospitals in Second Half of Year 2015
Subject Areas : medical documentszahra kavosi 1 , mersad rezaie 2 , ali shojaie 3 , Hamid Talebianpour 4
1 - Associate professor, Department of Health Services Management, School of Management and Medical Informatics, Shiraz university of Medical Sciences, Shiraz, Iran
2 - Student Health Services Management, School of Management and Medical Informatics, Shiraz university of Medical Sciences, Shiraz, Iran
3 - M.A Business Administrator, Shiraz university of Medical Sciences, Shiraz, Iran
4 - M.A Student in Health Economics, School of Management and Medical Informatics, Shiraz university of Medical Sciences, Shiraz, Iran
Keywords: uncompensated cost, hospital and health system, guardian less patients,
Abstract :
Introduction: the guardian less patients are considered as hospital debtors and their financial burden is imposed on hospitals, this research has been conducted to evaluate the expenses of guardian less patients in selected hospitals of Shiraz University Medical Science. Research Method: this cross-sectional study has evaluated the financial burden that guardian less patients imposed on Shiraz selected Hospitals in the second half of the year 1393. The data was gathered through review of patient invoice and medical records using a self-administrated check list. The gathered data was analyzed using, ANOVA Test in SPSS21 software. Results: the findings indicated that 183 guardian less patients were discharged from hospital in the study period. Most of the patients were men (%58/6), married (%52), native (%77/3) and had health insurance (%61/5). The total expenditure of these patients was 8535929734 IRR which 5184119454 IRR was reimbursed by insurance organization. 3330828022 IRR was not compensated. Uncompensated cost was statistically different in different hospital and based on type of who referred patient. Conclusion: Considering financial issues which hospitals face, using various interventions to decreasing uncompensated cost will be useful. Employing social workers who are professional in connecting with social support organizations and also improving population coverage of insurance plan will be helpful.
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2- Gerdtham UG, Søgaard J, Andersson F. Health expenditure growth: reassessing the threat of Ageing. Journal of Health Economic, 1992; 11(1): 63-84.
3- Beygi E, Agrell M, Karlsson P. Johannisson, Signal statistics in fiber-optical channels with polarization multiplexing and self-phase modulation, Journal of Lightw, Technol, 2011; 29(16): 2379–2386.
4- Gruber J, Rodriguez D. How much uncompensated care do doctors provide?, National bureau of economic research; 2007.
5- Hadley J, Zuckerman S, Iezzoni LI. Financial pressure and competition: Changes in hospital efficiency and cost-shifting behavior. Medical Care, 1996; 34(3): 205–219.
6- Ferrier GD, Resko MD, Valdmanis VG. Analysis of uncompensated hospital care using a DEA model of output congestion, Health care manage sci, 2006; 9: 181-188.
7- Hadley J, Holahan J. How much medical care do the uninsured use, and who pays for it? Health Affairs (Millwood), Supplemental Web Exclusives, 2003; 3: 66-81.
8- Xiong J, Hipgrave D, Myklebust K. Child health security in China: a survey of child health insurance coverage in diverse areas of the country. Social Science & Medicine, 2013; 97: 15–19.
9- Tang S, Meng Q, Chen L, Bekedam H, Evans T, Whitehead M. Tackling the challenges to health equity in China Lancet, 2008; 372: 1493–501.
10- Reiter KL, Harless DW, Pink GH .the Effect of Minimum Nurse Staffing Legislation On Uncompensated Care Provided By California Hospital, Medical Care Research And Review, 2010; 1-20.
11- Zhang W, Wang X. uncompensated care for children without insurance or from low-income families in a chinese childrens hospital, Medical science monitor; 2014: 1162–1167.
12- Holahan J, Garrett B. The Cost of Uncompensated Care with and without health reform. timely analysis of immediate health Policy issues, 2010.
13- Holahan, John, Bowen Garrett, Irene Headen, and Aaron Lucas. Health Reform: The Cost of Failure. Washington DC: The Urban Institute, 2009.
14- Fishman LE, Bentley JD. The evolution of support for safety-net hospitals. Health Affairs, 1997; 16(4): 30–47.
15- Graves JA. Medicaid Expansion Opt-Outs-and uncompensated care, The New England Journal of Medicine; 2012: 20.
16- Bosco G, Cigliutti R, Nespola A, et al. Experimental Investigation of Non-Linear Interference Accumulation in Uncompensated Links, Politecnico di Torino Porto Institutional Repository, June, 2012.
17- Friedman L, Baker GR, Carpenter C, Greene B, Kurz RS, Laditka SB, et al. Understanding health care financial management. Chicago, Health Administration Press; 2006: 115-153.
18- Veach MS, What’s On Your Plate?, Ten Top Issues for 2006, Healthcare Financial Management: Journal of the Healthcare Financial Management Association, 2006; 60 (1): 72-6.
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1- Di Matteo L. The determinants of the public– private mix in Canadian healthcare expenditures: 1975–1996. Health Policy, 2000; 52(2): 87-11.
2- Gerdtham UG, Søgaard J, Andersson F. Health expenditure growth: reassessing the threat of Ageing. Journal of Health Economic, 1992; 11(1): 63-84.
3- Beygi E, Agrell M, Karlsson P. Johannisson, Signal statistics in fiber-optical channels with polarization multiplexing and self-phase modulation, Journal of Lightw, Technol, 2011; 29(16): 2379–2386.
4- Gruber J, Rodriguez D. How much uncompensated care do doctors provide?, National bureau of economic research; 2007.
5- Hadley J, Zuckerman S, Iezzoni LI. Financial pressure and competition: Changes in hospital efficiency and cost-shifting behavior. Medical Care, 1996; 34(3): 205–219.
6- Ferrier GD, Resko MD, Valdmanis VG. Analysis of uncompensated hospital care using a DEA model of output congestion, Health care manage sci, 2006; 9: 181-188.
7- Hadley J, Holahan J. How much medical care do the uninsured use, and who pays for it? Health Affairs (Millwood), Supplemental Web Exclusives, 2003; 3: 66-81.
8- Xiong J, Hipgrave D, Myklebust K. Child health security in China: a survey of child health insurance coverage in diverse areas of the country. Social Science & Medicine, 2013; 97: 15–19.
9- Tang S, Meng Q, Chen L, Bekedam H, Evans T, Whitehead M. Tackling the challenges to health equity in China Lancet, 2008; 372: 1493–501.
10- Reiter KL, Harless DW, Pink GH .the Effect of Minimum Nurse Staffing Legislation On Uncompensated Care Provided By California Hospital, Medical Care Research And Review, 2010; 1-20.
11- Zhang W, Wang X. uncompensated care for children without insurance or from low-income families in a chinese childrens hospital, Medical science monitor; 2014: 1162–1167.
12- Holahan J, Garrett B. The Cost of Uncompensated Care with and without health reform. timely analysis of immediate health Policy issues, 2010.
13- Holahan, John, Bowen Garrett, Irene Headen, and Aaron Lucas. Health Reform: The Cost of Failure. Washington DC: The Urban Institute, 2009.
14- Fishman LE, Bentley JD. The evolution of support for safety-net hospitals. Health Affairs, 1997; 16(4): 30–47.
15- Graves JA. Medicaid Expansion Opt-Outs-and uncompensated care, The New England Journal of Medicine; 2012: 20.
16- Bosco G, Cigliutti R, Nespola A, et al. Experimental Investigation of Non-Linear Interference Accumulation in Uncompensated Links, Politecnico di Torino Porto Institutional Repository, June, 2012.
17- Friedman L, Baker GR, Carpenter C, Greene B, Kurz RS, Laditka SB, et al. Understanding health care financial management. Chicago, Health Administration Press; 2006: 115-153.
18- Veach MS, What’s On Your Plate?, Ten Top Issues for 2006, Healthcare Financial Management: Journal of the Healthcare Financial Management Association, 2006; 60 (1): 72-6.