جستجوی مقالات مرتبط با کلیدواژه « هزینه های بیمارستان » در نشریات گروه « پزشکی »

The impact of population aging on health expenditure is inevitable. It affects health expenditure by causing changes in people’s health status and the demand for health care services. In this study, we aim to investigate the age-related and gender-related differences in hospital admission rate, length of stay, and hospital costs of people in Iran.

This is a quantitative, descriptive-analytical study with a cross-sectional design conducted on data of 41 million Iranian people covered by the Iran Health Insurance Organization in 2020. Hospital admission rate, length of stay, and hospital costs were dependent variables. Hospital costs included insurance payments, patients’ out-of-pocket spending, and government subsidies. Age and sex of the patients, ownership of the hospital, type of patients’ medical files were descriptive variables. The Mann-Whitney U test was used to compare hospital costs between elderly (>60 years of age) and non-elderly (<60 years of age) groups and between females and males. Spearman’s correlation test was used to find the correlation between age and dependent variables. 

During the study period, there were about 3,800,000 hospital admissions. The rate of hospital admission in the elderly was 3.7 times higher than that of non-elderly groups. The average length of stay was 1.3 days for the elderly, and 2.2 days for the non-elderly. In the elderly group, men had a higher hospital admission rate than women, while in non-elderly groups, women had a higher admission rate. The average hospital cost was 28 million IRR for the non-elderly and 45 million IRR for the elderly. The average cost of surgery, hospitalization, medicine and medical consumables for the elderly was 1.5 times more than that of the non-elderly. There was a positive and significant relationship between the hospital admission rate and age of the patients (r=0.879, P<0.001). As the age of the patients increased, the length of stay in the hospital increased significantly (r=0.582, P<0.001). The relationship between patients’ age and the average hospital cost was also positive and significant (r=0.582, P=0.006).

Hospital admission rate, length of stay, and average hospital costs are significantly higher for the elderly in Iran.

Considering the role of hospitals in increasing the health level of society, it is very important to evaluate, measure and improve their performance. The aim of this study was to investigate the impact of the COVID-19 epidemic on the economic status and performance of hospitals affiliated to Iran University of Medical Sciences.

The present applied study is a descriptive-analytical study that was conducted on three non-specialized hospitals using data from two periods of time, 2019 and 2020. Raw data related to six financial indicators and six performance indicators were collected by referring to the financial and medical records units of the hospitals. The non-parametric Wilcoxon test and the paired-samples t-test were used in SPSS software for data analysis.

The results showed that after the covid-19 epidemic, the average indicators of bed occupancy rate decreased by 12% and the average length of stay and bed turnover increased by 12% and 10%, respectively; these changes were statistically significant (p-value<0.05). Furthermore, the financial indicators of dedicated laboratory revenues, dedicated imaging revenues, and hospital expenses increased significantly by 26, 17 and 27%, respectively (p-value<0.05).

Considering the significant impact of the COVID-19 epidemic on the financial and economic performance of hospitals and the possibility of other epidemic-prone emerging infectious diseases, it seems that special support for hospitals is necessary in this regard.

The outbreak of Covid-19 canceled unnecessary hospital admissions. Therefore, hospitals face economic consequences. In this context, this research has investigated the effect of the Corona virus pandemic on the revenue of a hospital in Tehran.

This study is retrospective interrupted time series studies.In this time series study, the monthly revenue of all services provided by a hospital in Tehran was collected and analyzed in the form of a census in two groups before and during the Covid-19 outbreak. Data analysis was done using Eviews. Chow test was used to detect structural breaks in the studied time series.

The findings of this study showed that the outbreak of Covid-19 reduced the revenue of all hospital services. According to the negative coefficient of the variable of the Covid-19 period and the regression coefficient, it indicates the existence of a negative relationship between the total revenue of the hospital and the prevalence of Covid-19. After the outbreak of Covid-19, the revenue of laboratory services and internal services decreased by 50% compared to the previous year after the outbreak of Covid-19 and continued to decrease by 20%.

The results of the study showed in the Covid-19 pandemic, with the change of admission priorities, the number of referrals decreased due to the fear of the hospital being infected with financial shocks. it is suggested that the hospital managers take action to train the forces, improve service productivity, reduce costs, and make optimal use of potential financial and human resources during the peace period.

Readmission is a hospital quality and outcome measure. The aim of this study was to investigate the rate of readmission and its causes and costs in inpatient wards of a university hospital in Iran.

One-year data from a 320-bed training center were extracted to determine readmission, admission, final diagnosis, and costs. According to a specialized study, readmission cases were classified into one of 20 groups, and one of the 10 causes of the disease. Data analysis was performed using chi-square and logistic regression tests via SPSS software.

Out of a total of 17,542 hospitalizations, 1214 (6.92%) were readmitted, accounting for 8.27% of the total hospitalization costs. Among the classes of causes of readmission, unrelated complications of disease and recurrence of the disease were the most common causes of readmission, respectively. Among the inpatient wards, the highest percentage of readmission was related to the gynecology ward. The results of multiple logistic regression showed that the chances of readmission in the age groups between 15 to 65 years and under 15 years, was respectively 32.3% [confidence interval (CI): 0.78-0.58; odds ratio (OR) = 0.67] and 58.1% (CI: 0.51-0.32; OR = 0.41) lower than the age group over 65 years (P < 0.050). The chance of readmission in patients covered by social security, accidental, health and miscellaneous insurance was respectively 35.0% (CI: 0.50-0.84; OR = 0.65), 37.8% (CI: 0.43-0.89; OR = 0.62), 23.1% (CI: 0.98-0.59; OR = 0.76) and 68.9% (CI: 0.89-0.11; OR = 0.32) lower than patients with armed insurance coverage (P < 0.050).

The results of the study indicate the importance of monitoring the rate, process, and costs of readmission as one of the key indicators of hospital performance quality.

One of the objectives of each system is cost of management and costing to help the organizations to provide high quality goods and services at a competitive environment. The present study was done to computing of cost price of hospital services at the NICU section of according to activity-based costing (ABC) method. This is a cross-sectional study. The costing of hospitalization was calculated based on activity at the Bent-Al-Hodi hospital of Bojnourd in 2015. The data was collected by observation, interview and review of documents and records. Data were analyzes according to activity-based costing (ABC) method using the Excel software. In this study the costing of provided services by the NICU section was 37/292/952/569 Rials, equivalent to 13.6% out of the total of costs of hospital. 76.45%, 1.44%, 21.24% and 0.87% of the costing were related to staff compensation, materials and consumables, indirect overhead and expenses direct overhead respectively. The cost of one-day hospital bed occupied by a patient was calculated about 8,609,905 Rials The Majority of the costs of the NICU service is consist of the costing of staff services charge. Hence, optimal use of resources and staffs help to increasing productivity and more services as well. Usage of the proper consumption patterns in equipment and materials can have a huge impact on decreasing of the cost price.

The aim of this study was to determine the effect of Iran’s health system evolution plan, tariffs change on performance, revenue, and expenditure of a big tertiary hospital in Iran in 2015.

This cross-sectional descriptive study was conducted in a big tertiary hospital, (Imam Reza), in 1394 using activity based costing in four time spans: before and after health system evolution, after tariff change, and one year after the inauguration of the evolution. Data relating performance, revenue, and expenditure were gathered and analyzed using descriptive statistics by Excel 2013 Software.

Cost, revenue, and profit of hospital were increased by 31%, 82%, and 4.6% after health system evolution and by 42%, 38%, and 1.7% after tariff change, respectively. Hospital encountered with 17% loss one year after the inauguration of the evolution, however, cost and revenue of hospital were increased 23% and 3%, respectively. The highest change in physician and personnel income with 103% and 91% rise was related to after tariff change. After health system evolution and tariff change, operating room income was increased 33% and 124%, respectively. One year after the inauguration of the evolution, the operating room income didn’t change and the amount of surgeries decreased by 9%.

Performance and financial indicators of Imam Reza hospital have been affected substantially by health system evolution; however, it has not equally affected all revenue and expenditure items.

The Iran medical tariff rate system that for the first time was carried out enjoying the California book in 1983, after 30 years had been evolved due to numerous reasons and with compilation and prophecy of relative value book of health services entered to the new stage. The implementation of a new book will affect on the hospitalization expenses of insured persons.
The population of the study, records of hospitalizedinsuredhealthinsurance organization in the hospitals of the city of Ilam in September and October2014 and were the most common examples of actions that census methods, their data in accordance with the objectives of the studying the Czech records, coded and entered intothecomputerusingSPSS21 softwareanalysiswas performed.
Findings: Totally, the average cost of common surgical procedures95/61percent. In August 7% and in October 5% of the insured paid their costs; hence, averageshareofa total of74/76% increased. Shareof9percent to87percentinOctober. Respectively, 11% and 5% were covered by subsidy in September and October. 9% of patients in SeptemberandOctoberwas4% ofthe total costs. 1% and2% in October-off costs in September was a commitment paid by the patient. Additionalinsurancecontributionis minimalat(0%) of the costs coverage.
Discussion & By implementing the relative value book and prophecy the relevant provisions to it, the final payment share of medical expenses of those insurance pocketsby increasing the Organization share and subsidies help reduce to 5%.

Effective delivery of medicines and supplies is one of the most important determinants of quality of healthcare provided in hospitals. This study was designed: (1) to delineate the problems of management in provision, procurement, storage and distribution of supplies in hospitals after implementation of the health system reform project in Iran, (2) to explore the pitfalls in this process and (3) to provide scientific and practical solutions. In this qualitative - descriptive study, in order to identify the effective factors on irregular provision of supplies in hospitals, five brainstorming sessions attended by 20-25 head nurses (supervisors) of operating rooms of 6 university hospitals in Mashhad and relevant experts was held. At the end of 160 person-working hours during the meetings, the problems and the effective factors on them were discussed by the participants, and in addition, solutions to resolve the problems were raised. For providing suitable supplies for patients in the hospitals, the following process was proposed: 1. Visiting the patient by treating physician and requesting the necessary supplies by the physician, 2. Setting up and confirming the request for the required supplies by the department supervisor, 3. Sending the request to the technical in-charge for hospital supplies, 4. Coordinating between technical in-charge for hospital supplies and the supplier of the hospital, 5. Provision and delivery of supplies by the supplier of the hospital to the supplies warehouse together with matching the entry products with requested product by the technical in-charge for hospital supplies, 6. Charging the product to the account of the department supervisor, 7. Charging the supplies from the account of the supervisor to the account of the patient 8. Confirming the invoices of the supplies by the treating physician, the supervisor, and circular and scrub nurses, 9. Disbursement of the approved invoices, 10. Sending back the surplus supplies Preventing the wastage of financial resources and facilities as well as providing medical supplies with the best price are of the most important factors effective on the appropriate provision of supplies in hospitals. To this end, in addition to regular monitoring by hospital administrators, an optimized process which helps to systematize the provision and recharging of supplies and equipment is needed.

Senior hospital managers needs to accurate information on the financial resources and facilities to effectively manage their organization. The objective of this study was to investigate the annual statistical characteristics of patients admitted to a referral hospital in Iran. In this study, all patients admitted to Mashhad Imam Reza Hospital in 2012 were studied. Data including age, gender and length of stay obtained from the informatics unit and daily cost of stay calculated by the accounting unit were entered into a statistical software. The daily cost of hospital stay in each department was calculated based on daily bed charge, the average cost of drugs and ancillary medical services (such as radiography or physiotherapy). During 2012, 54,181 patient/admissions (50.3% female) were reported from Mashhad Imam Reza Hospital. The mean (SD) age of the patients was 40.6 (22.8) years. The highest number of patient/admissions was reported from medical toxicology (7488, 13.8%) and urology (6259; 11.6%) departments. Mean age of patients admitted to internal medicine emergency section and (64.3) and CCU#1 (62) was the highest. The longest duration of hospital stay was found in Infectious disease intensive care unit (ICU) with average of 493.9 hours and the shortest length of stay was noted in medical toxicology department (53.6 hours). The highest cost of hospital stay was related to cardiac surgery ICU ($1,664) followed by cardiac surgery department ($952) and the lowest cost was related to psychosomatic ($41) and medical toxicology ($84) departments. There was a significant correlation between length of stay and hospital costs (P < 0.001). There was also a significant direct correlation between patient's age and length of stay (P < 0.001). Providing equitable health services can be achievable by using precise reliable statistical information. By devising hospital protocols for various diseases (rational drug administration and definition of time to discharge), healthcare maximization and reduction in unnecessary healthcare costs can be achieved.

To determine frequency of motorcycle accident and its hospital costs on injured persons referring to Shohada university hospital in Khoramabad, Iran. A descriptive study was conducted on all injured persons who referred to Shohad-e-Eshayer in Khormabad between June 2005 till July 2006. All demographic and some data related to cost of accidence of 375 individuals were collected. A 20-items questionnaire was designed for this study. Of total, fifteen persons (4%) died. Approximately ninety percent were male. Individuals aged 16-25 years accounted for 56.8% all of injured. Head trauma was reason for 56.2% of mortality rate. Most of injured (92%) not used helmet. Total hospital cost of persons was 981572746 Rial (101194 $).these injured persons included 4/1% of total injured that referral to hospital. 14/7% of total injured traffic accidents were motorcycle injured accident.1/2% of total hospitalization in center included motorcycle injured persons. Based on Pearson coefficient test, there was a significant statistical relationship between length of stay in emergency department and number of rider (P=0.03) and also, total length of stay with total hospital cost (P<0.0001). The findings of this study indicate that motorcycle accident imposes direct and indirect cost on social and health system, therefore must be reduce it.