Performing Relative Values Book of Health Services and Its Effects on Deductions of Health Insurance in Bills of Non-Educational Hospitals of University of Medical Sciences of Hormozgan Province in 2014
Introduction:One of reforms performed in health evolution planwas to amend tariff of medical services in the form of presentation of relative values services book. In this study, we discuss effect of the amendments on one of the most important problems of financial structure of health system that is insurance deductions.
Methodology: in analytic-descriptive study which has been performed as occasional, 83413 files sent to Iran’s health insurance from non-educational hospitals (12 hospitals) of Hormozgan medical sciences university have been discussed and 628 files having deductions have been studied. The data has extracted by using checklist which compiled for deductions of outpatient and hospitalization services and then analysed by SPSS software version 22 and square t test.
Results: the results of present study showed that Minab city has high deductions compared other provinces (4/6062*108), also, the results showed that drug deductions, anesthesia and surgery and outpatient services had not significant difference before and after change of tariff. But additional services (p<0/05,t-2/511), diagnostic services (p<0/05, t-2/406), doctors and expert’s services (p<0/05, t-2/402) and hospitalization services (p>0/05, t-1/695) had significant difference before and after change of tariff.
Concluding: total results showed that presentation of relative values book of services had not significant effect on deductions by increment tariff and change of obligations of insurances but in some cases, it increase deductions which shall perform necessary preparation in order to remove this strategy.
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