Identifying the causes of insurance deductions in Peymaniyeh Hospital and ways to reduce them: A qualitative study

Document Type : Research Paper

Authors

1 Department of nursing, Jahrom University of medical sciences, Jahrom, Iran.

2 Research Center for Non-Communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran

Abstract

Introduction: Hospitals, as the most important units providing health services, have always allocated a major part of the country's healthcare resources and budget.
Methodology: The present study was conducted using a qualitative method with a phenomenological approach, which is the study of Peymaniyeh Hospital in Jahrom. The statistical population of the research is insurance experts, social security and health insurance experts, hospital managers, hospital presidents, and hospital finance officers. Data collection was done by semi-structured interview method with open questions, which reached the saturation point with the participation of 8 people, and the 7-step Claysey method was used for data analysis.
Findings: Based on the opinions and experiences of the participants in the study, two main themes and seven sub-themes were mentioned for the causes of insurance deductions (manpower errors and weaknesses and errors caused by the structure of the hospital) and for suggested solutions for prevention and Reduction of insurance deductions, four main topics and ten sub-themes were extracted, which are providing human resources, improving the level of awareness of doctors, employees, supervisors and managers, organizing the system and paying attention to the matter of supervision and inspection as the main topics of the class
Conclusion: Since the reduction of insurance deductions has a significant contribution in increasing the hospital's income and consequently the timely payment of salaries and finally the satisfaction of doctors and medical staff; It can ensure the provision of higher quality services with more motivation.

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medical journal of mashhad university of medical sciences
Volume 65, Issue 6
January and February 2023

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