Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Thu, Nov 21, 2024
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Volume 34, Issue 1 (2-2020)
Med J Islam Repub Iran 2020 |
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Sarabi-Asiabar A, Alidoost S, Sohrabi R, Mohammadibakhsh R, Rezapour A, Moazamigoudarzi Z et al . Iranian public hospitals' challenges regarding revenue deficits: A mixed-method study. Med J Islam Repub Iran 2020; 34 (1) :849-857
URL: http://mjiri.iums.ac.ir/article-1-6185-en.html
URL: http://mjiri.iums.ac.ir/article-1-6185-en.html
Ali Sarabi-Asiabar 
, Saeide Alidoost , Rahim Sohrabi , Roghayeh Mohammadibakhsh , Aziz Rezapour , Zahra Moazamigoudarzi , Narges Rafiei
, Saeide Alidoost , Rahim Sohrabi , Roghayeh Mohammadibakhsh , Aziz Rezapour , Zahra Moazamigoudarzi , Narges Rafiei
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran , rafiei.n@iums.ac.ir
Abstract: (1347 Views)
Background: The main part of hospitals’ funding comes from insurance organizations. In some cases, for different reasons such as not filed services or unpaid health insurance bills, a part of these funding cannot be derived from health insurance companies. This study aims to describe different aspects of the hospitals’ revenue deficits in Iranian public hospitals.
Methods: This was a mixed-method study consisting of qualitative and quantitative studies. Qualitative data were collected through 17 semi-structured interviews and were analyzed using the analytical framework by MAXQDA.10. Quantitative data were analyzed by the TOPSIS method and Smart TOPSIS Solver.3.2.0.
Results: Based on the framework analysis, five sets of the underlying causes of hospital revenue deficits were identified and categorized in 5 themes: bottlenecks, direct causes of revenue deficits, root causes of revenue deficits, revenue deficits management strategies, and challenges and barriers to managing revenue deficits. Through inadequate clinical documentation and failed to provide the insurance organization’s requirements, the surgical units, operating rooms, and inpatient units were found as the main sources of revenue deficit. Lack of senior management commitment and inconsistency of insurance organizations for evaluating claims are often listed as the major barriers to effective implementation of corrective interventions.
Conclusion: Revenue deficits occurs in most hospital departments and in all stages of converting services into revenue, and a variety of human and organizational factors contribute to them. Therefore, focusing on the main causes of deductions and the participation of all individuals and departments involved in it is critical to reducing deductions.
Methods: This was a mixed-method study consisting of qualitative and quantitative studies. Qualitative data were collected through 17 semi-structured interviews and were analyzed using the analytical framework by MAXQDA.10. Quantitative data were analyzed by the TOPSIS method and Smart TOPSIS Solver.3.2.0.
Results: Based on the framework analysis, five sets of the underlying causes of hospital revenue deficits were identified and categorized in 5 themes: bottlenecks, direct causes of revenue deficits, root causes of revenue deficits, revenue deficits management strategies, and challenges and barriers to managing revenue deficits. Through inadequate clinical documentation and failed to provide the insurance organization’s requirements, the surgical units, operating rooms, and inpatient units were found as the main sources of revenue deficit. Lack of senior management commitment and inconsistency of insurance organizations for evaluating claims are often listed as the major barriers to effective implementation of corrective interventions.
Conclusion: Revenue deficits occurs in most hospital departments and in all stages of converting services into revenue, and a variety of human and organizational factors contribute to them. Therefore, focusing on the main causes of deductions and the participation of all individuals and departments involved in it is critical to reducing deductions.
Type of Study: Original Research |
Subject:
Health Management and Economics
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