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A survey in causes and rates of under reimbursement bills imposed on admitted patient's under social security insurance in medical teaching hospitals in Yazd province in 2008
Roohollah Askari, Hamid Reza Dehghan, Mohammad Amin Bahrami, Fatemeh Keshmiri,
Volume 9, Issue 3 (7 2011)
Abstract

Background: The hospitals are the most significant providers of health care services. According to more health funds spending by hospitals, economic management in hospitals is necessary. Determining the causes and rates of insurance under reimbursement bills was the objective of this study.

Materials and Methods: This research is a descriptive cross-sectional survey was done in 2008. The samples of study were the al records' patients who undertaken of social security insurance system in the teaching hospitals of Shahid Sadoughi University of Medical Science. The data complied in SPSS 16 software and then analyzed.

Results: In this study, 9.8% cases of all hospitalization bills were deducted. The highest rates of under reimbursement bills was in Afshar hospital (12.7%), followed by burn hospital (12.5% ), Shahid Sadoughi hospital (10%), and Shahid Rahnemoon hospital (8.2%). The highest rates of under reimbursement bills imposed to the surgeon fees (28.4%), treatment fees (15.06%), and medicine (14.3%) costs. However assistant surgeon fees had no under reimbursement. The most important causes of under reimbursement were defects in the insurance records of patients and noncompliance with insurance organization regulations.

Conclusion:  Training of human resources and optimized use of hospital information systems could be helpful to hospitals for reducing insurance reimbursement to ultimately improve hospitals to financial statements. 


Designing an assessment framework based on educational standards required for internship in HealthCare Management Assessment of the HealthCare Management students according to educational standards
Noushin Kohan, Fatemeh Keshmiri, Roohollah Askari,
Volume 21, Issue 3 (12-2022)
Abstract 
Background: It is expected that graduates of healthcare management have the necessary skills to perform various managerial and administrative positions. This study was carried out with the aim of designing and compiling an evaluation framework for students based on educational standards in the internship period.
Materials &Methods: The current study was conducted in four phases: In the first phase, in order to identify the problem and assess the needs, the existing curriculum and topics were examined, as well as the studies conducted in this field. In the second phase, the perspective of the stakeholders was used to complete and modify the initial framework. In the third phase, worksheets for registering internship learning activities were prepared for students and a checklist of educational and learning objectives, personal and management skills, and skills for developing professional qualifications was compiled. Finally, a specialized panel was used to determine the type of formative and final exams.
Results: The problems and challenges of internships can be investigated in 4 areas: inappropriate planning of the course, faculty, group - professors and hospital. In designing the evaluation tool, 9 criteria were taken into consideration. Also, tests designed in a compilation framework were used as formative tests and reasoning tests were used as final tests.
Conclusion: The compiled framework can be used as a valid and comprehensive tool to evaluate the practical competence and capabilities of healthcare management students during the internship period.
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