Prioritizing insurance deductions factors of Shahid Mohammadi hospital inpatients records using Shannon Entropy, Bandar Abbas, Iran

AUTHORS

Farid Khorrami 1 , Rahil Hosseini Eshpala 2 , * , Tayebeh Baniasadi 3 , Neda Azarmehr 4 , Farahnaz Mohammady 5

1 MSc of Health Information Technology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

2 MSc Student in Medical Informatics, Tehran University of Medical Sciences, Tehran, Iran.

3 MSc Student in Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.

4 MSc student in Public Administration, Tehran Pun University , Tehran, Iran.

5 MSc of Public Administration, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

How to Cite: Khorrami F, Hosseini Eshpala R, Baniasadi T , Azarmehr N, Mohammady F. Prioritizing insurance deductions factors of Shahid Mohammadi hospital inpatients records using Shannon Entropy, Bandar Abbas, Iran, Hormozgan Med J. 2013 ; 17(1):e87945.

ARTICLE INFORMATION

Hormozgan Medical Journal: 17 (1); e87945
Published Online: March 10, 2013
Article Type: Research Article
Received: October 01, 2012
Accepted: March 10, 2013

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Abstract

Introduction: Due to the low tariffs of diagnostic and treatment services in public hospitals
and the high cost of health care facilities, the need to receive all revenues from insurance
agencies is essential. This study was carried out by the main purpose of prioritizing
insurance deductions according to objective intervention in Shahid Mohammadi hospital in
Bandar Abbas.
Methods: In this cross-sectional study the research population includes all 2300 inpatient
records that were under insurance deductions during August to January of 2008. The data
were collected by referring to the documents of insurance organizations and Shahid
Mohammadi hospital records. The deduction factors of bills were weighted and ranked by
Shannon Entropy method and the descriptive data was analyzed using SPSS16 software.
Results: The highest deductions were related to villagers health insurance fund (Khadamat
Darmani-Rostaeian) (53%), City hospitalization health insurance fund (khadamat Darmani-
Bestari Shahri) and social insurance (Taamin Ejtemaei), with 14 and 11 percent,
respectively. The orthopedic ward (33%) and general surgery ward (17%) had the highest
deductions among all of the hospital wards. After weighting and prioritizing deduction
factors, surgeon commission, medicine, geographic full time of physicians and anesthesia
were the main factors of the deductions.
Conclusion: According to the results, most of the deduction factors were pertinent to the
surgery wards that were due to the lack of the doctors and the personnel knowledge who
were involved in the treatment process under the insurance laws. The health care team
training, use of hospital information systems and providing deductions feedback to the
employees can reduce deductions.

Keywords

Health Insurance – Reimbursement – Medical Record

© 2013, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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