Evaluation of the causes of prescription deductibles in a teaching hospital in Kermanshah

Abstract

Objectives: Due to the fact that most of insurance companies have deductions and long delays in the reimbursement of bills. They are causing dissatisfaction in the hospitals of the contracting party. Therefore, the present study was conducted with the aim of determining the causes of prescription deductibles in a teaching hospital in Kermanshah, Iran in 2018. Methods: In this cross-sectional and descriptive-analytical study, all 560 cases related to 2018 year that were covered by the insurance of the hospital were examined. Data were analyzed using the SPSS software version 23. The significant level was set at 5 percent. Results: The results of the present study showed that the mean and standard deviation of prescription deductibles in the hospital during 2019 were 16596782.90 and 335966366.43 Rails, respectively. The highest amount of prescription deductibles was recorded in January and the lowest was recorded in March. The highest cause of prescription deductibles in the opinion of the participants with a frequency of 44.4% was related to the lack of accurate and precise registration of drugs and equipment in the doctorchr('39')s and nursing notes. Conclusion: The findings suggest review of medication application forms by at least two people, reminding and educating doctors, inspection by insurance and income personnel regularly, encouraging staff if deductions are reduced, reducing the time interval between shifts of physicians and nurses, increasing cooperation between insurance companies and income personnel with the pharmacy department, and using specialists to update the price of medicines before entering the pharmacy might help to lessen prescription deductibles

Keywords

• hospital
• drug deductions
• insurance