The Average Expenses Covered by Insurance for Angioplasty Surgery on Patients Insured by Iran Health Insurance Organization (IHIO) in Three Hospitals Selected in March 2018

Infectious diseases were the biggest health complication of the world in the last decades but nowadays non infectious diseases are the major health complications. Coronary artery diseases are a major problem in the world. This study aim to compare the expenses covered by IHIO for angioplasty surgery in three hospitals based retrospective System.

This is a cross-sectional descriptive-analytical study to works on 532 patients hospitalized for angioplasty surgery in three hospitals A, B and C in March 2018 who was insured by IHIO. For findings that are more accurate the expenses covered by the insurance categorized to hospital stay, surgery, drug and equipment, paraclinic and angiography and other costs and data analyzed by SPSS 22. After applying the normality test on the data of each hospital separately it was clear that data distribution was not normal so Kruskal–Wallis test was used for comparison between groups.

The average expenses covered by IHIO for hospital A, B and C were 9.9, 8.7 and 10.6 million Tomans orderly. Also the most expenses portion were for the drug and equipment which were 54%, 52% and 58% for A, B and C hospitals in orderly. The results demonstrated that the selected hospitals had acted differently in stay, drug and equipment, paraclinic measures and other costs. Finally there was a significant difference between the average expenses covered by IHIO for A, B and C hospitals.

The payment methods in health system affect the behavior of service providers and the service quality and hospitals are different in patients treatment, therefor it is essential applying the prospective reimbursement (Global payment system for prevalent surgical that patterned from diagnosis related group systems).