Review the Referral Times and Outpatient Expenses Caused by Driving Accidents in the Follow-up Treatment Period in Ilam Insured of Health Insurance Organization, First Quarter of 2018

According to the law costs associated with disasters and accidents, it is the responsibility of the Ministry of Health and Medical Education for up to two months after discharge. But because there is no specific mechanism to identify the outpatient costs of these patients, these costs are imposed on the health insurance organization. The purpose of the study is to determine that; how the referral times and outpatient costs of the insured by the health insurance organization caused by driving accidents during the essential visits period in Ilam province.

The study was conducted retrospectively and descriptively. The statistical population includes insured that referred to Imam Khomeini Hospital in Ilam city during the first quarter of 2018 caused by accidents driving. The referral times and outpatient costs of 454 insured covered by health insurance were reviewed and recorded, coded and entered into the computer by census. Data were analyzed by SPSS 21 software and the tables and graphs were designed and extracted by central tendency indicators and data descriptions were performed.

During the essential visits period the insured of health insurance that have been injured due to driving accidents during the first quarter of 2018, a total they had 888 visits times and had cost 7,979,319,264 Rials. Each study sample had 1.96 times outpatient visits at the time of the study and has produced a cost of 2,082,582 Rials for the Health Insurance Organization.

The results of the study per year show that on average the 3216 times visit an amount of 1,057,278,832 Rials will be imposed to the Health Insurance Organization. It is suggested that the Health Insurance Organization adopts a method that this costs to be covered by the Ministry of Health and from the sources from the 10% third party premiums from the paragraph B of Article 37 of the Fifth Plan law.