Comparative study of the situation of insurance deductions in the hospital before and after the implementation of the productivity promotion system

Introduction Hospital insurance deductions, in addition to wasting significant amounts of hospital resources and revenues and reducing hospital financial capacity, also impose additional financial burdens on the patient by increasing the costs that patient has to pay. Therefore, the present study aims to compare the status of insurance deductions before and after the implementation of productivity promotion system in Loghman and Imam Hossein (AS) hospitals in Tehran.

A descriptive-cross-sectional study with practical purposes conducted in Loghman Hakim and Imam Hossein (AS) hospitals in Tehran by random sampling classification based on the minutes of the insurance organization's meetings on 310 cases and deductions applied by the organization. Insurance in 1396 as insurance deductions before the implementation of the productivity promotion plan and 1397 as insurance deductions after the implementation of the productivity promotion plan and using spss 26 software and descriptive and average statistics methods and The independent T test has been analyzed.

The results of data analysis showed that the average social security insurance deductions include doctor's visit (P = 0.007), doctor's fee (P = 0.00), drug deduction (P = 0.011), laboratory deduction (P = 0.00) and average total deduction. (P = 0.00) in Imam Hossein (AS) Hospital, after the implementation of the productivity improvement plan, there was a statistically significant difference compared to before its implementation, which showed an increase in insurance deductions after the implementation of the productivity improvement plan. However, the amount of insurance deductions for patient consumables did not show a significant difference before and after the implementation of the productivity improvement plan (P = 0.38). Also, the average social security insurance deductions including equipment and drug deductions (P = 0.002) and the average total deductions (P = 0.004) in Loghman Hakim Hospital after the implementation of the productivity improvement plan had a statistically significant difference compared to before its implementation. It has been shown that the increase in insurance deductions after the implementation of the productivity promotion plan, while the amount of deductions for patient supplies other than medicine has not shown a significant difference before and after the implementation of the productivity promotion plan (P = 0.38). The results of the analysis of health service insurance deductions in both Imam Hossein Hospital (P = 0.81) and Loghman Hakim Hospital (P = 0.10) showed that the amount of insurance deductions later than the implementation of the productivity improvement plan compared to before Its implementation has not shown a statistically significant difference.

The productivity improvement plan has not only had no effect on reducing the amount of insurance deductions, but has also increased the amount of deductions in deductions issued by social security insurance.