تحلیل هزینه‌های مستقیم بیماران بستری منتظر دریافت ضربان‌ساز (مطالعه موردی: مرکز آموزشی درمانی شهید مدنی تبریز)

نوع مقاله: مقاله پژوهشی

نویسندگان

1 استادیار، گروه اقتصاد سلامت، مرکز تحقیقات پزشکی مبتنی بر شواهد، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

2 دانشجوی دکترای سیاستگذاری سلامت، مرکز تحقیقات پزشکی مبتنی بر شواهد، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

3 دکترای داروسازی، مرکز ملی تحقیقات بیمه سلامت، سازمان بیمه سلامت ایران، تهران، ایران

4 دانشجوی دکترای مدیریت خدمات بهداشتی و درمانی، مرکز تحقیقات قلب و عروق، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

5 کارشناس مدیریت خدمات بهداشتی و درمانی، مرکز تحقیقات پزشکی مبتنی بر شواهد، دانشگاه علوم پزشکی تبریز، تبریز، ایران

6 کارشناس مدیریت خدمات بهداشتی و درمانی، مرکز تحقیقات قلب و عروق، دانشگاه علوم پزشکی تبریز، تبریز، ایران

10.30476/jha.2020.68034.1192

چکیده

مقدمه: هزینه‌های مربوط به درمان بیماران قلبی-عروقی بخش عمده‌ای از هزینه­های بهداشتی و درمانی را تشکیل می‌دهد. از این رو، بررسی هزینه‌های این بیماران دارای اهمیت است. برای این منظور در پژوهش حاضر هزینه‌های مستقیم مربوط به بیماران بستری منتظر دریافت ضربان‌ساز در مرکز آموزشی درمانی شهید مدنی تبریز از دیدگاه بیمارستان تحلیل شده است.
روش پژوهش: پژوهش حاضر از نوع توصیفی-مقطعی بوده و در آن تعداد 135 بیمار دریافت‌کننده ضربان‌ساز دائم در سال 1395 بررسی شده است. در این پژوهش میانگین هزینه کل به ازای هر بیمار، هزینه هر روز بستری در بخش‌های عادی و مراقبت‌های ویژه، میزان صرفه‌جویی هزینه در صورت دریافت به موقع ضربان‌ساز به تفکیک سهم بیمار و بیمه، درصد هزینه پرداخت‌شده به وسیله بیماران و هزینه بهره‌وری از دست رفته به ازای روزهای بستری اضافی محاسبه شده است.  
یافته‌ها: نتایج این پژوهش نشان می­دهد که مجموع هزینه کل بیماران برای تعبیه ضربان‌ساز در سال 1395 در روزهای انتظار در حدود 2 میلیارد ریال، میانگین هزینه به ازای هر بیمار در حدود 20 میلیون ریال و میانگین هزینه به ازای هر روز بستری حدود 3 میلیون ریال است. در طول روزهای بستری، میانگین هزینه هر بیمار و میانگین هزینه روز بستری در بخش سی‌سی‌یو، به ترتیب، در حدود 29 و 4 میلیون ریال و هم‌چنین، میانگین هزینه هر بیمار و میانگین هزینه روز بستری در بخش آی‌سی‌یو، به ترتیب، در حدود 92 و 6 میلیون ریال است. افزون براین، هزینه بهره‌وری از دست رفته به ازای هر بیمار در حدود 2 میلیون ریال محاسبه شد.
نتیجه‌گیری: افزایش روزهای انتظار بیماران موجب افزایش هزینه‌های بیمارستان و سازمان‌های بیمه‌گر می­شود. از این رو، با اتخاذ راهکارهای مناسب برای کاهش روزهای انتظار بیماران (به عنوان نمونه، اولویت‌بندی بیماران بر اساس اصول علمی متناسب با منابع مالی و اقتصادی و تدوین دستورعمل بالینی مناسب) می‌توان در هزینه‌های سلامت صرفه‌جویی کرد و بیمه‌های سلامت می‌توانند در تخصیص منابع مالی به صورت کاراتری عمل کنند.  

کلیدواژه‌ها


عنوان مقاله [English]

Analyzing the Direct Costs of Patients Waiting for Receiving Pacemakers (A Case Study: Shahid Madani Educational Center, Tabriz)

نویسندگان [English]

  • A. Mahboob Ahari (Ph. D.) 1
  • G. Alizadeh 2
  • M. Firoozi (Ph.D.) 3
  • S. Pourreza 4
  • M. Rezaei 5
  • A. Saei 6
1 Assistant Professor, Department of Healthcare Economic, Evidence-based Medical Research Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2 Ph. D. Student of Health Policy Making, Evidence-Based Medical Research Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
3 Pharmaceutical Physician, Health Insurance National Research Center, Iran Health Insurance, Tehran, Iran
4 Ph. D. Student of Treatment and Care Management Services, Cardiovascular Reserach Center, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
5 B. A. in Treatment and Care Management Services, Evidence-based Medical Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
6 B. A. in Treatment and Care Management Services, Cardiovascular Reserach Center, Tabriz University of Medical Sciences, Tabriz, Iran
چکیده [English]

Introduction: A major part of health care costs is dedicated to the costs of treating patients with cardiovascular disease constitute so that investigating the costs of these patinets is imporatnt. To this end, the dircet costs of hospitalized patients waiting for receiving pacemaker in Shahid Madani Hospital in Tabriz has been analyzed from the view of hospital in this study.  
Method: This is a descriptive cross-sectional study. The statistical population included 135 patients receiving a permanent pacemaker. The average cost per patient, cost of each day of admission to ordinary sectors, the CCU and the ICU, cost saving in case of reciving a pacemaker timely regarding the patient’s share of the insurance, the percentage of out-of-pocket payment and the cost of lost productivity were calculated for additional hospitalization days.
Results: The results show that the total cost of pacemaker insertion on the waiting list is almost 2 billion Rilas, the average cost per patient is about 20 million Rials and the average cost of per day hospitalization is approximately 3 million Rials. During the hospitalization days, the average cost of per patient and the average cost of per day hospitalization in the CCU are respectively 29 million Rials and 4 million Rilas. Also, the average cost of per patient and the average cost of per day hospitalization in the ICU are respectively 92 million Rials and 6 million Rials. The lost productivity cost for ecah patient is nearly two million rials.
Conclusion: Increasing the patinets waiting days would result in boosting the costs of hospital and the insurer organizations. Therefore, healthcare costs can be cost-effcetive by adopting proper strategies to decrease the number of waiting days for patients (for example, pririotizing patients based on scientific principles in terms of financial and economic funds and following an appropraite clinical instrcution) and health insurance can function more effectively in allocating funds.

کلیدواژه‌ها [English]

  • cost
  • hospital
  • Lost Productivity
  • Pacemaker
  • Waiting time
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