بررسی تأثیر طرح تحول نظام سلامت و تعرفه‌گذاری بر اساس کتاب ارزش‌های نسبی بر عملکرد دپارتمان زنان: مطالعه موردی در یک بیمارستان بزرگ

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشیار مدیریت خدمات بهداشتی درمانی، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 دانشجوی کارشناسی ارشد، گروه آموزش بهداشت و ارتقای سلامت، کمیته تحقیقات دانشجویی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشجوی کارشناسی ارشد، گروه علوم مدیریت و اقتصاد سلامت، کمیته تحقیقات دانشجویی، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استادیار گروه طب سوزنی و مکمل، دانشکده طب سنتی و مکمل، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استادیار گروه مدارک پزشکی و فن‌آوری اطلاعات سلامت، دانشکده علوم پیراپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

6 استادیار اقتصاد سلامت، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: طرح تحول نظام سلامت از جمله اصلاحات عمده نظام سلامت ایران در چند سال گذشته است. با توجه به اهمیت بررسی تأثیر این مداخلات بر اقتصاد و عملکرد بیمارستان، مطالعه حاضر با هدف تعیین تأثیر طرح تحول نظام سلامت و تعرفه‌گذاری بر اساس کتاب ارزش‌های نسبی بر عملکرد دپارتمان زنان بیمارستان امام رضا (ع) مشهد انجام شد.
روش‌کار: این مطالعه توصیفی مقطعی به روش هزینه‌یابی مبتنی بر فعالیت در سال‌های 94-1392 در دپارتمان زنان بیمارستان امام رضا (ع) مشهد انجام شد. برای تحلیل اقتصادی- عملکردی دپارتمان زنان از سه دسته داده شامل: داده‌های مربوط به اقلام هزینه‌ای، اقلام درآمدی و شاخص‌های عملکردی استفاده شد. داده‌ها با استفاده از فرم‌های گردآوری داده‌ها استخراج و با استفاده از نرم‌افزار Exel و روش‌های آمار توصیفی (میانگین، انحراف معیار، درصد و ...) تحلیل شدند.
یافته‌ها: درآمد کل دپارتمان بعد از طرح تحول 54% و بعد از تغییر ارزش نسبی به قبل از آن 75% افزایش یافته است. بیشترین افزایش درآمد مربوط به اتاق عمل بعد از ارزش نسبی بوده است (128%). هزینه دپارتمان بعد از طرح تحول 3% و بعد از تغییر ارزش نسبی به قبل از آن 79% افزایش یافته است. زایمان سزارین نسبت به زایمان طبیعی 3/2% کاهش پیدا کرده است.
نتیجه‌گیری: طرح تحول بر شاخص‌های مالی و عملکردی دپارتمان زنان بیمارستان امام رضا (ع) مشهد تأثیر مثبت داشته است. این تأثیر در بین اقلام درآمدی و هزینه‌های مختلف، به صورت یکسان نبوده است.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of "Iran's Health System Evolution" And "Tariff Change" based on relative values book on Performance of Obstetrics and Gynecology Department: A case study in a Big Hospital

نویسندگان [English]

  • Hosein Ebrahimipour 1
  • Samira Olyani 2
  • Alireza Rezazadeh 3
  • Ali Khorsand Vakilzadeh 4
  • Somayeh Fazaeli 5
  • Mina Jafari 3
  • Arezoo Shabanifar 3
  • Mehdi Yousefi 6
1 Associate Professor, Department of Treatment Health Services Management, Social Determinants of health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
2 MSc. Student, Department of Health Education & Promotion, Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
3 M.Sc. Student, Department of Health Economics and Management Sciences, Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant Professor, Department of Acupuncture and Complementary Medicine, School of Complementary and Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Assistant Professor, Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad, University of Medical Sciences, Mashhad, Iran.
6 Assistant Professor, Department of Health Economics, Social Determinants of health Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: Health system evolution plan has been of main corrections in in Iran's health system in the last previous years. Due to the importance of these interventions on the economic and performance of the hospital, this study was performed with aim to determine the effect of health system evolution plan and Tariff change based on relative values book on the performance of obstetrics and gynecology department in Imam Reza hospital in Mashhad.
Methods: This cross-sectional descriptive study was conducted by Activity Based Costing in obstetrics and gynecology department of Imam Reza hospital in Mashhad in 2013-2015. For economic-performance analysis of obstetrics and gynecology department, three categories were used including: data related to cost, data related to income, and performance indexes. Data were extracted by data gathering forms and were analyzed using descriptive statistics by Excel Software and statistical descriptive methods (mean, standard deviation, percentage, …).
Results: Total income of this department has increased respectively by 54% and 75% after health system evolution and tariff change. The highest increase of income has related to operating room after tariff change (128%). After both health system evolution and tariff change, total expenditure of this department has increased respectively by 3% and 79%. Cesarean section rate has decreased about 2/3% after evolution.
Conclusion: Evolution plan has positive effect on the performance and financial indicators of obstetrics and gynecology department of Imam Reza hospital. This effect was not equal among revenue and expenditure items.

کلیدواژه‌ها [English]

  • Cost Analysis
  • Health Care Reform
  • Hospital
  • Hospital costs
  • Obstetrics and gynecology department
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