بررسی بار مالی حاصل از عدم تطابق انجام سونوگرافی با استانداردهای کشوری در زنان باردار با حاملگی کمخطر در مادران تحت پوشش مراکز جامع سلامت شهر اصفهان در سال 1398

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دکتری بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

3 دانشیار اقتصاد سلامت، مرکز تحقیقات مدیریت و اقتصاد سلامت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

چکیده

مقدمه: عدم تطابق مراقبت­های دوران بارداری و زایمان با دستورالعمل­ها و استاندارهای کشوری، بار مالی قابل توجهی را به نظام سلامت وارد می کند. از آنجایی که در ایران تاکنون مطالعه­ای در زمینه­ بررسی کمی موارد انجام سونوگرافی در بارداری­های کم­خطر صورت نگرفته است، لذا مطالعه حاضر با هدف تعیین بار مالی حاصل از عدم تطابق انجام سونوگرافی با استانداردهای کشوری در زنان باردار با حاملگی کم­خطر در مادران انجام شد.
روش‌کار: در این مطالعه مقطعی تحلیلی، 230 زن باردار با حاملگی کم‌خطر که در فاصله زمانی مهر 1398 تا مهر سال 1399 جهت انجام مراقبت‌های دوران بارداری به مراکز جامع سلامت مراجعه کرده بودند، مورد بررسی قرار گرفتند. سونوگرافی‌های انجام گرفته در دوران بارداری با استفاده از چک‌لیست محقق‌ساخته استخراج و وضعیت تطابق آن با استانداردهای کشوری، مورد بررسی قرار گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) انجام شد.
یافته­ها: میانگین دفعات انجام سونوگرافی در بارداری در هر فرد به‌طور میانگین 5 بار (4 بار سونوگرافی تک‌بعدی و 1 بار سونوگرافی سه‌بعدی) بود که تقریباً معادل 2 برابر میزان تعریف شده­ استاندار کشوری است (3 سونوگرافی تک‌بعدی). همچنین فقدان انطباق انجام خدمات سونوگرافی در بارداری بر مبنای میزان باروری کلی در سال با افزایش بار مالی بیمه­های پایه (7/364 میلیارد ریال)، افزایش بار مالی پرداخت از جیب سونوگرافی تک‌بعدی و سه‌بعدی (2898 میلیارد ریال) و وارد آمدن هزینه­ تقریبی 3260 میلیارد ریال بر پیکره­ نظام سلامت همراه است.
نتیجه‌گیری: عدم تطابق انجام خدمات سونوگرافی با استانداردهای کشوری با آثار متعددی همچون تحمیل هزینه­های مازاد بر خانواده و سازمان­های بیمه­گر همراه است. رعایت استاندارهای مراقبت­های تشخیصی و درمانی در دوران بارداری می­تواند با توقف دریافت خدمات غیرضروری در دوران بارداری و کاهش بار مالی حاصل از آن شود.

کلیدواژه‌ها

عنوان مقاله [English]

Financial burden due to non-compliance of ultrasound with national standards in pregnant women with low-risk pregnancy covered by the health centers of Isfahan, 2019

نویسندگان [English]

  • Raziye Pourkazemi 1
  • Mahsa Shaali 2
  • Reza Rezayatmand 3
1 Phd of Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
2 M.Sc. of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
3 Associate Professor, Health Management and Economics Research Center, Isfahan University of Medical Science, Isfahan, Iran.
چکیده [English]

Background and Aim: Non-compliance of pregnancy and childbirth care with national guidelines and standards incur a huge financial burden on health system. This study aimed to estimate the financial burden of ultrasound screening for low-risk pregnant women which is not in accordance with national standards.
Methods: This was a cross-sectional study in which 230 pregnant women with low-risk pregnancies, getting care in comprehensive health centers, were assessed in terms of the number of ultrasounds they had during their pregnancy and to see how it would be in accordance with national standards. The financial burden was estimated based on the total fertility rate per year from the perspective of health insurance as well as patients.
Results: The average number of ultrasounds performed in pregnancy per person was 5 times (4 one-dimensional ultrasound and one three-dimensional ultrasound), which is almost twice the defined level of the national standard (3 one-dimensional ultrasound). It was estimated that this imposed a financial burden of about 364,707,521,587 Rials on basic insurers. Also, individuals incur a financial burden of about 2,898,188,006,140 Rials. It meant that following national standard for performing ultrasound examination during low-risk pregnancy would have saved 3260 billion IRR for Iranian health system.
Conclusion: Non-compliance of ultrasound services with national standards is associated with several effects such as imposing additional costs on the family and insurance organizations. Following national standards for prenatal care would stop providing unnecessary services during pregnancy and reduce related costs which would be beneficial both for pregnant women and health system. 

کلیدواژه‌ها [English]

  • Financial burden
  • Pregnancy
  • Standard
  • Ultrasound

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 5
مرداد 1401
صفحه 58-66

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