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Comparing global-operations reimbursements with their actual costs in the Cancer Institute, Tehran

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Author(s): M Arab | H Zeraati | R Ravangard | A Gholinejad

Journal: Journal of School of Public Health and Institute of Public Health Research
ISSN 1735-7586

Volume: 6;
Issue: 2;
Start page: 59;
Date: 2008;
Original page

Keywords: Remuneration methods | Global system | Global operations reimbursement rates | Actual costs

ABSTRACT
Backgrounds and Aim: One of the remuneration methods in the hospital system in Iran is per case, based on a classification system termed Global system (GS). The GS, supported by Iran's Ministry of Health and Medical Education (MOHME), was established in 1999 and is now used for cost reimbursement in the second- and third-levels of health care services. In this system, patients are classified into 60 categories, based on the most frequent surgical operations. However, it now appears, that there are many questions about this system. This study aims to compare the global operations reimbursement rates with actual costs in the Cancer Institute, Tehran, in 2003 and 2004. "nMaterials and Methods: This survey was a retrospective, analytical-descriptive one aiming at comparing the global operations reimbursement rates with actual costs in 646 global operations carried out in the Cancer Institute in 2003 and 2004. The global-operations and actual-costs data were gathered from Hospital Information Systems (HIS) and High Council of Insurance annual regulations, respectively, and analyzed using SPSS 11.5 software and the Wilcoxon non-parametric test."nResults: The differences between the cost reimbursement rates of global operations and their actual costs were lower in 2004 as compared to those in 2003. Also, the actual costs of operations were higher than the global operations reimbursement rates in both years and the difference was significant statistically in either year (P
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