Out-of-pocket payments in hospital bills: a challenge to management
Autor(a) principal: | |
---|---|
Data de Publicação: | 2018 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Enfermagem (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000502511 |
Resumo: | ABSTRACT Objetive: To analyse out-of-pocket payments (OOP) by health insurance company in hospital bills. Method: Cross-sectional study with quantitative approach. The information was obtained in the database of a health insurance company in the north of Paraná State and categorised into administrative and technical OOP. We analysed reports regarding OOP made in eight hospitals of the accredited network company, from 2013 to 2015. Results: The analysed data totalled 36 thousand items paid out-of-pocket. The highest OOP rates occurred in hospital 1 (67.6%); emergency room service (50.1%); time of hospitalization, ≤ 1 day (70.8%) and medical-hospital materials (59.2%). The year with the highest rates of administrative (54.51%) and technical (48.05%) OOP was 2013. Conclusion: We concluded that OOP are indicators for the institutions to check the critical topics to be improved and that managers must work on originator aspects of OOP, to prevent greater loss. |
id |
ABEN-1_22c5f35e107229bef8d862a450823390 |
---|---|
oai_identifier_str |
oai:scielo:S0034-71672018000502511 |
network_acronym_str |
ABEN-1 |
network_name_str |
Revista Brasileira de Enfermagem (Online) |
repository_id_str |
|
spelling |
Out-of-pocket payments in hospital bills: a challenge to managementSupplementary HealthNursing AuditHospital CostsHospital AdministrationPre-Paid Health InsuranceABSTRACT Objetive: To analyse out-of-pocket payments (OOP) by health insurance company in hospital bills. Method: Cross-sectional study with quantitative approach. The information was obtained in the database of a health insurance company in the north of Paraná State and categorised into administrative and technical OOP. We analysed reports regarding OOP made in eight hospitals of the accredited network company, from 2013 to 2015. Results: The analysed data totalled 36 thousand items paid out-of-pocket. The highest OOP rates occurred in hospital 1 (67.6%); emergency room service (50.1%); time of hospitalization, ≤ 1 day (70.8%) and medical-hospital materials (59.2%). The year with the highest rates of administrative (54.51%) and technical (48.05%) OOP was 2013. Conclusion: We concluded that OOP are indicators for the institutions to check the critical topics to be improved and that managers must work on originator aspects of OOP, to prevent greater loss.Associação Brasileira de Enfermagem2018-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000502511Revista Brasileira de Enfermagem v.71 n.5 2018reponame:Revista Brasileira de Enfermagem (Online)instname:Associação Brasileira de Enfermagem (ABEN)instacron:ABEN10.1590/0034-7167-2016-0667info:eu-repo/semantics/openAccessRodrigues,July Anne Rossi MichelinCunha,Isabel Cristina Kowal OlmVannuchi,Marli Terezinha OliveiraHaddad,Maria do Carmo Fernandez Lourençoeng2018-10-03T00:00:00Zoai:scielo:S0034-71672018000502511Revistahttp://www.scielo.br/rebenhttps://old.scielo.br/oai/scielo-oai.phpreben@abennacional.org.br||telma.garcia@abennacional.org.br|| editorreben@abennacional.org.br1984-04460034-7167opendoar:2018-10-03T00:00Revista Brasileira de Enfermagem (Online) - Associação Brasileira de Enfermagem (ABEN)false |
dc.title.none.fl_str_mv |
Out-of-pocket payments in hospital bills: a challenge to management |
title |
Out-of-pocket payments in hospital bills: a challenge to management |
spellingShingle |
Out-of-pocket payments in hospital bills: a challenge to management Rodrigues,July Anne Rossi Michelin Supplementary Health Nursing Audit Hospital Costs Hospital Administration Pre-Paid Health Insurance |
title_short |
Out-of-pocket payments in hospital bills: a challenge to management |
title_full |
Out-of-pocket payments in hospital bills: a challenge to management |
title_fullStr |
Out-of-pocket payments in hospital bills: a challenge to management |
title_full_unstemmed |
Out-of-pocket payments in hospital bills: a challenge to management |
title_sort |
Out-of-pocket payments in hospital bills: a challenge to management |
author |
Rodrigues,July Anne Rossi Michelin |
author_facet |
Rodrigues,July Anne Rossi Michelin Cunha,Isabel Cristina Kowal Olm Vannuchi,Marli Terezinha Oliveira Haddad,Maria do Carmo Fernandez Lourenço |
author_role |
author |
author2 |
Cunha,Isabel Cristina Kowal Olm Vannuchi,Marli Terezinha Oliveira Haddad,Maria do Carmo Fernandez Lourenço |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Rodrigues,July Anne Rossi Michelin Cunha,Isabel Cristina Kowal Olm Vannuchi,Marli Terezinha Oliveira Haddad,Maria do Carmo Fernandez Lourenço |
dc.subject.por.fl_str_mv |
Supplementary Health Nursing Audit Hospital Costs Hospital Administration Pre-Paid Health Insurance |
topic |
Supplementary Health Nursing Audit Hospital Costs Hospital Administration Pre-Paid Health Insurance |
description |
ABSTRACT Objetive: To analyse out-of-pocket payments (OOP) by health insurance company in hospital bills. Method: Cross-sectional study with quantitative approach. The information was obtained in the database of a health insurance company in the north of Paraná State and categorised into administrative and technical OOP. We analysed reports regarding OOP made in eight hospitals of the accredited network company, from 2013 to 2015. Results: The analysed data totalled 36 thousand items paid out-of-pocket. The highest OOP rates occurred in hospital 1 (67.6%); emergency room service (50.1%); time of hospitalization, ≤ 1 day (70.8%) and medical-hospital materials (59.2%). The year with the highest rates of administrative (54.51%) and technical (48.05%) OOP was 2013. Conclusion: We concluded that OOP are indicators for the institutions to check the critical topics to be improved and that managers must work on originator aspects of OOP, to prevent greater loss. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000502511 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672018000502511 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0034-7167-2016-0667 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Brasileira de Enfermagem |
publisher.none.fl_str_mv |
Associação Brasileira de Enfermagem |
dc.source.none.fl_str_mv |
Revista Brasileira de Enfermagem v.71 n.5 2018 reponame:Revista Brasileira de Enfermagem (Online) instname:Associação Brasileira de Enfermagem (ABEN) instacron:ABEN |
instname_str |
Associação Brasileira de Enfermagem (ABEN) |
instacron_str |
ABEN |
institution |
ABEN |
reponame_str |
Revista Brasileira de Enfermagem (Online) |
collection |
Revista Brasileira de Enfermagem (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Enfermagem (Online) - Associação Brasileira de Enfermagem (ABEN) |
repository.mail.fl_str_mv |
reben@abennacional.org.br||telma.garcia@abennacional.org.br|| editorreben@abennacional.org.br |
_version_ |
1754303034751451136 |