教育干预对住院记录中保险单据扣款错误的影响评估

Mahmood Mousavi, Zohreh Karimiankakolaki
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摘要

研究背景本研究旨在探讨教育干预对医院工作人员在扣除 COVID-19 患者医疗保险住院记录时保险文件出错率的影响。研究方法这项半实验研究的目标人群是所有参与 Covid-19 患者管理的人员。在 Chaharmahal 省和 Bakhtiari 省 COVID-19 基地的医院中,以抽签方式选出一家医院作为教育目标组(24 人),一家医院作为对照组(16 人)。为衡量教育效果,确定了两家医院在 2016 年 10 月和 3 月两个时间段内 19 名医保患者的所有病例样本量。数据收集采用核对表和直接查阅档案、医保系统和医院 HIS 系统的方式进行。数据分析采用 SPSS21 软件进行。结果干预医院 "Covid 19 住院病人 "的医保扣款次数从 1833 次大幅下降至 933 次(P < .005),而对照医院则从 447 次上升至 2712 次(P < .005)。在干预医院中,旅馆服务的扣款减少最多,从 235(12.8%)例减少到 2(0.2%)例(p < .001),药品从 335(18.2%)例减少到 56(6%)例(p < .001)。结论结果表明,在冠状病毒大流行期间对员工进行有关 COVID-19 保险单据错误的培训减少了 COVID-19 患者记录中保险扣款的数量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the Effect of Educational Intervention on the Error of Insurance Documents on Deductions in Hospitalization Records
Background: This study aims to consider the effect of an educational intervention on the error rate of insurance documents in the deducting of hospitalization records of COVID-19 patients' health insurance among hospital staff. Methods: The target population of this semi-experimental study was all personnel involved in the management of patients with Covid-19. Among the hospitals of the COVID-19 site in Chaharmahal and Bakhtiari provinces, one hospital was selected as the educational target group (24 individuals) and one hospital was considered as the control group (16 individuals) by lottery. To measure the effectiveness of education, the sample size of all cases of 19 patients with health insurance in two hospitals during two periods of October and March 2016 was determined. Data collection was performed by checklists and direct reviews of files, the health insurance system, and the hospital HIS system. Data analysis was performed using SPSS21 software. Results: The number of deductions in the case of "Covid 19 hospitalized patients" of the health insurance decreased significantly in the intervention hospital from 1833 to 933 (p < .005) and increased in the control hospital from 447 to 2712 (p < .005). In the intervention hospital, the highest decrease in deductions in the hoteling service was from 235 (12.8%) to 2 (0.2%) cases (p < .001), and for medicines from 335 (18.2%) to 56 (6%) cases (p < .001). Conclusion: The results demonstrated that staff training on the error in COVID-19 insurance documents during the coronavirus pandemic outbreak has reduced the number of insurance deductions in COVID-19 patients' records.
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