The Comparison of the Global Surgery Fees and the Actual Cost in Two Educational Hospitals Affiliated to Tehran University of Medical Sciences

Abstract

Background: Global surgeries include ninety operations in the common surgical procedures, with the annual fixed fees; which the insurance companies pay hospitals accordingly. The aim of this study was to compare the global fees to these surgeries’ real costs and to investigate the affecting factors in two teaching hospitals affiliated to Tehran University of Medical Sciences.

Methods: This longitudinal retrospective descriptive-analytic study was conducted on all hospital records with global surgeries in three months in 2012 to 2013in two educational hospitals affiliated to Tehran University of Medical Sciences.Data were collected using the researcher’s –made checklist and extracted from the HIS (Hospital Information System). SPSS, EXCEL, and STATA software were used to analyze the data and to obtain the difference between the recorded costs and global fees.

Results: The global fees were less than the recorded costs in both hospitals. The recorded costs in hospital B were much less than hospital A for the same surgeries. In hospital B, costs have been reduced for some surgeries in 2013comparedto 2012 by reducing the patients’ length of stay and time management.

Conclusion: Fees in the referral hospitals of Tehran University, which usually involve complicated patients, should be determined more accurately. However, this study suggested that hospitals can greatly reduce the cost of global surgeries throughclinical and cost management.

Keywords: Global surgery, Hospital, Fee