Evaluation of the Effect of Educational Intervention on the Error of Insurance Documents on Deductions in Hospitalization Records

Mahmood  Mousavi; Zohreh  Karimiankakolaki

doi:10.18502/jsbch.v8i1.15611

Mahmood Mousavi Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran
Zohreh Karimiankakolaki Department of Health, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran

DOI: https://doi.org/10.18502/jsbch.v8i1.15611

Keywords: Education, Covid-19, Hospitalization, Hospital

Abstract

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.