The Comparison of the cost of patient records in a global system with corresponding retrospective reimbursement system: a case study in Iran

Introduction: The reimbursement mechanism of the cost of treatment is an important factor which directly or indirectly affects the financial management and control of hospitals costs, hence different countries use different reimbursement systems. This study evaluated the prospective reimbursement system (global system); at one of the hospitals in Hormozgan University of Medical Sciences. Methods: This descriptive-analytical study evaluated 1286 Global inpatient records in Fekri hospital affiliated to Hormozgan University of Medical Sciences. First the actual cost of care and length of stay for each of the global records was extracted using the hospital information system. Then the average cost and patient's stay for each of global procedures were compared with the cost and length of stay determined by Iran global system. Data analysis was performed using descriptive statistics and T-test was used to test the research questions. Results: One quarter of all inpatient records belonged to global payment system. 62% of global records belonged to OB/GY operations, 20% to general surgery and 18% to ophthalmic surgery. The analysis of the cost of 86% of surgery global records showed to be beneficial for the hospital, where 91% of these cost differences were found to be significant. For more than 99% of cases in global system, the average length of stay was less than average standard length of stay, and for 64% cases this difference was found to be statistically significant. Conclusion: Regarding the reduction of length of stay of patients in global payment system, the review and implementation of global payment system for other diagnoses and operations is highly recommended.