A Scoping Review of Health Insurance Deductions in Hospitals: Root Causes and Solutions

Context: The issue of insurance deductions is one the major problems that lead to shortage financial resources in hospitals. present study was conducted review root causes and propose solutions reduce them Iranian Methods: This a scoping literature on health hospitals Iran within 2000 - 2023 synthesize findings original Persian English studies focused strategies relevant concepts terminology were found through medical subject headings (MeSH). articles screened based preferred reporting items for systematic reviews meta-analysis (PRISMA) checklist. Analysis research data (text articles) carried out by content analysis technique MAXQDA software (version 10). Results: A total 1121 publications identified, which 41 met inclusion criteria reviewed. Based analysis, most (61%) published 2016 2020, 12.2% included qualitative, 48.8% performed Finally, 46 35 extracted. leading associated with service delivery, registration, sending documents, conversion services into revenue. important dimensions providing registering lack familiarity providers rules regulations, coding relative value book, extravagance motivation earn more revenue, strong infrastructure register services. Furthermore, reducing categorized three groups, namely meta (ministries health), macro (universities), mezzo (hospitals). top deductibles several dimensions, such as providers, process modification, policy reform, modification. these four teaching documentation principles all staff, familiarizing physicians laws correct coding, continuous interaction between companies hospitals, revisions repayment system. Conclusions: could be determined dimensions. To manage number deductions, should carefully examined document regulation audit, each hospital use according weak points. However, solving not only related hospitals; it necessary policymakers managers ministries health, universities sciences, organizations adopt policies, especially field information management, deductions. According presented topics, efficiency and, ultimately, quality care can improve accurate understanding deficits. It also prevents waste main support survival.