Prioritizing insurance deductions factors of Shahid Mohammadi hospital inpatients records using Shannon Entropy, Bandar Abbas, Iran

Introduction: Due to the low tariffs of diagnostic and treatment services in public hospitals and the high cost of health care facilities, the need to receive all revenues from insurance agencies is essential. This study was carried out by the main purpose of prioritizing insurance deductions according to objective intervention in Shahid Mohammadi hospital in Bandar Abbas. Methods: In this cross-sectional study the research population includs all 2300 inpatient records that were under insurance deductions during August to January of 2008. The data were collected by referring to the documents of insurance organizations and Shahid Mohammadi hospital records. The deduction factors of bills were weighted and ranked by Shannon Entropy method and the descriptive data was analyzed using SPSS16 software. Results: The highest deductions were related to villagers health insurance fund (Khadamat Darmani-Rostaeian) (53%), City hospitalization health insurance fund (khadamat Darmani-Bestari Shahri) and social insurance (Taamin Ejtemaei), with 14 and 11 percent, respectively. The orthopedic ward (33%) and general surgery ward (17%) had the highest deductions among all of the hospital wards. After weighting and prioritizing deduction factors, surgeon commission, medicine, geographic full time of physicians and anesthesia were the main factors of the deductions. Conclusion: According to the results, most of the deduction factors were pertinent to the surgery wards that were due to the lack of the doctors and the personnel knowledge who were involved in the treatment process under the insurance laws. The health care team training, use of hospital information systems and providing deductions feedback to the employees can reduce deductions.