Using Casemix System For Hospital Reimbursement In Social Health Insurance Programme
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Using Casemix System For Hospital Reimbursement In Social Health Insurance Programme
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Author : Syed Aljunid
language : en
Publisher: Partridge Publishing Singapore
Release Date : 2020-11-26
Using Casemix System For Hospital Reimbursement In Social Health Insurance Programme written by Syed Aljunid and has been published by Partridge Publishing Singapore this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-11-26 with Health & Fitness categories.
Social Health Insurance (SHI) is one of the vehicles in achieving Universal Health Coverage. However, in many low- and middle-income countries, implementation of SHI failed to provide efficient and effective coverage due to poor provider payment method. Indonesia has introduced social health insurance in 2014. With the population of more than 270 million, Indonesia is the biggest country in the world that implemented SHI with casemix system (INA-CBG) as the prospective provider payment method. In this book, we presented an outcome of a study implemented in the largest hospital in Jakarta, Indonesia that compared the impact of using casemix system as provider payment method with fee-for-service. A total 32,227 outpatients and 8,270 inpatients medical records were reviewed and included in the study. In addition, a survey was also conducted among billing administrators to assess the cost of the billing process and their perceptions on the two reimbursement methods. The total hospital charges, length of stay of inpatients, rate of unnecessary admissions and cost of billing process were among the indicators of efficiency compared in the study between the two provider payment methods. The book provides comprehensive evidence to confirm the advantages of casemix system as an efficient provider payment method in SHI programme.
Implementation Of Casemix System As Prospective Provider Payment Method In Social Health Insurance A Case Study Of Acheh Provincial Health Insurance
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Author : Prof Dr Syed Mohamed Aljunid
language : en
Publisher: Partridge Publishing Singapore
Release Date : 2022-11-20
Implementation Of Casemix System As Prospective Provider Payment Method In Social Health Insurance A Case Study Of Acheh Provincial Health Insurance written by Prof Dr Syed Mohamed Aljunid and has been published by Partridge Publishing Singapore this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-11-20 with Business & Economics categories.
The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.
Governing Health Systems
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Author : Michael R. Reich
language : en
Publisher: Routledge
Release Date : 2016-10-21
Governing Health Systems written by Michael R. Reich and has been published by Routledge this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-10-21 with Business & Economics categories.
Governing Health Systems: For Nations and Communities Around the World examines the complex relationships between governance and performance in community and national health systems. Each chapter provides an in-depth case study, using both qualitative and quantitative methods, on health systems in many countries, including Uganda, Ghana, India, Zambia, Japan, Nigeria, Indonesia, Brazil, Palestine, and South Korea. The chapters were written by former Takemi Fellows, who were mid-career research fellows at the Harvard T.H. Chan School of Public Health, and their colleagues. This case study approach yields important findings as well as contextual insights about the challenges and accomplishments in addressing governance issues in national and community health systems around the world. Health policymakers around the world are struggling to address the multiple challenges of governing health systems. These challenges also represent important themes for the research mission of the Takemi Program in International Health at the Harvard T.H. Chan School of Public Health. This book is based on the program’s thirtieth anniversary symposium held in October 2013 at Harvard. The studies presented in this book—deep examinations of illustrative examples of health system governance for communities and nations—contribute to our knowledge about global health and assist policymakers in dealing with the complex practical problems of health systems. In short, this book addresses central questions about governing health systems—and why governance matters.
Status Report
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Author :
language : en
Publisher:
Release Date : 1994
Status Report written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994 with Medical care, Cost of categories.
Case Mix
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Author : F. H. Roger France
language : en
Publisher: Sage Publications Limited
Release Date : 2001
Case Mix written by F. H. Roger France and has been published by Sage Publications Limited this book supported file pdf, txt, epub, kindle and other format this book has been release on 2001 with Medical categories.
Title page -- Foreword -- Contents -- List of authors -- Nomenclatures, Classifications and Case-Mix: From Patient Description to Abstraction -- Case Mix in Australia: AR-DRG - A Smooth Process Involving States and aCommonwealth Government, -- Case Mix in Austria: Five Years Experience with a New Hospital Financing System -- Case Mix in Belgium: A Rapid Coverage and a Progressive AP-DRG Use -- Case Mix in Denmark: Status on the Development and Use of the Nord "Dk" DRG -- Case Mix in Finland: From the Fin to the Nord DRG -- Case Mix in France: Is there a French Way from Problem to Paradigm in Healthcare? The DRG/PMSI SAGA -- Case Mix in Germany: DRG-Based Hospital Payment in Germany -- Case Mix in Great Britain: from DRG to HRG, Healthcare Resources Groups -- Case Mix in Ireland: Budgeting Basis for Acute Hospital Services -- Case Mix in Japan: Towards a J-DRG -- Case Mix in South Korea: The Demonstration of the KDRG -- Case Mix in Mexico: A Progressive Implementation -- Case Mix in The Netherlands: The DBC 2003 Project -- Case Mix in Romania: History of Case-Mix Development -- Case Mix in Russia: A Possible Development in a New Social Security System -- Case Mix in South Africa: Pilot Projects -- Case Mix in Spain: Financial and Clinical Management -- Case Mix in Sweden: From Spri to the Nord DRG -- Case Mix in Switzerland: From an Information to a Financing System? -- Case Mix in the USA: Fifteen Years of DRG-Based Hospital Financing in the United States -- International Studies on Health Systems: The Strength of Combining Data Sources -- Author Index
Diagnosis Related Groups In Europe Moving Towards Transparency Efficiency And Quality In Hospitals
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Author : Busse, Reinhard
language : en
Publisher: McGraw-Hill Education (UK)
Release Date : 2011-11-01
Diagnosis Related Groups In Europe Moving Towards Transparency Efficiency And Quality In Hospitals written by Busse, Reinhard and has been published by McGraw-Hill Education (UK) this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-11-01 with Education categories.
Summary: The volumes in the European Observatory on Health Systems and Policies series focus on key issues for health policy-making in Europe. This book is a joint venture between the WHO/EO and the EuroDRG which addresses the challenges of using Diagnosis Related Group systems in Europe.
A Health Sector Strategy For The Europe And Central Asia Region
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Author : Verdon S. Staines
language : en
Publisher: World Bank Publications
Release Date : 1999-01-01
A Health Sector Strategy For The Europe And Central Asia Region written by Verdon S. Staines and has been published by World Bank Publications this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999-01-01 with Medical categories.
The health systems inherited by transition countries of Europe and Central Asia (ECA) are changing in response to fundamental and unprecedented challenges. Although the desired shape of future health systems in many ECA countries is discernible, the process for getting there must be invented along the way. 'A Health Sector Strategy for the Europe and Central Asia Region' reviews substantive issues facing health policymakers in ECA. It summarizes the World Bank's experience so far in this arena and the lessons it suggests. Furthermore, it outlines both an external strategy by which the Bank's ECA health staff could assist countries to restructure their health systems and an internal strategy by which the staff could organize their own activities to achieve this result. The publication offers those outside the Bank a basis for professional dialogue to foster constructive change in the Bank's approaches.
The Globalization Of Managerial Innovation In Health Care
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Author : John Kimberly
language : en
Publisher: Cambridge University Press
Release Date : 2008-12-18
The Globalization Of Managerial Innovation In Health Care written by John Kimberly and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008-12-18 with Business & Economics categories.
An examination of patient classification systems in fifteen different countries throughout the world.
Intergovernmental Perspective
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Author :
language : en
Publisher:
Release Date : 1986
Intergovernmental Perspective written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1986 with Federal government categories.
Each issue concentrates on a different topic.
Health Information E Book
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Author : Mervat Abdelhak
language : en
Publisher: Elsevier Health Sciences
Release Date : 2014-12-24
Health Information E Book written by Mervat Abdelhak and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-12-24 with Medical categories.
Uncover the latest information you need to know when entering the growing health information management job market with Health Information: Management of a Strategic Resource, 5th Edition. Following the AHIMA standards for education for both two-year HIT programs and four-year HIA programs, this new edition boasts dynamic, state-of-the-art coverage of health information management, the deployment of information technology, and the role of the HIM professional in the development of the electronic health record. An easy-to-understand approach and expanded content on data analytics, meaningful use, and public health informatics content, plus a handy companion website, make it even easier for you to learn to manage and use healthcare data. - Did You Know? boxes highlight interesting facts to enhance learning. - Self-assessment quizzes test your learning and retention, with answers available on the companion Evolve website. - Learning features include a chapter outline, key words, common abbreviations, and learning objectives at the beginning of each chapter, and references at the end. - Diverse examples of healthcare deliveries, like long-term care, public health, home health care, and ambulatory care, prepare you to work in a variety of settings. - Interactive student exercises on Evolve, including a study guide and flash cards that can be used on smart phones. - Coverage of health information infrastructure and systems provides the foundational knowledge needed to effectively manage healthcare information. - Applied approach to Health Information Management and Health Informatics gives you problem-solving opportunities to develop proficiency. - EXPANDED! Data analytics, meaningful use, and public health informatics content prepares HIM professionals for new job responsibilities in order to meet today's, and tomorrow's, workforce needs. - EXPANDED! Emphasis on the electronic health care record educates you in methods of data collection, governance, and use. - NEW! Chapter on data access and retention provides examples of the paper health record and its transition to the EHR. - NEW! Focus on future trends, including specialty certifications offered by the AHIMA, the American Medical Informatics Associations (AMIA), and the Health Information Management Systems Society (HIMSS), explains the vast number of job opportunities and expanded career path awaiting you.