[ relation between insurance funds of medical service insurance and heart inpatients costs in Karaj hospitals [Iran]]

ABSTRACT

Nowadays in Iran the majority of health and medical budget is spent on contagious diseases, especially in the field of heart disease diagnosis. This research aimed at surveying the relation between insurance funds of medical service and heart inpatients costs in the second half of the year 1388. The research is through applied method and its methodology is descriptive analysis in which nine hospitals have been under survey counting all members of society under study. The data were extracted from patients' files through a checklist and the reliability of checklist was confirmed by specialists of health services management field and the managers of medical service insurance. The data analysis was performed through SPSS software. The findings show that self-employed fund was the most cost mean [44111000 Rials] and fund of other parts was the least [12067000 Rials]. In all insurance funds, except funds of other social strata, the most costs were related to hoteling costs. Considering the fact that self-employed fund allocated the most average of heart diseases cost, cultural reengineering by medical services insurance organization and more surveillance insurance organization on side arrangement organization has become the most effective solution for controlling the cost of sanitation and increasing revenue services for insured people. Instruction insured people and society about prevention and remedy diseases at primary phase can decrease the cost of bed ridden.