2014). Ancak. ayaktan ge

Transkript

1 PAY PER CASE PAYMENT MODEL IN HOSPITALS: COMPARISON OF P Yazar / Author: i Abstract Today, the fact that the prices of health care services are not determined according to the financial situation affects the financial sustainability of the hospitals. In Turkey, there has not been a significant increase in tpatient wages for approximately nine years. However, the hospital's labor, material and operating costs are increasing every year. The purpose of this study is to compare the remuneration costs of a university hospital with inpatient examinations. At the end of the research, the total income of the hospital from the inpatient was TL and inpatient costs was determined as TL. Social Security Institution (SSI) has an average repayment of 66.3TL for one patient. However, the cost of a polyclinic patient of the hospital is 81.6TL. For this reason, it is thought that the perincident price should be increased by at least about 15% in future periods. Keywords: Pay per case, reimbursement, cost, hospital TL gider ise TL TL geri TL olarak Anahtar Kelimeler: ). Ancak ayaktan ge i yigitv@hotmail.com. 752

2 2016:254) (Ersoy, 2014:i) (Tatar, 2011:103). Geri (Waters and Hussey, 2004:175). veril 2.. Bu. Bire hizmetlerini sunanlar 2011:104;. Hangi finansman 2011:103). (Tatar, (Tatar, 753

3 1. Bismarck Modeli 1883 Otto Van Bismarck ve daha sonra hale. Bir veya birden fazla kar olmayan kamu mevcut. Herkes, gelirinin belirli bir sigortaya. miktar gelire. Hizmetler bir fiyat listesi hekim ve hastanelere sigorta. Gerekli her ve tedavi faaliyetleri. hastaneler hizmeti sunan kurumlar aittir. Almanya, Avusturya, Fransa, Hollanda ve gibi. 2. Semashko Modeli Eski Sovyetler ilk (Nikolai Semashko) ile bilinir. Hastane ve hekimler de dahil sistemi devlet kontrol edilir. hizmetleri herkes. Rusya ve Avrupa sistemdir. 3. Beveridge Modeli ekonomist ve sosyal reformcu William Beveridge ile bilinir. Beveridge modelinin ortaya bu model genellikle Ulusal Hizmeti (National Health ServiceNHS) ile. Danimarka, Finlandiya, Portekiz, Yunanistan gibi modelin temel hizmetlerinin vergilere olarak finanse edilmesidir. 4. Pazar Bu sistem daha Amerika Devletlerinde. Borowitz and Atun, 2007;Tatar, 2011; den 2002:256) (Jegers et al. 754

4 2.1 niversite 2.2. (Normand and Weber; 2009:89). Bu dikkate Gazete, 2006). (Resmi 755

5 Tablo Beyin ve Sinir Cerrahisi Genel Cerrahi Kalp ve Damar Cerrahisi Kardiyoloji KulakBurun Ortopedi ve Travmatoloji e Estetik Cerrahi Kaynak: (SUT, 2013) ilave edilmektedir her 756

6 3. yetleri 4. Bulgular B TL gelir elde Tablo 1. Grup Adedi Toplam Tutar (TL) % Yatarak ,45 57,29 Ayakta ,32 21, ,97 13, ,25 7,57 TOPLAM: ,99 100,00 (39 757

7 Tablo 2. Gelir S. Ortalama No Toplam Ayaktan Vaka % % Tutar(TL) Birim Fiyat 1 Acil , , , , Beyin ve Sinir Cerrahisi 586 2, , , , , , , , Dermatoloji , , , , , , Genel Cerrahi , , , , , , , , , , , , Kalp ve Damar Cerrahisi 476 1, , Kardiyoloji 861 3, , KulakBurun , , , , Ortopedi ve Travmatoloji , , Plastik Cerrahi 527 1, , Psikiyatri 749 2, , , , , , , ,41 73 TOPLAM: , , ,60 TL ola 758

8 Tablo 3. Gid. Personel Giderleri Laborat ,51 % , ,02 Memurlar , , , , , , , , ,33 En , , , , ,80 meti Giderleri , , , , , , ,42 Giderleri , , , , , , ,20 Hazine Hissesi , ,68 28,64 32,13 39,24 Genel Toplam ,60 100,00 0,00 759

9 Tablo 4 aplama Tablosu , ,61 66,37 Kar/Zarar 15,23 (Mathauer and Wittenbecher, 2013:753) benzer k (Ayano TL gider ise

10 ak hastanenin ss: a (DRG) Bilimler Dergisi, 13(51), Borowitz, M. ve Atun, R. (2007). The unfinished journey from Semashko to Bismarck: health reform in Central Asia from 1991 to Central Asian Survey, 25(4), doi: / Ankara2013. ss: lmesi. Gazi hospitals under a capitation payment scheme. Health Economics, Policy, and Law, 8, doi: /s Practical Health Guide No:8, Ireland ( ) Hospital Payment Mechanisms: Theory And Practice In Transition Countries, McKee, M. and Healy, J. (eds.) In: Hospital in a Changing Europe, Open University Press, 2002BuchinghamPhiladelphia, pp: Jegers, M., Kesteloot, K., De Graeve, D. ve Gilles, W. (2002). A typology for provider payment systems in health care. Health Policy, 60, Asia and the Pasific : Best Practices and Remaining Challen Washington, D.C. (The International Bank For Reconstruction and Development), 2011Washington. pp:70 Mathauer, I. ve Wittenbecher, F. (2013). Hospital payment systems based on diagnosisrelated groups: experiences in low and middleincome countries. Bulletin of the World Health Organization, 91(10), A. doi: /blt Normand, C.,Weber A (2009).. Social Health Insurance: A Guidebook For Planning. ADB / ILO/ WHO / GTZ. 2009Eschborn. pp:

11 Resmi Gazete (2006 Resmi Ga 133. Tengi Waters, H. R. ve Hussey, P. (2004). Pricing health services for purchasersa review of methods and experiences. Health Policy, 70(2), (16), 253. doi: /sb