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Specific Features of Payment of Cases of Interrupted Treatment in Inpatient Clinics

Issue № 22 | 2015 (4)

Abstract

According to official statistics the number of hospitalization cases of interrupted treatment because of the transfer of patients to other in-patient clinics or due to fatal case annually amounts to about a million or 2.5% of the total number of hospitalized patients. This volume would be much bigger, should it include the cases of in-patient clinic treatment interrupted for other reasons (unauthorized leaving, non-observance of hospital regimen and other reasons). However, the statistics unjustifiably considers them as the cases of finished treatment, which results in an increased volume of medical care rendered in in-patient clinics. A new approach should also be used to making payments for cases of interrupted treatment. At present when these payments are effected at the level of Subjects, the following factors are not taken into account: the form of hospitalization (emergency /planned), how the patient is prepared for hospitalization (availability of the required minimum of diagnostic data), the reason for interrupted treatment, patient’s real stay in the inpatient clinic. Absence of a clear procedure of accountability, control and payment of cases of interrupted treatment in inpatient clinics would result in distortion of statistical data in terms of assessment of actual volumes of rendered medical care as well as in the wrong reimbursement of expenses incurred by a medical organization. Transition to an effective method of payment for cases of completed treatment in in-patient clinics of diseases included in the relevant group of diseases (including clinical-statistical group) requires registration of cases of interrupted treatment, defining clear rules of reimbursement of expenses incurred by medical organizations, as well as taking measures to minimize these expenses.

Keywords

interrupted cases of treatment, medical assistance in inpatient clinics, obligatory medical insurance (OMI).

For citations

Obukhova O.V., Brutova A.S., Bazarova I.N. Specific Features of Payment of Cases of Interrupted Treatment in Inpatient Clinics. Medical Technologies. Assessment and Choice. 2015; 4(22): 37–42.

mt_22_2015-4_37-42