Volume 24, Issue 1 (3-2021)                   jha 2021, 24(1): 43-53 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Sohrabi Anbouhi Z, SoleimaniMovahed M, Rezapour A, Mazdaki A. Factors affecting the uncompensated costs in Hospitals of Iran University of Medical Sciences: Panel Data Approach. jha 2021; 24 (1) :43-53
URL: http://jha.iums.ac.ir/article-1-3459-en.html
1- M.Sc. student, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
2- Assistant Professor, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. , soleimanimovahed.m@iums.ac.ir
3- Associate Professor, Health management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
4- M.Sc., governmental management, Health management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
Abstract:   (2265 Views)
Introduction: Uncompensated care causes many financial problems for hospitals. It would be helpful to use any interventions to reduce uncompensated costs. This study aimed to investigate factors affecting Iran University of Medical Sciences (IUMS) hospitals' uncompensated costs during 2014-2018.
Methods: The present study was an analytical and applied research with monthly data from 2014 to 2018. The study population included all hospitals affiliated to Iran University of Medical Sciences, and the tool was an Excel data collection form. Data analysis was performed using EViews 10 software. Model estimation was carried out using the panel's econometric approach.
Results: Uncompensated costs during the study period averaged 25 million dollars. The largest share of uncompensated costs belonged to insurance deductions, debts of poor and foreign patients. The results showed a significant positive relationship between the variables of foreign patients, outpatients, hospital beds, bed occupancy rate, and length of stay with uncompensated costs. There was no significant relationship among the variables of number of surgeries, number of hospitalized patients, and uncompensated costs. Moreover, the bed rotation coefficient variable did not affect uncompensated costs, and the hospital beds had the most positive effect on uncompensated costs, followed by the variables of the length of stay and number of foreign patients.
Conclusion: The results of the study showed the high level of uncompensated costs in IUMS hospitals. Due to uncompensated costs’ effect on hospital revenues, it seems that identifying the causes of deductions and subsequently ways to reduce insurance deductions as well as expanding insurance coverage to mitigate non-recoverable costs can be effective.
Full-Text [PDF 1058 kb]   (1062 Downloads)    
Type of Study: Research | Subject: Health Economics
Received: 2021/01/23 | Accepted: 2021/03/17 | Published: 2021/04/19

1. Rezapoor A, Ebadifard Azar , Abbasi broujeni P. Situation of resource allocation in iranian, s health system. Journal of Hospital. 2013;11(4):53-64. [In Persian]
2. Di Matteo L. The determinants of the public-private mix in canadian health care expenditures: 1975-1996. Health Policy. 2000;52(2):87-112. [DOI:10.1016/S0168-8510(00)00071-3]
3. Meyer R, Degoulet P. Assessing the capital efficiency of healthcare information technologies investments: an econometric perspective. Yearb Med Inform. 2008;17(01):114-27. [DOI:10.1055/s-0038-1638591]
4. Ellemdin S, Rheeder P, Soma P. Providing clinicians with information on laboratory test costs leads to reduction in hospital expenditure. S Afr Med J. 2011;101(10):746-8.
5. Tabibi SJ, Maleki MR, Mirzaie A, Farshid P. The effect of hospital wards combination on the on going expenditure of Tehran Bou Ali hospital. Health Information Management. 2011;7(4): 490-5. [In Persian]
6. Veach MS. What's on your plate? Ten top issues for 2006: healthcare finance is not just a full plate; it's numerous full plates that all must be kept from tumbling. Healthcare Financial Management. 2006;60(1):72-7.
7. Gruber J, Rodriguez D. How much uncompensated care do doctors provide? Journal of Health Economics. 2007;26(6):1151-69. [DOI:10.1016/j.jhealeco.2007.08.001]
8. The Iranian National Institute for Health Research. Health Expenditures in I.R Iran (Household expenditure and income survey of national statistical center of Iran, 2016) [Internet]. 2019 [cited 2021 Mar 3]; Available from: https://nih.tums.ac.ir/UpFiles/Documents/0bab95e1-6276-4a3a-8f8c-8cd0ef5b5259.pdf [In Persian]
9. Hadley J. Sicker and poorer-The consequences of being uninsured: A review of the research on the relationship between health insurance, medical care use, health, work, and income.Med Care Res Rev. 2003;60(2_suppl):3S-75S. [DOI:10.1177/1077558703254101]
10. American Hospital Association. Uncompensated hospital care cost fact sheet [Internet]. 2019 [Updated 2021 Jan 1; cited 2021 Mar 3]; Available from: https://www.aha.org/fact-sheets/2020-01-06-fact-sheet-uncompensated-hospital-care-cost.
11. Atkinson G, Helms WD, Needleman J. State trends in hospital uncompensated care. Health Aff (Millwood). 1997;16(4):233-41. [DOI:10.1377/hlthaff.16.4.233]
12. Chen J, O'Brien MJ, Mennis J, Alos VA, Grande DT, Roby DH, et al. Latino population growth and hospital uncompensated care in California. Am J Public Health. 2015;105(8):1710-7. [DOI:10.2105/AJPH.2015.302583]
13. Kavosi Z, Rezaie M, Shojaie A, Talebianpour H. Hospital expenditures of guardian less patients in shiraz selected hospitals in second half of year 2015. Journal of Healthcare Management. 2016;7(3):29-38. [In Persian]
14. Mann JM, Melnick GA, Bamezai A, Zwanziger J. A profile of uncompensated hospital care, 1983-1995. Health Aff(Millwood). 1997;16(4):223-32. [DOI:10.1377/hlthaff.16.4.223]
15. Al-Mulali U. Oil consumption, co2 emission and economic growth in mena countries. Energy. 2011;36(10):6165-71. [DOI:10.1016/j.energy.2011.07.048]
16. Mashayekh S, BashiriManesh N, Shahrokhi SS. Earnings management and investment behavior of fimes. Journal of Empirical Studies in Financial Accounting. 2014;11(40):77-99. [In Persian]
17. Shahhosseini S, Vasfi AsfestaniSh, Naserzadeh S. The role of intellectual property rights in economic growth: Case study of trips. Iranian Journal of Trade Studies (IJTS). 2017;21(84):65-92. [In Persian]
18. Akhbari R, Taee H. Identifying hysteresis effect in unemployment rate with emphasis on second generation panel unit root and panic method. Journal of Applied Economics Studies in Iran. 2017;6(22):1-31. [In Persian]
19. Linden M, Ray D. Life expectancy effects of public and private health expenditures in oecd countries 1970-2012: Panel time series approach. Economic Analysis and Policy. 2017;56:101-13. [DOI:10.1016/j.eap.2017.06.005]
20. Zeinali A. Investigating the relationship between board independence and cash investment sensitivity with emphasis on the financial viability of listed companies in tehran stock exchange. Journal of Accounting and Management Vision. 2019;2(11):46-60. [In Persian]
21. Rostami Z, Nasiripour AA. Comparison of the deductions of insurance bills in an education-treatment center in iran before and after health care reform. Health Information Management. 2019;15(6):281-7. [In Persian]
22. Emamgholipour S, Raadabadi M, Zarezadeh M. Factors affecting insurance deductions before and after the implementation of health reform plan: A case study. Journal of Health Administration. 2019;22(4):62-71. [In Persian]
23. Omrani M, Farajzadeh F, Rashidi G. Determination of the causes of income deficits at hospitals affiliated to Shahid Beheshti university of medical sciences. J. Med. Counc. Islam. Rep. Iran. 2012; 30(3):265-71. [In Persian]
24. Amery H, Jafari A, Panahi M. Determining the rate of catastrophic health expenditure and its influential factors on families in Yazd province. Journal of Health Administration. 2013;16(52):51-60.
25. Zhang W, Wang X, Li J, Xu Z. Uncompensated care for children without insurance or from low-income families in a chinese children's hospital. Med Sci Monit. 2014;20:1162-67. [DOI:10.12659/MSM.890368]
26. Dranove D, Garthwaite C, Ody C. Uncompensated care decreased at hospitals in Medicaid expansion states but not at hospitals in nonexpansion states. Health Affairs. 2016;35(8):1471-9. [DOI:10.1377/hlthaff.2015.1344]
27. Revere L, Large J, Langland-Orban B, Zhang H, Delgado R, Amadi T. Changes in hospital uncompensated care following the texas medicaid waiver implementation. Journal of Health Care Finance. 2018;44(3):1-11.
28. Camilleri S, Diebold J. Hospital uncompensated care and patient experience: An instrumental variable approach. Health Serv Res. 2019;54(3):603-12. [DOI:10.1111/1475-6773.13111]
29. Rosko MD. The supply of uncompensated care in Pennsylvania hospitals: motives and financial consequences. Health Care Manage Rev. 2004;29(3):229-39. [DOI:10.1097/00004010-200407000-00008]
30. Davidoff AJ, LoSasso AT, Bazzoli GJ, Zuckerman S. The effect of changing state health policy on hospital uncompensated care. Inquiry. 2000; 37(3):253-67.
31. Zarei E, Pouragha B, Khodakarim S. Out of pocket payment by inpatients of public hospitals after health sector evolution plan a cross-sectional study in tehran city. Journal of Hospital. 2017;16(3):9-17. [In Persian]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Journal of Health Administration

Designed & Developed by : Yektaweb