HASTANELERDE AYAKTAN VAKA BAŞI ÖDEME MODELİ: POLİKLİNİK MALİYETLERİ İLE GERİ ÖDEME FİYATLARININ KARŞILAŞTIRILMASI

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752 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 1.753.953-TL and inpatient costs was determined as 2.156.439-TL. Social Security Institution (SSI) has an average repayment of 66.3-TL for one patient. However, the cost of a polyclinic patient of the hospital is 81.6-TL. For this reason, it is thought that the per-incident price should be increased by at least about 15% in future periods.

Keywords: Pay per case, reimbursement, cost, hospital

-TL gider ise 2.156.439-TL -TL geri -TL olarak

Anahtar Kelimeler:

______________________________________________________________________

1.

2014). Ancak ayaktan ge

- .

i

yigitv@hotmail.com

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753

2016:254)

(Ersoy, 2014:i)

(Tatar, 2011:103). Geri (Waters and Hussey, 2004:175).

veril 2.

. Bu

- .

Bire

hizmetlerini sunanlar

(Tatar,

2011:104; . Hangi finansman

(Tatar,

2011:103).

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754

Borowitz and Atun, 2007;Tatar, 2011; den

(Jegers et al.

2002:256)

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

. 1. Bismarck

Modeli

Eski Sovyetler ilk (Nikolai Semashko)

ile bilinir. Hastane ve hekimler de dahil sistemi devlet

kontrol edilir. hizmetleri herkes .

Rusya ve Avrupa sistemdir.

2. Semashko Modeli

ekonomist ve sosyal reformcu William Beveridge ile bilinir.

Beveridge modelinin ortaya

bu model genellikle Ulusal Hizmeti (National Health Service-NHS) ile

. Danimarka, Finlandiya,

Portekiz, Yunanistan gibi

modelin temel hizmetlerinin vergilere olarak

finanse edilmesidir.

3. Beveridge Modeli

Bu sistem daha Amerika Devletlerinde . 4. Pazar-

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755 2.1

niversite

2.2.

(Normand and Weber; 2009:89). Bu dikkate

(Resmi

Gazete, 2006).

(5)

756

Tablo1.

1 43

2 44

3 Beyin ve Sinir Cerrahisi 55

4 49

5 45

6 49

7 41

8 55

9 50

10 Genel Cerrahi 55

11 49

12 49

13 43

14 56

15 61

16 Kalp ve Damar Cerrahisi 56

17 Kardiyoloji 68

18 Kulak-Burun- 43

19 51

20 Ortopedi ve Travmatoloji 49

21 e Estetik Cerrahi 55

22 49

23 50

24 50

25 55

Kaynak: (SUT, 2013)

ilave edilmektedir.

2.3.

her

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757 3.

yetleri

4. Bulgular B

-TL gelir elde

Tablo 1.

Grup Adedi Toplam Tutar (TL) %

Yatarak 24 2.151 4.695.202,45 57,29

Ayakta 29 26.425 1.753.953,32 21,40

20 1.542 1.126.339,97 13,74

9 968 620.177,25 7,57

TOPLAM: 82 31.086 8.195.672,99 100,00

-

(39- -

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758

Tablo 2.

S. No

Gelir Ortalama

Ayaktan Vaka Birim Fiyat

% Toplam

Tutar(TL) %

1 Acil 2.394 9,06 181.430 10,34 76

2 400 1,51 19.983 1,14 50

4 Beyin ve Sinir Cerrahisi 586 2,22 47.428 2,70 81

5 128 0,48 5.545 0,32 43

6 353 1,34 16.697 0,95 47

7 1.449 5,48 85.259 4,86 59

8 Dermatoloji 1.587 6,01 62.025 3,54 39

10 352 1,33 27.186 1,55 77

11 650 2,46 54.101 3,08 83

12 Genel Cerrahi 1.167 4,42 90.610 5,17 78

13 98 0,37 14.003 0,80 143

14 913 3,46 84.195 4,80 92

15 1.337 5,06 55.943 3,19 42

16 6.055 22,91 471.321 26,87 78

17 1.593 6,03 99.060 5,65 62

18 Kalp ve Damar Cerrahisi 476 1,80 25.666 1,46 54

19 Kardiyoloji 861 3,26 58.887 3,36 68

20 Kulak-Burun- 1.353 5,12 66.788 3,81 49

21 861 3,26 67.956 3,87 79

22 Ortopedi ve Travmatoloji 1.024 3,88 55.125 3,14 54

23 Plastik Cerrahi 527 1,99 27.305 1,56 52

24 Psikiyatri 749 2,83 36.168 2,06 48

27 143 0,54 8.021 0,46 56

29 1.031 3,90 68.520 3,91 66

338 1,28 24.733 1,41 73

TOPLAM: 26.425 100,00 1.753.953 100,00 66

10.178.435,60-

- -

-TL ola

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759

Tablo 3.

% Gid.

Laborat 662.231 6,51

28,64

418.145 4,11

1.834.318 18,02

Personel Giderleri

Memurlar 653.035 6,42

32,13

29.500 0,29

6.846 0,07

17.815 0,18 956.221 9,39 1.370.460 13,46 235.964 2,32 37.560 0,37

39,24

33.502 0,33

En 350.049 3,44

104.914 1,03 11.111 0,11 12.107 0,12 1.506.735 14,80 meti

Giderleri 28.869 0,28

676.695 6,65

802 0,01

126.361 1,24 25.085 0,25 89.115 0,88 42.838 0,42

Giderleri 63.493 0,62

7.431 0,07

19.315 0,19 19.016 0,19 59.723 0,59 169.499 1,67 427.949 4,20

Hazine Hissesi 112.332 1,10

69.398 0,68 Genel Toplam 10.178.435,60 100,00

0,00

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760

Tablo 4 aplama Tablosu

1.853.942,61 2.156.439 26.425 81,61 66,37

Kar/Zarar -15,23

(Mathauer and Wittenbecher, 2013:753)

benzer k

(Ayano

1.753.953-TL gider ise 2.156.439-

(10)

761

- ak hastanenin

-

-153.

5 50.

- -975-590-521-

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