AN ASSESSMENT OF THE APPROPRIATENESS OF THE RATES OF DIAGNOSTIC SERVICES DEPARTMENT OF THE GOVERNMENT SERVICE INSURANCE SYSTEM
BY : ELVIRA G. RODRIGUEZ MD (MAY 2008)
ABSTRACT :
THIS STUDY SOUGHT TO APPLY A TOOL FOR REVISING THE DIAGNOSTIC RATES OF THE DIAGNOSTIC SERVICES DEPARTMENT (DSD) OF THE GOVERNMENT INSURANCE SYSTEM IN ORDER TO ENSURE THE DEPARTMENT'S VIABILITY AND SUSTAINABILITY AND TO ENHANCE ITS FINANCIAL PERFORMANCE. DUE TO ABSENCE OR LACKING OPERATIONAL AND FINANCIAL DATA, ONLY THE DIRECT AND INDIRECT COSTS AND NUMBER OF PATIENTS SEEN FOR CY 2007 WERE USED IN THE PROJECTIONS. PERTINENT INFORMATION WERE COLLECTED THROUGH FOCUS GROUP DISCUSSION AND KEY INFORMANT INTERVIEW OF ALL DSD STAFF AND THE RESULTS WERE VALIDATED BY THEIR RESPECTIVE SUPERVISORS. THE DIAGNOSTIC RATES WERE COMPUTED USING THE RELATIVE UNIT VALUE METHOD WHICH WAS BASED ON SKILL, TECHNOLOGY AND TIME UTILIZED TO PERFORM THE TEST. THE INTENTION OF THIS STUDY WAS TO APPLY THE RUV METHOD APPROPRIATE AND SUITED TO THE STRUCTURE AND OPERATIONS OF THE DSD.
THE COMPUTED RATE COMPARED TO THE EXISTING RATE, UNDER THE NORMAL SCENARIO HAD A WIDE VARIANCE. THE COMPUTED RATES OF PREGNANCY TEST AND DRUG TEST WERE LOWER THAN THEIR EXISTING RATES. THIS WAS THE CASE UNDER THE OPTIMISTIC AND PESSIMISTIC SCENARIOS..
COMPARISON OF THE COMPUTED RATES UNDER THE NORMAL SCENARIO WITH THE 2008 PGH RATES SHOWED THAT THERE WAS NO MARKED DIFFERENCE. MOREOVER, THE COMPUTED RATES FOR BLOOD TYPING, URINALYSIS, PREGNANCY TEST AND DRUG TEST WERE LOWER THAN THE 2008 PGH RATES FOR THESE EXAMS.
REDUCING THE COMPUTED RATES UNDER THE NORMAL SCENARIO BY HALF AND COMPARING THEM WITH EXISTING RATES PROVED FAVORABLE FOR PREGNANCY TEST AND DRUG TEST AND A VARIANCE RANGE OF Php 19.00 - 96.00 FOR BLOOD TYPING, URINALYSIS AND BLOOD CHEMISTRIES.
AN INTENSIVE AND SUSTAINED THRUST AND EFFORT TOWARDS INCREASING CLIENTELE UNDERGOING THESE PROCEDURES IS NEEDED TO ENSURE THE MAINTENANCE OF REASONABLE RATES.
ABSTRACT :
THIS STUDY SOUGHT TO APPLY A TOOL FOR REVISING THE DIAGNOSTIC RATES OF THE DIAGNOSTIC SERVICES DEPARTMENT (DSD) OF THE GOVERNMENT INSURANCE SYSTEM IN ORDER TO ENSURE THE DEPARTMENT'S VIABILITY AND SUSTAINABILITY AND TO ENHANCE ITS FINANCIAL PERFORMANCE. DUE TO ABSENCE OR LACKING OPERATIONAL AND FINANCIAL DATA, ONLY THE DIRECT AND INDIRECT COSTS AND NUMBER OF PATIENTS SEEN FOR CY 2007 WERE USED IN THE PROJECTIONS. PERTINENT INFORMATION WERE COLLECTED THROUGH FOCUS GROUP DISCUSSION AND KEY INFORMANT INTERVIEW OF ALL DSD STAFF AND THE RESULTS WERE VALIDATED BY THEIR RESPECTIVE SUPERVISORS. THE DIAGNOSTIC RATES WERE COMPUTED USING THE RELATIVE UNIT VALUE METHOD WHICH WAS BASED ON SKILL, TECHNOLOGY AND TIME UTILIZED TO PERFORM THE TEST. THE INTENTION OF THIS STUDY WAS TO APPLY THE RUV METHOD APPROPRIATE AND SUITED TO THE STRUCTURE AND OPERATIONS OF THE DSD.
THE COMPUTED RATE COMPARED TO THE EXISTING RATE, UNDER THE NORMAL SCENARIO HAD A WIDE VARIANCE. THE COMPUTED RATES OF PREGNANCY TEST AND DRUG TEST WERE LOWER THAN THEIR EXISTING RATES. THIS WAS THE CASE UNDER THE OPTIMISTIC AND PESSIMISTIC SCENARIOS..
COMPARISON OF THE COMPUTED RATES UNDER THE NORMAL SCENARIO WITH THE 2008 PGH RATES SHOWED THAT THERE WAS NO MARKED DIFFERENCE. MOREOVER, THE COMPUTED RATES FOR BLOOD TYPING, URINALYSIS, PREGNANCY TEST AND DRUG TEST WERE LOWER THAN THE 2008 PGH RATES FOR THESE EXAMS.
REDUCING THE COMPUTED RATES UNDER THE NORMAL SCENARIO BY HALF AND COMPARING THEM WITH EXISTING RATES PROVED FAVORABLE FOR PREGNANCY TEST AND DRUG TEST AND A VARIANCE RANGE OF Php 19.00 - 96.00 FOR BLOOD TYPING, URINALYSIS AND BLOOD CHEMISTRIES.
AN INTENSIVE AND SUSTAINED THRUST AND EFFORT TOWARDS INCREASING CLIENTELE UNDERGOING THESE PROCEDURES IS NEEDED TO ENSURE THE MAINTENANCE OF REASONABLE RATES.
