根据2002年《国家卫生安全法》(NHSA)第41条,在2012-2014年期间在第7区支付急救抚恤金,以提高卫生系统的质量,并指导尽量减少产科和妇科病例的问题

Y. Werawatakul, S. Paholpak, V. Bhudhisawasdi, Boonsong Patjanasoonton, P. Leelapanmetha, Supattra Somchit, Suphat Thatphet, Nadtaya Mills, Supannee Selander, Saijai Saipunya
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Materials and Methods: All of the FAS medical cases records regarding S41NHSA in the R7NHSO  during 2012-2014 were collected. The medical diagnosis that led to the fial approval of FAS  payment by NHSO was reviewed. The working group of the Sub-Committee to Control the  Quality and Standard of the Public Health Service of the R7NHSO had created the guideline  to minimize the problems in obstetric and gynecological cases.  Results: The R7NHSO included 4 provinces in the Northeast which are Khon Kaen, Kalasin, Roi Et,  and Maha Sarakham. The numbers of FAS payment cases during 2012-2014 were 79, 106,  and 110 cases or 295 cases in 3 years. The ratio of S41NHSA complaint per total number of  in-patients was low but increasing yearly during this 3 years period. The province with more  number of in-patients had a more FAS cases and a more FAS payment. The fie most common  FAS payment cases in descending rate were from department of obstetrics (54.38%), surgery  (13.9%), medicine (10.5%) pediatric (7.4%) and orthopedics (3.73%). The obstetric department  shared the greatest part of FAS payment cases and money. The top fie number of cases  (percentage) FAS payment in obstetrics were neonatal death 59 (30.73%), shoulder dystocia  41 (21.35%), unintended pregnancy after tubal ligation 40 (20.83%), maternal death 20 (10.42%)  and cerebral palsy 6 (3.13%). The total amount of FAS money paid during the 2012-2014 was  54.68 million Baht for the whole R7NHSO, of which was from Khon Kaen 22.99 million Baht,  Kalasin 12.89 million Baht, Roi Et 12.30 million Baht, and Maha Sarakham 6.49 million Baht.  The average FAS payment was 185,361.36 Baht/case. The authors suggested 5 items of quality  improvement methods to reduce obstetric loss. Conclusion: The FAS cases and FAS payment in R7NHSO were rising. Most of the FAS cases and  payment were from the department of obstetrics. Many diagnoses that caused FAS cases and  payments were preventable. A good policy of man power arrangement of obstetricians, a  continuously in-service training, and a better incentive for the service providers, the consultation  and transferring system of the risky patients should be revised.","PeriodicalId":36742,"journal":{"name":"Thai Journal of Obstetrics and Gynaecology","volume":"25 1","pages":"119-129"},"PeriodicalIF":0.0000,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The First Aid Solatium Payment Regarding Section 41 of 2002 National Health Security Act (NHSA) in region 7 during 2012-2014 for quality improvement of the health system and guideline to minimize the problems in obstetric and gynecological cases\",\"authors\":\"Y. Werawatakul, S. Paholpak, V. 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引用次数: 0

摘要

目的:分析英国国家医疗服务体系办公室(R7NHSO)第7地区2002年《国家卫生安全法》(S41NHSA)第41条规定的导致支付急救安慰金(FAS)的医疗诊断,以及病例数量和支付金额的大小。重点关注FAS集中度最高的产科专业的FAS病例和支付情况,为减少产科和妇科病例中的问题进行质量改进。该研究仅在2012-2014年期间进行。材料与方法:收集2012-2014年R7NHSO中所有与S41NHSA相关的FAS病历。对导致NHSO正式批准FAS付款的医学诊断进行了审查。R7NHSO公共卫生服务质量和标准控制小组委员会的工作组制定了该指南,以尽量减少产科和妇科病例中的问题。结果:R7NHSO包括东北部的4个省,即孔敬省、卡拉辛省、罗依省和马哈萨拉坎省。2012-2014年FAS支付案例数分别为79、106和110例,或3年内的295例。S41NHSA投诉占住院总人数的比例较低,但在这3年期间每年都在增加。住院人数较多的省份FAS病例较多,FAS支付较多。FAS支付最常见的5个案例依次为产科(54.38%)、外科(13.9%)、内科(10.5%)、儿科(7.4%)和骨科(3.73%),其中产科在FAS支付案例和费用中所占比例最大。产科FAS支付的前五例(百分比)是新生儿死亡59例(30.73%)、肩难产41例(21.35%)、输卵管结扎后意外怀孕40例(20.83%)、产妇死亡20例(10.42%)和脑瘫6例(3.13%)。2012-2014年,整个R7NHSO支付的FAS总金额为5468万泰铢,其中孔敬2299万泰铢,Kalasin 1289万泰铢、Roi Et 1230万泰铢和Maha Sarakham 649万泰铢。FAS的平均付款额为185361.36泰铢/箱。作者提出了5项质量改进方法,以减少产科损失。结论:R7NHSO的FAS病例数和FAS支付量均呈上升趋势。FAS病例和支付的费用大部分来自产科。许多导致FAS病例和付款的诊断是可以预防的。产科医生人力资源配置的良好政策,持续的在职培训,以及对服务提供者更好的激励,应修订高危病人的会诊和转运制度。
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The First Aid Solatium Payment Regarding Section 41 of 2002 National Health Security Act (NHSA) in region 7 during 2012-2014 for quality improvement of the health system and guideline to minimize the problems in obstetric and gynecological cases
Objectives: To analyze the medical diagnosis that led to payments of the fist aid solatiums (FAS)  regarding Section 41 of 2002 National Health Security Act (S41NHSA) in the region 7 of NHS  Office (R7NHSO) and the magnitude in both number of cases and amount of money paid. To  focus FAS cases and payment in the obstetric specialty which had the greatest part of FAS  payment, and to fid out the quality improvement for reducing the problems in obstetric and  gynecological cases. The study was done for only during 2012-2014. Materials and Methods: All of the FAS medical cases records regarding S41NHSA in the R7NHSO  during 2012-2014 were collected. The medical diagnosis that led to the fial approval of FAS  payment by NHSO was reviewed. The working group of the Sub-Committee to Control the  Quality and Standard of the Public Health Service of the R7NHSO had created the guideline  to minimize the problems in obstetric and gynecological cases.  Results: The R7NHSO included 4 provinces in the Northeast which are Khon Kaen, Kalasin, Roi Et,  and Maha Sarakham. The numbers of FAS payment cases during 2012-2014 were 79, 106,  and 110 cases or 295 cases in 3 years. The ratio of S41NHSA complaint per total number of  in-patients was low but increasing yearly during this 3 years period. The province with more  number of in-patients had a more FAS cases and a more FAS payment. The fie most common  FAS payment cases in descending rate were from department of obstetrics (54.38%), surgery  (13.9%), medicine (10.5%) pediatric (7.4%) and orthopedics (3.73%). The obstetric department  shared the greatest part of FAS payment cases and money. The top fie number of cases  (percentage) FAS payment in obstetrics were neonatal death 59 (30.73%), shoulder dystocia  41 (21.35%), unintended pregnancy after tubal ligation 40 (20.83%), maternal death 20 (10.42%)  and cerebral palsy 6 (3.13%). The total amount of FAS money paid during the 2012-2014 was  54.68 million Baht for the whole R7NHSO, of which was from Khon Kaen 22.99 million Baht,  Kalasin 12.89 million Baht, Roi Et 12.30 million Baht, and Maha Sarakham 6.49 million Baht.  The average FAS payment was 185,361.36 Baht/case. The authors suggested 5 items of quality  improvement methods to reduce obstetric loss. Conclusion: The FAS cases and FAS payment in R7NHSO were rising. Most of the FAS cases and  payment were from the department of obstetrics. Many diagnoses that caused FAS cases and  payments were preventable. A good policy of man power arrangement of obstetricians, a  continuously in-service training, and a better incentive for the service providers, the consultation  and transferring system of the risky patients should be revised.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
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