Clinical pathways – the Bulgarian approach

Ganova-Iolovska, Milka; Geraedts, Max

doi:10.1007/s10389-008-0239-0

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…CPs are negotiated and included in NFC for the first time in 2001 as NHIF paid for only 21 CPs. Gradually, the number of CPs increased to 30 in 2002, 81 in the years 2003-2004, and to 120 in 2005 (7). For the treatment of patients with diagnoses that are not included in the CPs, hospitals receive funding from the Ministry of Health which is based on a budget.…”

Section: Resultsmentioning

confidence: 99%

Clinical pathways - a retrospective view on their application as a financial tool in Bulgarian hospitals.

Koeva-Dimitrova

Atanasova

2016

Scripta Scientifica Salutis Publicae

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INTRODUCTION: During the period 2000-2001, clinical pathways were developed and implemented as a temporary solution for financing the hospitals in Bulgaria. The aim of this article is to study and trace the application of clinical pathways as a tool for hospital funding in Bulgaria. MATERIALS AND METHODS: In order to examine the implementation and the progress of CPs in Bulgarian hospitals we have studied Bulgarian and foreign publications. In addition to this, we have also included official reports published by the Ministry of Health, Ministry of Finance, National Health Insurance Fund (NHIF), the National Center of Public Health and Analyses (NCPHA) and others. RESULTS AND DISCUSSION: CPs were negotiated and included for the first time in the National Framework Contract in 2001. Gradually, the number of CPs increased and reached more than 300 in 2015. The introduction of CPs as a tool for financing hospital care is related to the need of fixing the prices of the respective CPs. Initially, the NHIF and the Bulgarian Medical Association developed a common methodology for fixing the prices of CPs. From 2011, an amendment to the Health Insurance Act stipulates that the procedures for valuation and payment of activities by NHIF are defined by specific methodologies. We have found that not all hospitals submit information to the specialized software for hospitals which is the only tool for analyzing the costs structure in the health care establishments at present. CONCLUSION: The clinical pathways are not accepted as a sufficient effective mechanism for hospital funding in Bulgaria. Moreover, the lack of accurate and comparable information makes the analyses incomplete and vulnerable.

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Section: Resultsmentioning

confidence: 99%

Clinical pathways - a retrospective view on their application as a financial tool in Bulgarian hospitals.

Koeva-Dimitrova

Atanasova

2016

Scripta Scientifica Salutis Publicae

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Billing and Review Perspectives in Healthcare

Fredrickson

2020

Theory and Practice of Business Intelligence in Healthcare

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The relatively recent and more pervasive retention of electronic healthcare data has provided new opportunities for the advancement of analytics and business intelligence tools within healthcare. The tasks comprising the delivery process for healthcare provide numerous points for data capture, and associated analyses to improve efficiencies and quality of care. In general, healthcare data is extracted from transaction-based systems designed for billing, scheduling, and workflow. However, data characterizing medical events can be further leveraged to assist in the diagnosis and treatment of patients. In fact, healthcare information technology (HIT) to improve patient diagnosis and treatment is remarkably neglected. This chapter outlines the process flow for healthcare delivery, describes the data extracted during this process flow, details the enablers and inhibitors of HIT and accompanying analytics, presents concerns about data integrity and quality, and provides some methods for data cleansing and staging.

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Clinical pathways – the Bulgarian approach

Abstract: Nutzungsbedingungen AbstractBackground Over the past 20 years, the use of clinical pathways has increased rapidly in many countries.

Cited by 2 publications

References 16 publications

Clinical pathways - a retrospective view on their application as a financial tool in Bulgarian hospitals.

Clinical pathways - a retrospective view on their application as a financial tool in Bulgarian hospitals.

Billing and Review Perspectives in Healthcare

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