A trend analysis of surgical operations under a global payment system in Tehran, Iran (2005–2015)

• Main Authors: Faranak Behzadi Goudari, Arash Rashidian, Mohammad Arab, Mahmood Mahmoudi, Ebrahim Jaafaripooyan
• Format: Article
• Language: English
• Published: Electronic Physician 2018-03-01
• Series: Electronic Physician
• Subjects: Global Payment System; Time Series Analysis; Surgical Operation
• Online Access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942572/

Background: Global payment system is a first example of per-case payment system that contains 60 commonly used surgical operations for which payment is based on the average cost per case in Iran. Objective: The aim of the study was to determine the amount of reduction, increase or no change in the trend of global operations. Methods: In this retrospective longitudinal study, data on the 60 primary global surgery codes was gathered from Tehran Health Insurance Organization within the ten-year period of 2005-2015 separately, for each month. Out of 60 surgery codes, only acceptable data for 46 codes were available based on the insurance documents sent by medical centers. A quantitative analysis of time series through Regression Analysis Model using STATA software v.11 was performed. Results: Some global surgery codes had an upward trend and some were downwards. Of N Codes, N83, N20, N28, N63, and N93 had an upward trend (p<0.05) and N32, N43, N81 and N90 showed a significant downward trend (p<0.05). Similarly, all H Codes except for H18 had a significant upward trend (p<0.000). As such, K Codes including K45, K56 and K81 had an increasing movement. S Codes also experienced both increasing and decreasing trends. However, none of the O Codes changed according to time. Other global surgical codes like C61, E07, M51, L60, J98 (p<0.000), I84 (p<0.031) and I86 (p<0.000) shown upward and downward trends. Total global surgeries trend was significantly upwards (B=24.26109, p<0.000). Conclusion: The varying trend of global surgeries can partly reflect the behavior of service providers in order to increase their profits and minimize their costs.