COMPARATIVE STUDY OF FINANCING MECHANISM OF EMERGENCY MEDICAL SERVICE IN THE FORM OF INTEGRATED MANAGEMENT OF PRE-HOSPITAL AND HOSPITAL EMERGENCY IN SELECTED COUNTRIES AND IRAN

ALI JAMAL MOHAMMADI¹, SEYED JAMALEDIN TABIBI², LEILA RIAHI³, MAHMOUD MAHMOUDI MAJDABADI FARAHANI⁴

¹PhD Candidate of Health Services Management, Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran - ²Professor, Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran - ³Assistant Professor, Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran - ⁴Professor, Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran

Background and objective: Organizing medical services in emergency and payment systems of costs associated with these ser- vices is quite different in different countries. In recent years, many countries have attempted to reform in this area to be reduced the number of false visits to the emergency department and utilization of medical services in pre-hospital and hospital emergency to be done reasonably and properly.

Methods: This research is a descriptive study and with comparative approach. Developed countries in different parts of the world on the basis of having accepted models of service delivery and availability of information were selected. Information about mechanism of payment of costs of emergency care in the countries studied is collected and then on the basis of comparative tables, factors affecting the pattern of payment of costs of emergency care in the form of integrated management of pre-hospital and hospital emergency of studied countries were extracted.

Results: A significant difference can be observed between the number of visits to emergency departments for every 1,000 peo- ple in selected countries and Iran; Iran and Australia has the largest number of outpatients to emergency departments and has the largest number of patients admitted in the emergency departments but the proportion of patients admitted in all visits to the emer- gency department is slightly higher than other countries; there are multiple payment mechanisms for those involved in providing emergency medical services. In addition, payment systems to pre-hospital and hospital emergency in a country often have different mechanisms.

Conclusion: Despite the lack of financial and human resources in the health system of Iran, to meet the expectations of patients needing emergency care, we need to reform emergency services and this action requires a reorganization of pre-hospital emergency and upgrade the emergency department at the hospital and enjoying budget resources of outpatient care in pre-hospital emergency to pay for treatment of outpatients outside of hospital emergency department using effective approaches on improving payment mechanism in pre-hospital and hospital emergency in Iran.