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Running Head: EssayIntroduction: In the year 1949, the medical facilities of Saudi Arabia were not very convincingand there were countable hospitals and doctors. But since then a huge advancement has takenplace in the field of healthcare services. The Saudi Ministry of Health gives around 60% of thesehealth services while the remaining is provided by other agencies which are connected bygovernment as well as private service providers. A major plan of development in relation tohealthcare services in Saudi Arabia has built a mega-infrastructure domain for the advancementof healthcare for the people of the nation. Quick changes in medical facilities and many trainingprograms have been started to train the people of Saudi Arabia. Health development plans havebeen started by the government to address the people of Saudi Arabia and bring changes inpositive terms in their health. The changes health of the population is addressed by improving theskills attained by various medical personnel and providing financial services to various sectorsproviding medical facilities. The poor people belonging to very low class have been facingenormous problems related to health because they do not have enough funds to improve theirhealth and their lifestyle is very unhygienic which pushes them towards health problems. InSaudi Arabia, 53% of the population has faced health issues due to lack of funds in 2015. Majordevelopments have brought health services to every corner of the vast kingdom. Compared to1949, the number of doctors and nurses has multiplied 25 times and 20 timesin 2015. There aremany factors leading to bad health for example bad eating habits, drinking and smoking,unhygienic environment etc. Such factors need to be eradicated for living beings to live healthyand live longer. People need to change their living styles to improve their health. Government inmany countries has started opening healthcare centers at easily reachable points where cheap andeconomical but best healthcare services will be provided and all is done especially for the benefitof poor people. Healthy mind can do wonders and people need to stay healthy to bring about2
Running Head: Essaychange. Many people cannot afford to improve their health as they cannot afford the high fees sothe government has been making efforts to provide best services in fewer prices.Effect of changes on delivery of healthcare: The expenses related to healthcare are increasingday by day and the patients are growing enormously in number and therefore, it has becomeimperative to figure out new and cost effective ways to manage the records and costs relatedareas. This helps in the improvement of problems which are being faced by hospitals, which arerelated to costs. There is a dire need of various processes to lower down costs as it helps toanalyze that whether the information given by healthcare industries correspond to theinformation which is given in the records which are maintained regarding the patients. The mainpurpose is to figure out what are the errors related to sequencing and coding which has aninfluence over the assignments in Saudi Arabia [ CITATION Seb01 \l 1033 ].As the number of audit cases has been escalated in Saudi Arabia exponentially with time andalso the hospitals have been scrutinized by the auditors very closely to ensure that they arefollowing the right practices and are not over charging or under charging. There is always a greatpossibility that coders often under code in the system with the fear that auditor while scrutinizingmight curtail down the diagnosis-related group or refuse the claim in its entirety. The auditorsmake the reports and documentation properly & accurately and report all the factors affecting theassignment and the reimbursements related to the medical records [ CITATION AMo162 \l 1033 ].3
Running Head: EssayDevelopments related to changesDiagnosis related group: Saudi Arabia has come up with DRG. The provider has to give a fulland accurate medical record which comprises of documents that helps to support all ICD codesand the DRG. A written report is submitted to the provider after the audit is complete. Theauditing is done, which should correspond coding guidelines, coding manual, coding clinic etc.The parties involved in the auditing process should work in compliance with all the laws and theinformation of the patients should be kept confidential [ CITATION Ahm12 \l 1033 ]. The auditingdocuments are based on the records which are present and available at the time when notificationcomes regarding the audit. This will be the base for initiating the auditing program and helps toachieve better standards of auditing. Diagnosis-related group helps to dividecases of thehospitals into one of the 467 groups and the last group is considered as "Ungroup able". Thisprocess of division was discovered in collaboration byRobert B Fetter, a student of theYaleSchool of Management andJohn D. Thompson, MPH, of theYale School of Public Health.Case mix index: CMI used by the nation is a value which is assigned to adiagnosis relatedgroupof patients in a health care environment. The CMI value is utilized in figuring out theallocation of resources for care for and treatment of the patients in the group. The financedepartment keeps a check on the case-mix index (CMI) and on the good side the hospital’s CMIcan go as higher as possible. A high CMI implies that the performance of the hospital is going inthe right direction and the hospital is getting a high amount of money from a single patient. Atthe time of calculation of CMI, a specific time period is chosen for example a month, twomonths or a year [ CITATION Alm11 \l 1033 ]. During that time period, all the DRGs that have been4
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