Impact of Medical Insurance Contracts Elements on the Profitability of Hospitals

Dr. Mohyedin Hamza*, Dr. Tarek Almbaidin and Emad Al-Rabi
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Dr. Mohyedin Hamza*: Associate Professor/Department of Accounting/Zarqa University, Jordan
Dr. Tarek Almbaidin: Associate Professor/Department of Accounting/Zarqa University, Jordan
Emad Al-Rabi: Researcher/Department of Accounting/Zarqa University, Jordan

The Journal of Social Sciences Research, 2019, vol. 5, issue 2, 569-576

Abstract: This study aims at identifying the impact of the elements of medical insurance contracts on the profitability of hospitals- a case study. To this end, the researchers collected the financial statements and the analytical reports of medical claims and the determinants of the origin of these claims (the actual deduction) from the accounts of the Islamic Hospital as well as the contracts and agreements signed between the Islamic Hospital and insurance companies showing the agreed contractual deduction on the hospital services, (The Medical Laboratories Department, Radiology Department, Pharmacy Department, Medical Procedures Department, and Medical Supplies Department) for the period 2006-2016. A set of appropriate statistical methods were applied through the SPSS program. The study results show that the study variable has, to a large extent, an impact on the profitability of the Islamic Hospital. The study provided a set of recommendations, mainly: establishing a division of medical approvals and audits that coordinates between the insured and the insurance company to guarantee the veracity of medical procedures.

Keywords: Medical insurance; Contracts elements; Profitability of hospitals (search for similar items in EconPapers)
Date: 2019
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