Control Systems for Managing Medical Resources in Medical Organizations

Presenter: Racheli Magnezi, School of Health Sciences

Abstract

Rationale: The high costs of medical services, technological progress, and the development of public awareness have increased the need for cost containment of high quality medical services.

Objectives: To describe the concept of authorization systems in medicine, and the practical attempt of health organizations to demonstrate the impact of types of authorization on health expenditures,and the outcomes.

Methodology: An attempt to identify an appropriate concept, and to adapt control system and health information to effective performance, has taken four years. Several pilot studies were conducted, with the help of experts in health system management, experienced in medicine, budgets, and information systems.

Results: The life cycle of information systems and the concept of controlling the medical budget within the health organization comprise three main components, each with additional forms of control, such as: pre-performance authorization (contracts and agreements, medications, medical instrumentation and equipment, medical services); authorization during performance (authorization of hospitalization); and the post-performance stage (retrospective authorization). Results reveal that not only does the use of computerized control systems help in the decision-making process to provide medical services, but also enables the integration and control of several bodies within the health organization, and is thus cost effective. The educated use of medical resources decreases hospitalization length stay , allows effective use of organizational resources (personnel and medical services), saves costs, helps channel patients to intelligent services, permits analysis and integration of competent contracts for the purchase of services as well as risk distribution between hospitals and the health organization.

Conclusions: Authorization is perceived as a bridge between areas of performance in an organization and the level of expectations and strategy, organizational structure, and the function of employees. Its dynamic design predicts constant benefits in organizational goals and objectives, according to changing needs and possibilities.