Universidade de São Paulo. São Paulo, São Paulo, Brazil.
Rev Bras Enferm. 2020 Dec 21;73(suppl 5):e20190826. doi: 10.1590/0034-7167-2019-0826. eCollection 2020.
Evidence the scientific production on the analysis of disallowances through the audit of accounts made by nurses.
Integrative literature review whose sample of ten articles was selected on the basis of The Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, EMBASE, Scielo, Web of science, Virtual Health Library and on the portal PubMed.
The ten articles obtained were published in Brazil, 80% covering hospital contexts; with a quantitative (50%), exploratory (40%) and descriptive (60%) approach. Studies investigating the occurrence of disallowance prevailed to identify the most impacting items on billing and possibilities for improvements in the process of auditing accounts by nurses.
The verticalized knowledge of the disallowance analysis process is essential to identify non-conformities and propose improvements, aiming at assistance quality, adequate billing and consequent financial sustainability to health organizations.
通过对护士进行账目审计来分析拒付情况,为相关科学研究提供证据。
对十篇文章进行了综合文献回顾,这些文章的样本是根据《护理与联合健康文献累积索引》、《拉丁美洲和加勒比地区健康科学文献》、EMBASE、Scielo、Web of Science、虚拟健康图书馆以及 PubMed 门户检索到的。
获得的十篇文章均在巴西出版,80%的文章涵盖了医院环境;采用了定量(50%)、探索性(40%)和描述性(60%)方法。研究拒付发生的情况居多,旨在识别计费中最具影响力的项目,并为护士审计账目过程的改进提供可能性。
深入了解拒付分析过程对于识别违规行为和提出改进措施至关重要,目的是提高服务质量、计费的准确性以及医疗机构的财务可持续性。