Thesis title in English heremanagement processes of billing health services in public hospitals and determining the problems in implementation

The demand for health services, which is one of the fastest growing sectors in many countries and Turkey, is increasing exponentially every day. This increase in the demand for health services brings along the increase in health expenditures. Countries are making more and more efforts to use the share allocated to health services in their budget items more effectively and efficiently, to ensure the sustainability of health services, to control expenditures, to reduce costs, and for a fair and applicable health finance model. Many factors, especially repayment methods in health services, affect the quality of health services and the financial management of health service providers. In this framework, the purpose of this research is to determine the problems experienced in the invoicing management processes of public hospitals, which are necessary for the continuity and financial sustainability of public health services, and to offer solutions. The questionnaire prepared for this purpose was applied to the invoice employees of the hospitals with role registration groups B, AI and AII affiliated to the Ministry of Health, on a voluntary basis, in electronic environment. 312 participants returned to the research, and in the factor analysis of the data obtained in the research, it was determined that there are 7 main problematic factors that are effective in the billing processes of public hospitals. These factors are; Problems caused by HIMS and users (x̄=2,48), problems related to invoice creation and collection (x̄=3.19), problems caused by pricing of health services (x̄=4.15), problems caused by lack of control (x̄=3.45 ), problems originating from the invoicing unit of the institution (x̄=3.34), problems arising from the legislation (x̄=2.92) and finally the problems arising from the paying institution (x̄=2.49). Some of these factors are; It has been determined that there are differences according to age, gender, working time in the institution, institution status and occupational groups of the participants. Some of these factors are; It has been determined that there are differences according to age, gender, working time in the institution, institution status and occupational groups of the participants. For these problems; redesigning the invoicing processes, providing routine training to relevant personnel, intensifying audits, effective communication with stakeholders, preparing the necessary infrastructure for legislative amendments, and making repayments to health providers under market conditions, etc. It is thought that taking steps will contribute significantly to the solution of the problems.