The role of contractual arrangements in improving health sector ...

Weaknesses and limitations
Jordan
• With the absence of an effective referral system and co-payment, eligible patients may abuse
the services available in the two sectors.
• The accounting systems in both sectors, especially at the Ministry of Health, are not
sufficiently well developed to trace and document all services provided to patients and the
due charges. Therefore, the reported claims do not represent the real bill that should be
reimbursed.
• Some terms and articles in the agreement are not well stated and may have different
meanings and interpretations.
Table 5. Admissions and outpatient visits for insured patients treated outside Ministry of
health facilities and their cost, 2003
Organization/hospital Admissions Cost
(JD)
128
Cost per
admission
(JD)
Outpatient
visits
Cost
(JD)
Total costs
(JD)
RMS 8088 2 404 250 297 65 477 1 218 157 3 622 407
Prince Zeid Hospital/RMS 1832 203 526 111 27 717 508 300 711 826
JUH 14 349 6 166 458 429 245 923 4 806 258 10 972 716
KAH 7209 4 432 719 614 30 796 1 399 806 5 832 525
Al-Hussein Cancer Centre 745 1 407 305 1889 2602 259 855 1 667 160
Red Crescent Hospital 445 245 833 552 --- --- 245 833
Lozmila Hospital 627 419 600 669 --- --- 419 600
Al-Mowasah Hospital* 1450 480 000 331 --- --- 480 000
Al-Hayah Hospital* 547 292 500 535 --- --- 292 500
Other private hospitals
(emergency cases)
2682 4 192 014 1563 --- --- 4 192 014
Total 37 974 20 244 205 533 372 515 8 192 376 28 436 581
Source: Directorate of Health Insurance.
*The data for both hospitals cover the period from July–December, 2003
Jordan University Hospital and King Abdullah Hospital
Jordan University Hospital (JUH) was built in 1973 by the Ministry of Health as a referral
hospital. In 1975 it was handed over by the government to Jordan University to function as
teaching hospital to the Faculty of Medicine. The law by which the hospital was handed over to
the University stated that the JUH should continue to act as referral hospital to the Ministry of
Health and that the government should finance 50% of the hospital budget. The financial
arrangement between the government, represented by the Ministry of Health, and JUH has
changed frequently. The existing agreement, which was signed in 1998, specifies the obligations
and responsibilities of JUH as health care provider and the Ministry of Health as purchaser and
payer.