Development of Revenue Collection System Model Using Audit Program Medical Treatment Debtor Information Tao Ngoi Hospital Sakon Nakhon Province.

Abstract

     This study primarily aimed to 1) investigate the current state and analyze problems within Tao Ngoi Hospital's revenue collection and medical treatment debtor information verification systems 2) develop a revenue collection system model utilizing a medical treatment debtor information monitoring program for the hospital 3) evaluate the effectiveness of the developed system at Tao Ngoi Hospital. This was a Research and Development (R&D) study, adopting a four-phase system development approach. The research was conducted over seven months, from December 2024 to August 2025. Key research instruments included the newly developed medical treatment debtor information monitoring program and a performance evaluation questionnaire for revenue collection operations. The questionnaire, comprising 20 items on a rating scale, was developed based on literature review and related research. The sample consisted of 30 personnel responsible for revenue collection and healthcare sub-fund management at Tao Ngoi Hospital. Data were collected using questionnaires, open-ended questions for focus group discussions, and record forms. Quantitative data were analyzed using frequency, percentage, mean, standard deviation, and Paired t-tests were employed to compare mean differences.

     Results: The study results from Phase 1 identified the root causes of data inaccuracy as being related to personnel (insufficient staff, lack of skills/knowledge, low motivation), budget, equipment (lack of supporting software), and management (unclear structure). Specific problems were also found in the system's structure, workflow, and the completeness of data recording (Care), coding (Code), claiming (Claim), and accounting (Account). In Phase 2, a Quality Revenue Collection Center Committee and a Chief Financial Officer (CFO) Committee were appointed to improve staff capacity and technology adoption. A medical debt data verification program was developed to enhance the revenue collection process, reporting, and medical debt accounting in accordance with the chart of accounts, focusing on accuracy and completeness. The evaluation in Phase 3 showed that the developed system significantly improved operational efficiency and quality, with an average score increase of 2.83 points. This was followed by improvements in medical debt verification and accounting (2.60 points), and revenue collection (2.40 points). The average collection time for UC patients was reduced to 51 days, for civil servants to 61 days, and for social security patients to 79 days, all of which met the evaluation criteria.