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Vključevanje diplomiranih medicinskih sester v delo zdravstvene zavarovalnice : magistrsko delo
ID Olenik, Helena (Avtor), ID Ivanc, Blaž (Mentor) Več o mentorju... Povezava se odpre v novem oknu, ID Kraljić, Suzana (Recenzent)

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Izvleček
Uvod: V Sloveniji imamo od leta 1992 razvit sistem socialne varnosti, ki temelji na načelih obveznega zdravstvenega zavarovanja in na načelih prostovoljnega zdravstvenega zavarovanja. Zdravstveno zavarovanje v Sloveniji je urejeno z Zakonom o zdravstvenem varstvu in zdravstvenem zavarovanju. Sestavljeno je iz osnovnega in dodatnega zavarovanja (Štruc, 2010). V Sloveniji se zdravstvena varnost prebivalstva zagotavlja z javnim sistemom obveznega zdravstvenega zavarovanja, ki ga izvaja ZZZS. Manjši delež zdravstvenih izdatkov se pokriva tudi iz zasebnih sredstev (Fakin, 2012). Namen: Namen magistrskega dela je, da s pomočjo pregleda in analize strokovne in znanstvene literature predstavimo glavne značilnosti dela medicinske sestre v zavarovalništvu oziroma v zdravstveni zavarovalnici. Metode dela: Pri izdelavi magistrskega dela bomo uporabili kvalitativno metodo in deskriptivno raziskovalno metodo s kritičnim pregledom, zbiranjem in analiziranjem domače ter tuje literature. Uporabljena bo literatura iz podatkovnih baz CHINAL, MEDLINE in COBISS.SI. Uporabili bomo literaturo iz obdobja od leta 2010 do leta 2020. Rezultati: S kvalitativno analizo vsebine smo v raziskavi opredelili tri glavne teme, kjer smo poiskali odgovore na zastavljena raziskovalna vprašanja: delo diplomirane medicinske sestre v zdravstveni zavarovalnici, delovne izkušnje in dodatna prostovoljna zdravstvena zavarovanja. Ugotovili smo, da diplomirane medicinske sestre, ki so dlje časa zaposlene v zdravstveni zavarovalnici, izvajajo vse naloge, od najlažjih do zahtevnejših primerov. V primerjavi z obravnavo pacienta v bolnišnici ali v kakšni drugi zdravstveni ustanovi so delovne naloge diplomirane medicinske sestre pri zavarovalniški obravnavi zavarovanca zelo drugačne. Zaposlovanje diplomiranih medicinskih sester je po mnenju vseh intervjuvancev za zdravstveno zavarovalnico velika prednost. Razprava in zaključek: Zdravstveno zavarovanje zagotavlja socialno in zdravstveno varnost v primeru poškodbe ali bolezni. Zdravstvene zavarovalnice sledijo spremembam navad, stališč, vrednost in vedenju prebivalstva ter zahtevam po posameznih vrstah zdravstvenih zavarovanj. V prihodnosti bodo z razvojem novosti tudi diplomiranim medicinskim sestram dodeljene nove naloge v zdravstveni zavarovalnici skozi celoten proces zavarovanja, kot so na primer; sprejem zavarovanca v zavarovanje, trženje zavarovanja, za zdravstveno-izobraževalne programe glede ozaveščanja zavarovancev ter za podaljševanje in obravnavo zavarovalnega primera in zdravstvenega zavarovanja.

Jezik:Slovenski jezik
Ključne besede:magistrska dela, zdravstvena nega, zavarovalne storitve, dodatno zdravstveno zavarovanje, diplomirane medicinske sestre v zavarovalništvu, zdravstveno zavarovanje
Vrsta gradiva:Magistrsko delo/naloga
Tipologija:2.09 - Magistrsko delo
Organizacija:ZF - Zdravstvena fakulteta
Kraj izida:Ljubljana
Založnik:[H. Olenik]
Leto izida:2022
Št. strani:61 str., [10] str. pril.
PID:20.500.12556/RUL-143539 Povezava se odpre v novem oknu
UDK:616-083
COBISS.SI-ID:135360771 Povezava se odpre v novem oknu
Datum objave v RUL:24.12.2022
Število ogledov:1380
Število prenosov:94
Metapodatki:XML DC-XML DC-RDF
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Involvement of general nurses in the work of health insurance companies : master thesis
Izvleček:
Introduction: In Slovenia, we have developed a social security system since 1992, which is based on the principles of compulsory health insurance and the principles of voluntary health insurance. Health insurance in Slovenia is regulated by the Health Care and Health Insurance Act. It consists of basic and supplementary insurance (Štruc, 2010). In Slovenia, the health security of the population is ensured by the public system of compulsory health insurance implemented by the HIIS. A smaller share of medical expenses is also covered from private funds (Fakin, 2012). Purpose: The purpose of the master's thesis is to present the main characteristics of the work of a nurse in insurance or health insurance through a review and analysis of professional and scientific literature. Methods of work: In the preparation of the master's thesis we will use a qualitative method and a descriptive research method with a critical review, collection and analysis of domestic and foreign literature. Literature from CHINAL, MEDLINE and COBISS.SI databases will be used. We will use the literature from the period from 2010 to 2020. Results: During the qualitative analysis of the content, 3 main topics were formed through the research, which serve as answers to the research questions: the work of a graduate nurse in a health insurance company, work experience and additional voluntary health insurance. Graduate nurses who have been employed by a health insurance company for a long time perform all tasks, from the easiest to the most demanding cases. The treatment of an insured person is very different compared to the treatment of a patient in a hospital or other medical institution. According to all interviewees, hiring graduate nurses is a great advantage for the insurance company. Discussion and conclusion: Health insurance provides social and health security at the time of injury or illness. Health insurance companies follow changes in the habits, attitudes, values and, of course, the behavior of the population and the requirements for individual types of health insurance. In the future, with the development of innovations, nurses will also be assigned new tasks in the health insurance company throughout the entire insurance process, such as; admission of the insured to insurance, marketing of insurance, for health education programs regarding the awareness of the insured and, of course, for the extension and treatment of the insurance case and health insurance.

Ključne besede:master theses, nursing care, insurance services, supplementary health insurance, insurance nurses, health insurance

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