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Governmental designation of spine specialty hospitals, their characteristics, performance and designation effects: a longitudinal study in Korea.

 Sun Jung Kim  ;  Ji Won Yoo  ;  Sang Gyu Lee  ;  Tae Hyun Kim  ;  Kyu-Tae Han  ;  Eun-Cheol Park 
 BMJ OPEN, Vol.4(11) : 006525, 2014 
Journal Title
Issue Date
Efficiency, Organizational/statistics & numerical data ; Female ; Government ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Hospitals, Special/organization & administration ; Hospitals, Special/standards* ; Hospitals, Special/statistics & numerical data* ; Humans ; Inpatients/statistics & numerical data ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Longitudinal Studies ; Male ; Middle Aged ; Outcome Assessment (Health Care)/economics ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/statistics & numerical data* ; Patient Discharge/economics ; Patient Discharge/statistics & numerical data ; Republic of Korea ; Spinal Diseases/economics ; Spinal Diseases/therapy*
OBJECTIVES: This study compares the characteristics and performance of spine specialty hospitals versus other types of hospitals for inpatients with spinal diseases in South Korea. We also assessed the effect of the government's specialty hospital designation on hospital operating efficiency. SETTING: We used data of 823 hospitals including 17 spine specialty hospitals in Korea. PARTICIPANTS: All spine disease-related inpatient claims nationwide (N=645 449) during 2010-2012. INTERVENTIONS: No interventions were made. OUTCOME MEASURES: Using a multilevel generalised estimating equation and multilevel modelling, this study compared inpatient charges, length of stay (LOS), readmission within 30 days of discharge and in-hospital death within 30 days of admission in spine specialty versus other types of hospitals. RESULTS: Spine specialty hospitals had higher inpatient charges per day (27.4%) and a shorter LOS (23.5%), but per case charges were similar after adjusting for patient-level and hospital-level confounders. After government designation, spine specialty hospitals had 8.8% lower per case charges, which was derived by reduced per day charge (7.6%) and shorter LOS (1.0%). Rates of readmission also were lower in spine specialty hospitals (OR=0.796). Patient-level and hospital-level factors both played important roles in determining outcome measures. CONCLUSIONS: Spine specialty hospitals had higher per day inpatient charges but a much shorter LOS than other types of hospitals due to their specialty volume and experience. In addition, their readmission rate was lower. Spine specialty hospitals also endeavoured to be more efficient after governmental 'specialty' designation.
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4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
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