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The association of market competition with hospital charges, length of stay, and quality outcomes for patients with joint diseases: a longitudinal study in Korea

Authors
 Sun Jung Kim  ;  Eun-Cheol Park  ;  Ki-Bong Yoo  ;  Jeoung A Kwon  ;  Tae Hyun Kim 
Citation
 ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH, Vol.27(2) : 195-207, 2015 
Journal Title
 ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH 
ISSN
 1010-5395 
Issue Date
2015
MeSH
Economic Competition/statistics & numerical data* ; Female ; Hospital Charges/statistics & numerical data* ; Humans ; Joint Diseases/economics* ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Longitudinal Studies ; Male ; Middle Aged ; Patient Readmission/statistics & numerical data ; Quality of Health Care/economics ; Quality of Health Care/statistics & numerical data* ; Republic of Korea ; Treatment Outcome
Keywords
Herfindahl-Hirschman Index ; Korea ; hospital ; inpatient discharge ; length of stay ; market competition ; mortality ; readmission
Abstract
This study investigated the association of market competition with hospital charges, length of stay, and quality outcomes. A total of 279,847 patients from 851 hospitals were analyzed. The Herfindahl-Hirschman Index was used as a measure of hospital market competition level. Our results suggest that hospitals in less competitive markets charged more on charge per admission, possibly by increasing the length of stays, however, hospitals in more competitive markets charged more for daily services by providing more intensive services while reducing the length of stays, thereby reducing the overall charge per admission. Quality outcomes measured by mortality within 30 days of admission and readmission within 30 days of discharge were better for surgical procedures within competitive areas. Continued government monitoring of hospital response to market competition level is recommended in order to determine whether changes in hospitals' strategies influence the long-term outcomes of services performance and health care spending.
Full Text
http://aph.sagepub.com/content/27/2/195.long
DOI
10.1177/1010539514529812
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139733
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