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Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

Authors
 Sun Jung Kim  ;  Sang Gyu Lee  ;  Tae Hyun Kim  ;  Eun-Cheol Park 
Citation
 YONSEI MEDICAL JOURNAL, Vol.56(6) : 1721-1730, 2015 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2015
MeSH
Adult ; Aged ; Anus Diseases/economics ; Anus Diseases/therapy* ; Colonic Diseases/economics ; Colonic Diseases/therapy* ; Efficiency, Organizational ; Female ; Hospital Charges/statistics & numerical data* ; Hospitals, General/organization & administration ; Hospitals, Special/organization & administration ; Humans ; Inpatients/statistics & numerical data* ; Length of Stay/economics ; Length of Stay/statistics & numerical data* ; Male ; Middle Aged ; Outcome Assessment (Health Care)/economics ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/statistics & numerical data* ; Rectal Diseases/economics ; Rectal Diseases/therapy* ; Republic of Korea
Keywords
Specialty hospital ; colorectal-anal disease ; fees and charges ; length of stay
Abstract
PURPOSE: Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital.
MATERIALS AND METHODS: Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed.
RESULTS: Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges.
CONCLUSION: Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.
Files in This Item:
T201503898.pdf Download
DOI
10.3349/ymj.2015.56.6.1721
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141438
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