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Length of stay and readmission in lumbar intervertebral disc disorder inpatients by hospital characteristics and volumes

 Kyu-Tae Han  ;  Hyo Jung Lee  ;  Eun-Cheol Park  ;  Woorim Kim  ;  Sung-In Jang  ;  Tae Hyun Kim 
 HEALTH POLICY, Vol.120(9) : 1008-1016, 2016 
Journal Title
Issue Date
Female ; Hospital Bed Capacity/statistics & numerical data* ; Hospitals ; Humans ; Insurance Claim Review ; Intervertebral Disc* ; Length of Stay/statistics & numerical data* ; Lumbar Vertebrae* ; Male ; Middle Aged ; Outcome Assessment (Health Care)/methods ; Patient Readmission/statistics & numerical data* ; Personnel Staffing and Scheduling/statistics & numerical data ; Republic of Korea
Early readmission ; Hospital staffing ; Hospital volume ; Length of stay
In South Korea, lumbar intervertebral disc disorder (LIDD) patients are increasing in all age groups due to an aging population and changes in lifestyle, like sedentary, and there has been concern about reducing quality of care and increasing healthcare expenditure. Therefore, we aim to study the impact of hospital volume and hospital staffing, such as neurosurgeon or nurse, for length of stay or readmission in LIDD inpatients. We used health insurance claim data from 157 hospitals, consisting of 88,949 inpatient cases during 2010-2013. Multi-level models were analyzed to examine the association between LOS/readmission and both inpatient and hospital level variables. By the results, the average LOS was 10.85 days, and readmission within 30 days after discharge was 1063 (1.2%) cases. Higher hospital volume or number of neurosurgeons/ doctors showed inverse relation with LOS (per increases 100 cases=β: -0.0457, P-value<0.0001; per increases 1 neurosurgeon=β: -0.3517, P-value<0.0001; number of doctors per 100 beds=β: -0.1200, P-value<0.0001). And, higher number of registered nurses (RNs) showed inverse relation with early readmission. In conclusion, higher volume or staffing showed positive relation with improving efficiency and quality in care of LIDD. Therefore, health policy makers should consider providing incentives or motivation to hospitals with higher volume or more superior hospital staffing for effective management of excessive healthcare expenditure or reducing quality of care.
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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
Jang, Sung In(장성인) ORCID logo https://orcid.org/0000-0002-0760-2878
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