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Analysis of Hospital Volume and Factors Influencing Economic Outcomes in Cancer Surgery: Results from a Population-based Study in Korea

Authors
 Jung-A Lee  ;  So-Young Kim  ;  Keeho Park  ;  Eun-Cheol Park  ;  Jong-Hyock Park 
Citation
 Osong Public Health and Research Perspectives, Vol.8(1) : 34-46, 2017 
Journal Title
 Osong Public Health and Research Perspectives 
ISSN
 2210-9099 
Issue Date
2017
Keywords
hospital costs ; hospitalization ; length of stay ; neoplasms ; operative ; surgical procedures
Abstract
OBJECTIVES: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. METHODS: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. RESULTS: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. CONCLUSION: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals' cost of care and risk-adjusted mortality.
Files in This Item:
T201700999.pdf Download
DOI
10.24171/j.phrp.2017.8.1.05
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154582
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