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Impact of Hospital Specialization on Hospital Charge, Length of Stay and Mortality for Lumbar Spine Disease Inpatients

Authors
 Jae-Hyun Kim  ;  Eun-Cheol Park  ;  Young Hoon Kim  ;  Tae Hyun Kim  ;  Kwang Soo Lee  ;  Sang Gyu Lee 
Citation
 Korean Journal of Health Policy and Administration (보건행정학회지), Vol.28(1) : 53-69, 2018 
Journal Title
 Korean Journal of Health Policy and Administration (보건행정학회지) 
ISSN
 1225-4266 
Issue Date
2018
Keywords
Hospital ; Specialization ; Mortality
Abstract
Background: This study investigates association modified category medical specialization (CMS) and hospital charge, length of stay (LOS), and mortality among lumbar spine disease inpatients. Methods: This study used National Health Insurance Service–cohort sample database from 2002 to 2013, using stratified representative sampling released by the National Health Insurance Service. A total of 56,622 samples were analyzed. The primary analysis was based on generalized estimating equation model accounting for correlation among individuals within each hospital. Results: Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a shorter LOS (estimate, -1.700; 95% confidence interval [CI], -1.886 to -1.514; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a lower mortality rate (odds ratio, 0.635; 95% CI, 0.521 to 0.775; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per case (estimate, 192,658 Korean won; 95% CI, 125,701 to 259,614; p<0.0001). However, inpatients admitted with lumbar spine surgery patients at hospitals with higher modified CMS had lower hospital cost per case (estimate, -152,060 Korean won; 95% CI, -287,236 to -16,884; p=0.028). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per diem (estimate, 55,694 Korean won; 95% CI, 46,205 to 65,183; p<0.0001). Conclusion: Our results showed that increase in hospital specialization had a substantial effect on decrease in hospital cost per case, LOS, and mortality, and on increase in hospital cost per diem among lumbar spine disease surgery patients.
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DOI
10.4332/KJHPA.2018.28.1.53
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
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162155
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