Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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The Impact of Hospital Specialization on Length of Stay per Case and Hospital Charge per Case

병원 전문화가 건당 재원일수와 건당 의료비에 미치는 영향

  • Kim, Jae-Hyun (Department of Preventive Medicine, Ajou University School of Medicine) ;
  • Park, Eun-Cheol (Institute of Health Services Research, Yonsei University) ;
  • Kim, Tae Hyun (Institute of Health Services Research, Yonsei University) ;
  • Lee, Kwang Soo (Department of Health Administration, Yonsei University College of Health Sciences) ;
  • Kim, Young Hoon (Department of Healthcare Management, Eulji University Graduate School) ;
  • Lee, Sang Gyu (Institute of Health Services Research, Yonsei University)
  • 김재현 (아주대학교 의과대학 예방의학교실) ;
  • 박은철 (연세대학교 의과대학 보건정책 및 관리연구소) ;
  • 김태현 (연세대학교 의과대학 보건정책 및 관리연구소) ;
  • 이광수 (연세대학교 보건과학대학 보건행정학과) ;
  • 김영훈 (을지대학교 보건산업대학 의료경영학과) ;
  • 이상규 (연세대학교 의과대학 보건정책 및 관리연구소)
  • Received : 2016.02.12
  • Accepted : 2016.06.03
  • Published : 2016.06.30
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Abstract

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

Keywords

References

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