Health Policy Manag.
2016 Jun;26(2):107-114. 10.4332/KJHPA.2016.26.2.107.
The Impact of Hospital Specialization on Length of Stay per Case and Hospital Charge per Case
- Affiliations
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- 1Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea.
- 2Institute of Health Services Research, Yonsei University, Seoul, Korea. leevan@yuhs.ac
- 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 4Department of Hospital Management, Yonsei University Graduate School of Public Health, Seoul, Korea.
- 5Department of Health Administration, Yonsei University College of Health Sciences, Wonju, Korea.
- 6Department of Healthcare Management, Eulji University Graduate School, Seongnam, Korea.
- KMID: 2326661
- DOI: http://doi.org/10.4332/KJHPA.2016.26.2.107
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.
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