Yonsei Med J.  2015 Nov;56(6):1721-1730. 10.3349/ymj.2015.56.6.1721.

Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

• Kim SJ
• Lee SG
• Kim TH
• Park EC

• KMID: 2345905
• DOI: http://doi.org/10.3349/ymj.2015.56.6.1721

Abstract

PURPOSE
Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital.
MATERIALS AND METHODS
Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed.
RESULTS
Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges.
CONCLUSION
Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.

Keyword

Specialty hospital; colorectal-anal disease; fees and charges; length of stay

MeSH Terms

Adult
Aged
Anus Diseases/economics/*therapy
Colonic Diseases/economics/*therapy
Efficiency, Organizational
Female
Hospital Charges/*statistics & numerical data
Hospitals, General/organization & administration
Hospitals, Special/organization & administration
Humans
Inpatients/*statistics & numerical data
Length of Stay/economics/*statistics & numerical data
Male
Middle Aged
Outcome Assessment (Health Care)/economics/methods/*statistics & numerical data
Rectal Diseases/economics/*therapy
Republic of Korea

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