Health Policy Manag.
2018 Mar;28(1):53-69. 10.4332/KJHPA.2018.28.1.53.
Impact of Hospital Specialization on Hospital Charge, Length of Stay and Mortality for Lumbar Spine Disease Inpatients
- Affiliations
-
- 1Department of Health Administration, Dankook University College of Medicine, Korea.
- 2Institute of Health Promotion and Policy, Dankook University, Cheonan, Korea.
- 3Institute of Health Services Research, Yonsei University, Korea. leevan@yuhs.ac
- 4Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 5Department of Healthcare Management, Eulji University Graduate School, Seongnam, Korea.
- 6Department of Hospital Management, Yonsei University Graduate School of Public Health, Seoul, Korea.
- 7Department of Health Administration, Yonsei University College of Health Sciences, Wonju, Korea.
- KMID: 2410249
- DOI: http://doi.org/10.4332/KJHPA.2018.28.1.53
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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