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KMID : 0387320040140020001
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Korean Journal of Health Policy and Administration
2004 Volume.14 No. 2 p.1 ~ p.16
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Factors Influencing to Select Types of U.S. Hospital Network
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Kim Yang-Kyun
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Abstract
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The study purpose was to find which factors affect selection of hospital network types. This study used the 1998 American Hospital Association Annual Survey Database from Health Forum. Among these U.S. hospitals, the researcher selected hospitals located in Metropolitan Statistical Areas. Therefore the final observation cases for analysis are 1,971 Metropolitan Statistical Area hospitals in the United States.
To identify significant variables influencing hospital network types, the study used proportional odds logistics regression model on population size, Health Maintenance Organization penetration rate, and market competition rate of area including a hospital, types of hospital ownership, hospital bed size, proportion of Medicare patients and Medicaid patients in total hospital patients, and occupancy rate.
Contrary to conventional wisdom, selection of hospital network types was influenced by population size of area which a hospital located, types of ownership, hospital bed size, and proportion of medicare patients rather than Health Maintenance Organization penetration.
Population size 1,000,000-2,499,999 had the highest probability of selecting type Ⅳ (clinical-vertical integration) from an independent hospital, and a religious group owned hospitals and for-profit owned hospitals had the highest probability of selecting Type Ⅳ (clinical-vertical integration) from an independent hospital. A bed size had positive relation on selecting Type TV (clinical-vertical integration) from an independent hospital.
Unlikely general belief that the selecting types of hospital network was determined by the change of health insurance policy such as Health Maintenance Organizations and Preferred Provider Organizations, the types of hospital network were influenced by community characteristics such as population size, and hospital characteristics.
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KEYWORD
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Selection of Hospital Network Types, Health Maintenance Organization, Community Characteristics, Hospital Characteristics, Proportional Odds Logistic Regression
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