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KMID : 0387320180280010053
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Korean Journal of Health Policy and Administration
2018 Volume.28 No. 1 p.53 ~ p.69
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Impact of Hospital Specialization on Hospital Charge, Length of Stay and Mortality for Lumbar Spine Disease Inpatients
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Kim Jae-Hyun
Park Eun-Ah
Kim Young-Hoon
Kim Tae-Hyun
Lee Kwang-Soo
Lee Sang-Gyu
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Abstract
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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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KEYWORD
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Hospital, Specialization, Mortality
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