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KMID : 0387320240340010078
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Korean Journal of Health Policy and Administration
2024 Volume.34 No. 1 p.78 ~ p.86
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Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty
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Kim Mi-Sung
Jeong Hyoung-Sun
Yoo Ki-Bong
Kang Je-Gu
Jang Han-Sol
Lee Kwang-Soo
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Abstract
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Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use ofinpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals.
Methods: This study utilized 2021?2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. Thedependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable waswhether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type,surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number oforthopedic surgeons, and number of nurses).
Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospitalshowed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital.
This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital,indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients.
Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. Inour study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the costeffectivenessof specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals inmetropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designatingspecialty hospitals in non-metropolitan areas, such as introducing “semi-specialty hospitals (tentative name),” will lead to a reduction in healthdisparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals’ medicalstaff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriatelyallocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.
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KEYWORD
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pecialty hospitals, Medical use, Charges per case, Length of stay
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