Impact of Hospital Specialization on Hospital Charge, Length of Stay and Mortality for Lumbar Spine Disease Inpatients
10.4332/KJHPA.2018.28.1.53
- Author:
Jae Hyun KIM
1
;
Eun Cheol PARK
;
Young Hoon KIM
;
Tae Hyun KIM
;
Kwang Soo LEE
;
Sang Gyu LEE
Author Information
1. Department of Health Administration, Dankook University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Hospital;
Specialization;
Mortality
- MeSH:
Hospital Charges;
Hospital Costs;
Humans;
Inpatients;
Length of Stay;
Mortality;
National Health Programs;
Spine
- From:Health Policy and Management
2018;28(1):53-69
- CountryRepublic of Korea
- Language:English
-
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.
