PURPOSE: Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. MATERIALS AND METHODS: Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. RESULTS: Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. CONCLUSION: Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.
Adult ; Aged ; Anus Diseases/economics/*therapy ; Colonic Diseases/economics/*therapy ; Efficiency, Organizational ; Female ; Hospital Charges/*statistics & numerical data ; Hospitals, General/organization & administration ; Hospitals, Special/organization & administration ; Humans ; Inpatients/*statistics & numerical data ; Length of Stay/economics/*statistics & numerical data ; Male ; Middle Aged ; Outcome Assessment (Health Care)/economics/methods/*statistics & numerical data ; Rectal Diseases/economics/*therapy ; Republic of Korea

OBJECTIVETo investigate effect of clinical pathway management on pediatric pneumonia.

METHODData were colleted from children hospitalizated with bronchial pneumonia, bronchiolitis, mycoplasma pneumonia in Center of Respiratory Disorders in Children's Hospital of Chongqing Medical University from January 2011 to December 2012. According to implement of clinical pathway management, all patients were divided into pathway management group (n = 405) and non-pathway management group (n = 503). Length of stay, costs of hospitalization, clinical effect and use of antibiotics were compared in these two groups.

RESULTIn pathway management group, average length of stay of children with bronchial pneumonia and bronchiolitis was (6.1 ± 1.6) d and (6.2 ± 1.5) d respectively. While in non-pathway management group, length of stay was (7.2 ± 1.9) d and (7.3 ± 1.5) d (P = 0.000). There was no significant difference in length of stay between these two groups of children with mycoplasma pneumonia [ (6.9 ± 1.8) d vs.(7.7 ± 2.5) d] (P = 0.198). Costs of auxiliary tests in pathway management group was slightly higher than that in non-pathway management group. While other costs in pathway management group were significantly lower than those in non-pathway management group. Total costs of hospitalization of patients with these three diseases in pathway management group and non-pathway management group were ¥(4609 ± 1225) vs ¥ (5629 ± 1813) , ¥ (5006 ± 1250) vs. ¥ (5686 ± 1337), ¥ (4946 ± 1259) vs. ¥ (6488 ± 3032) respectively. There was a significant difference (P < 0.05). Percentages of antibiotics use in two groups were 70.9% vs.99.4%, 45.7% vs.93.4% and 96.2% vs.100.0%. Antibiotics related indicators such as mean number of day of use, ratio of combination and grade of antibiotics were significantly higher in pathway management group compared to non-pathway management group (P < 0.01). There was no significant difference in other indicators like clinical effect and unscheduled readmission in 30 days between two groups (P > 0.05).

CONCLUSIONClinical pathway management can regulate medical behaviors through reduction of medical costs, avoidance of excessive laboratory tests and therapy, and regulation of antibiotic use.

Adolescent ; Anti-Bacterial Agents ; administration & dosage ; economics ; therapeutic use ; Child ; Child, Preschool ; Community-Acquired Infections ; drug therapy ; economics ; therapy ; Cost Control ; Critical Pathways ; Female ; Hospital Administration ; Hospitals, Pediatric ; Humans ; Infant ; Length of Stay ; economics ; Male ; Pneumonia ; drug therapy ; economics ; therapy ; Pneumonia, Mycoplasma ; drug therapy ; economics ; therapy ; Retrospective Studies

BACKGROUNDTaiwan has implemented a National Health Insurance (NHI) program to provide uniform comprehensive coverage since 1995. Forced by the severe financial deficit, global budgeting is introduced to replace the original payment system in Taiwan's NHI. Under global budgeting system, the total budget is distributed to six geographical regions in Taiwan. There is no pre-determined budget for each hospital. In order to investigate the longitudinal trend of how global budgeting influences health care resource, it is essential to estimate the efficiency of resource allocation in Taiwan's NHI.

METHODSData Envelopment Analysis (DEA) and Malmquist index (MI) are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health, Taiwan, China. A value of MI greater than 1 indicates that total factor productivity progress has occurred, while a value of MI less than 1 indicates productivity loss.

RESULTSAs a result, 37 of the 184 DMUs in the analysis were found to be relatively efficient during the period, in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting. A trend of MI declines between 2002 and 2009 implies the volume of health care services decrease after adopting global budgeting system. Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level.

CONCLUSIONSThe regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system. Hence, a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.

Budgets ; Hospital Administration ; economics ; National Health Programs ; economics ; Resource Allocation ; methods ; Taiwan

Ventilator management systems can improve the utilization of hospital ventilator, reduce equipment idle and the workload of staff, improving the work efficiency. It lays a good foundation for the systematic centralized management of medical equipment, and makes the hospital information management more perfect.
Hospital Administration ; methods ; Hospital Information Systems ; organization & administration ; Software Design ; Ventilators, Mechanical ; economics ; utilization

This paper describes the heart of class supplies involved in bidding and purchasing code library classification principles and, in the hope of medical supplies through the establishment of bidding and purchasing code library to assist the health authorities and medical institutions for effective quality control. Clinical research oriented, CT, volume, operation cost, cost per capita, BEP.
Cardiac Surgical Procedures ; instrumentation ; Disposable Equipment ; supply & distribution ; Materials Management, Hospital ; economics ; organization & administration ; Purchasing, Hospital ; economics ; organization & administration

Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient.
Biomedical and Dental Materials ; economics ; supply & distribution ; Disposable Equipment ; economics ; supply & distribution ; Evidence-Based Medicine ; Purchasing, Hospital ; organization & administration

OBJECTIVES: This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. METHODS: The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. RESULTS: Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4~7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. CONCLUSIONS: Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.
Security Measures ; Outsourced Services/economics/*utilization ; Maintenance ; Logistic Models ; Korea ; Hospital Information Systems/*organization & administration ; Health Services Research ; Decision Making, Organizational ; Consumer Satisfaction ; Computer Security

In this paper, the SWOT analysis method is used to find out the internal strength, weakness, exterior opportunities and threats of the present medical devices' procurements in hospitals and some strategic considerations are suggested as "one direction, two expansions, three changes and four countermeasures".
Cost Savings ; Equipment and Supplies, Hospital ; economics ; Group Purchasing ; economics ; organization & administration ; Humans ; Marketing of Health Services ; methods ; Purchasing, Hospital ; organization & administration ; Quality Control

Based on the construction experiences of our hospital, we in this paper introduce some problems met with in the central gas-supply, and meanwhile we have presented several solutions and preventive measures for the reference of other hospitals.
Delivery of Health Care ; organization & administration ; Equipment Safety ; Equipment and Supplies, Hospital ; Gases ; economics ; supply & distribution ; Maintenance ; Oxygen ; economics ; supply & distribution ; Oxygen Inhalation Therapy ; instrumentation

The health check up flow of digital hospital can be consulted with the assembly line of industry factory. Because they have the following same features: highly specialized workstation, closeness and continuance, rhythm, balanced production, continuous production. The essential prerequisites are as the follows: The inspecting items and methods should be stable; advanced product mix and stable production design; standardized raw material, consumption, procedure, inspection method; there are lots of request for health inspection; the customers move at the least unit; the space arrangement should be reasonable; the time arrangement should be proportion. With the computer net, the digital inspection can achieves the raw material controlling accurately. The basis of check up line concerns about equipment, net and software, data collection, and personnel. The group technology is used in the health inspection flow design of the digital hospital in the field of items customers and zone redivided. The digital assembly linemic health inspect has the following stages: member registering, notice, check in, arrange order, time control, report, feedback and analysis. The assembly linemic has following advantages: increasing the productivity, the space utility, satisfaction of customer, fund returning, lowering the cost and ensuring the quality.
Computer Communication Networks ; Delivery of Health Care ; Hospital Administration ; economics ; Hospital Information Systems ; organization & administration ; Humans ; Preventive Health Services ; economics ; organization & administration