입원서비스의 집중화 수준과 진료비 간의 관계 분석: 2009년~2011년
A study on the relationship between the concentration status of inpatient services and medical charges per case between 2009 and 2011
1
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.
Abstract
Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.
참고문헌 (22)
- 건강보험심사평가원, "입원환자표본자료(2009-2011)", ~ (2013)
- 김원중, "중소병원의 전문화와 경영성과 : 수익성 분석을 중심으로", 병원경영학회지, 4(2), pp.85~105 (1999)
- 보건의료산업학회, "병원경영개론", pp.42~44 (2013), 현문사
- 유해원, "의료 서비스 제공의 전문화 수준이 병원 경영 성과에 미치는 영향", 박사, 경영학과 생산서비스경영전공, pp.2013
- 이광수, "의료기관 서비스 전문화 수준의 측정 및 분석", 보건행정학회지, 18(2), pp.67~85 (2008), 한국보건행정학회
- 이광수, "광역시소재 병원을 대상으로 한 전문화 수준의 다년간 추세분석", 보건행정학회지, 20(3), pp.21~35 (2010), 한국보건행정학회
- 이종건, "지식경영 전략 및 구조적 자본이 조직성과에 미치는 영향", 지식경영연구, 12(4), pp.77~90 (2011), 한국지식경영학회
- 전진환, "지식경영활동이 경영성과에 미치는 영향에 관한 연구 : 부산시 선도기업을 대상으로", 지식경영연구, 11(2), pp.37~56 (2010), 한국지식경영학회
- 최만규, "우리나라 중소병원의 도산실태와경쟁력 제고 방안", 보건과학논집, 31(1), pp.15~29 (2005)
- 한국보건산업 진흥원, "2011 보건산업백서", 404~ (2012)
- Barro, J. R., "The effects of cardiac specialty hospitals on the cost and quality of medical care", Journal of Healthcare Economics, 52(4), pp.702~721 (2006)
- Dayhoff D. A., "Measuring differences and similarities in hospital caseloads : a conceptual and empirical analysis", Healthcare Services Research, 28(3), pp.293~312 (1993)
- Devers K., "Specialty hospital : focused factories or c ream s kimmers?", Center for s tudying Health System Changes, 62, pp.1~4 (2003)
- Eastaugh S. R., "Hospital specialization and cost efficiency : benefit of trimming product lines", Hospital and Healthcare Services Administration, 37(2), pp.223~235 (1992)
- Eastaugh S. R., "Hospital strategy and f inancial performance", Health Care Managemet Review, 17(3), pp.19~31 (1992)
- Eastaugh S. R., "Hospital costs and specialization : benefit of trimming product lines", Journal of Health Care Finance, 28(1), pp.61~71 (2001)
- Eastaugh S. R., "Specialization and Hospital costs : benefits of trimming product lines", Journal of Health Care Finance, 32(4), pp.29~38 (2006)
- Eastaugh S. R., "Hospital costs and specialization : benef its of limiting the number of product lines", Journal of Health Care Finance, 36(2), pp.24~34 (2009)
- Evans R. G., "Information theory and the analysis of hospital cost structure", Canadian Journal of Economics, 5(3), pp.398~418 (1972)
- Farely D. E., "Measuring casemix specialization and the concentration of diagnosis in hospitals using information theory", Journal of Healthcare Economics, 8, pp.185~207 (1989)
- Farely D. E., "Case-mix specialization in the market for hospital services", Healthcare Services Research, 23(5), pp.754~783 (1990)
- Zwaniziger J., "Differentiation and specialization in the California hospital industry 1983 to 1988", Medical Care, 34(4), pp.361~372 (1996)