• BMJ open · Jan 2014

    Governmental designation of spine specialty hospitals, their characteristics, performance and designation effects: a longitudinal study in Korea.

    • Sun Jung Kim, Ji Won Yoo, Sang Gyu Lee, Tae Hyun Kim, Kyu-Tae Han, and Eun-Cheol Park.
    • Department of Public Health, Yonsei University College of Medicine, Seoul, South Korea Institute of Health Services Research, Yonsei University College of Medicine, Seoul, South Korea.
    • BMJ Open. 2014 Jan 1;4(11):e006525.

    ObjectivesThis study compares the characteristics and performance of spine specialty hospitals versus other types of hospitals for inpatients with spinal diseases in South Korea. We also assessed the effect of the government's specialty hospital designation on hospital operating efficiency.SettingWe used data of 823 hospitals including 17 spine specialty hospitals in Korea.ParticipantsAll spine disease-related inpatient claims nationwide (N=645 449) during 2010-2012.InterventionsNo interventions were made.Outcome MeasuresUsing a multilevel generalised estimating equation and multilevel modelling, this study compared inpatient charges, length of stay (LOS), readmission within 30 days of discharge and in-hospital death within 30 days of admission in spine specialty versus other types of hospitals.ResultsSpine specialty hospitals had higher inpatient charges per day (27.4%) and a shorter LOS (23.5%), but per case charges were similar after adjusting for patient-level and hospital-level confounders. After government designation, spine specialty hospitals had 8.8% lower per case charges, which was derived by reduced per day charge (7.6%) and shorter LOS (1.0%). Rates of readmission also were lower in spine specialty hospitals (OR=0.796). Patient-level and hospital-level factors both played important roles in determining outcome measures.ConclusionsSpine specialty hospitals had higher per day inpatient charges but a much shorter LOS than other types of hospitals due to their specialty volume and experience. In addition, their readmission rate was lower. Spine specialty hospitals also endeavoured to be more efficient after governmental 'specialty' designation.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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