Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Analyzing the Specialization Status of Hospital's Services in Korea

의료기관 서비스 전문화 수준의 측정 및 분석

  • Lee, Kwang-Soo (Dept. of Healthcare Management, School of Medicine, Eulji University) ;
  • Chun, Ki-Hong (Dept. of Preventive Medicine and Public Health, School of Medicine, Ajou University)
  • 이광수 (을지대학교 의과대학 의료경영학과) ;
  • 전기홍 (아주대학교 의과대학 예방의학교실)
  • Published : 2008.06.30
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Abstract

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

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References

  1. 김준홍. 중소병원 경영실적과 육성방안. 서울 : 한국병원경영연구원;2005
  2. 보건복지부. http://www.mohw.go.kr
  3. 이신호, 임준, 박수경, 오종희, 배성권, 이윤태, 박종애. 전문병원제도 도입에 관한 연구. 서울 : 한국보건산업진흥원;2003
  4. 이용균, 남은우, 김준홍. 전문병원제도 도입방안 연구. 서울 : 한국병원경영연구원;2006
  5. 정우진. 중소병원의 발전구상(I)-병원전문화를 중심으로. 보건복지 포럼 1997;3:11-19
  6. 채영문, 이경호, 강성홍, 김원중. 전문병원 도입방안. 전문병원 공청회자료. 서울:보건복지부;2003
  7. Dayhoff DA., Cromwell J. 1993. Measuring differences and similarities in hospital caseloads: a conceptual and empirical analysis. Health Services Research 28(3): 293-312
  8. Dranove, DM, Shanley, Simin C. 1992. Is hospital competition wasteful? RAND Journal of Economics 23(2): 247-263 https://doi.org/10.2307/2555987
  9. Eastaugh SR. 1992a. Hospital Specialization and cost Efficiency: benefits of trimming product lines. Hospital and Health Services Administration 37(2): 223-235
  10. Eastaugh SR. 1992b. Hospital strategy and financial performance. Health Care Management Review 17(3): 19-31 https://doi.org/10.1097/00004010-199222000-00004
  11. Eastaugh SR. 2001. Hospital costs and specialization: benefits of trimming product lines. Journal of Health Care Finance 28(1): 61-71
  12. Eastaugh SR. 2006. Specialization and hospital costs: benefits of trimming product lines. Journal of Health Care Finance 32(4): 29-38
  13. Farley DE, Hogan C. 1990. Case-mix specialization in the market for hospital services. Health Services Research 23(5): 754-783
  14. Farley DE. 1989. Measuring casemix specialization and the concentration of diagnoses in hospitals using information theory. Journal of Health Economics 8, 185-207 https://doi.org/10.1016/0167-6296(89)90003-9
  15. Hillner BE, Smith TJ, Desch CE. 2000. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. Journal of Clinical Oncology 18(11): 2327-2340 https://doi.org/10.1200/JCO.2000.18.11.2327
  16. Lee JG, Clarke RW. 1992. Restructuring improves hospital competitiveness. Healthcare Financing Management 46(11): 30-31, 33-34, 36-37
  17. Luft HS, Robinson JC, Garnick DW, Maerki SC, McPhee SJ. 1986. The role of specialized clinical services in competition among hospitals. Inquiry 23: 83-94 https://doi.org/10.1080/00201748008601892
  18. Luke RD. 1991. Spatial competition and cooperation in local hospital markets. Medical Care Review 48(2): 207-237 https://doi.org/10.1177/002570879104800204
  19. Mainous AG 3rd, Kohrs FP. 1995. A comparison of health status between rural and urban adults. Journal of Community Health 20(5): 423-31 https://doi.org/10.1007/BF02260438
  20. Shi L, Macinko J, Starfield B, Politzer R, Wulu J, Xu J. 2005. Primary care, social inequalities and all-cause heart disease and cancer mortality in US counties: Acomparison between urban and non-urban areas. Public Health 119(8): 699-710 https://doi.org/10.1016/j.puhe.2004.12.007
  21. Shortell SM, Morrison EM, Hughes SL, Friedman BS, Vitek JL (1987). Diversification of Health Care Services: The Effects of Ownership, Environment, and Strategy. In Scheffler, RM and Rossiter LF. Advances in Health Economics and Health Services Research. Greenwich, CT, JAI Press, Inc
  22. Succi MJ, Lee SD, Alexander JA. 1996. Effects of market position and competition on rural hospital closures. Health Services Research 31(6): 679-699
  23. Zwanziger J, Melnick GA, Simonson L. 1996. Differentiation and specialization in the California hospital industry 1983 to 1988. Medical Care 34(4): 361-372 https://doi.org/10.1097/00005650-199604000-00007

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