Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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The Trend of the Specialization of Hospitals in 2003 to 2005 in Metropolitan Cities

광역시소재 병원을 대상으로 한 전문화 수준의 다년간 추세분석

  • Lee, Kwang-Soo (Department of Health Care Management, College of Medicine, Eulji University) ;
  • Chun, Ki-Hong (Department of Preventive Medicine and Public Health, School of Medicine, Ajou University)
  • 이광수 (을지대학교 의과대학 의료경영학과) ;
  • 전기홍 (아주대학교 의과대학 예방의학교실)
  • Received : 2009.06.25
  • Accepted : 2010.08.09
  • Published : 2010.09.30
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Abstract

This study examined the changes in the service mix of Korean hospitals in 6 metropolitan cities between 2003 and 2005, and assessed whether the sample hospitals exhibit consistent trend or chance variation in multiple years. Three measures of hospital service mix, focusing on the specialization of services, were applied: information theory index, internal Herfindahl index, and number of distinct diagnosis-related groups (DRGs) treated. National Health Insurance claims were used to calculate the indexes. Specialization indexes were calculated in each year, and then examined to identify the pattern over time. Kappa analysis was applied to assess the agreements of specialization score between two years after hospitals were categorized into 4 groups with quartiles. Kappa score showed that the service mix of hospitals were changed during the study years. Specialization scores were increased given the market structure for three years. Hospitals which showed higher or lower specialization scores than the average of the scores consistently classified into the same group. Specialization indexes showed relatively consistent pattern over 3 years, and such consistencies were evident for hospitals regardless of the specialization status. Policy makers can identify the degree of specialization with the indexes, and it could provide a picture of how hospital services were mixed and changed over time.

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References

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