Lee Kwang-soo, Chun Ki-Hong, Lee Jung-Soo
Department of Healthcare Management, College of Medicine, Eulji University, South Korea.
Health Policy. 2008 Jul;87(1):41-9. doi: 10.1016/j.healthpol.2007.10.003. Epub 2007 Nov 19.
The objective of this study is to explain the relationship between the case-mix specialization index and efficiency of inpatient hospital care services. Hospital specialization was measured using the information theory index constructed from diagnosis-related group numbers of hospitals in Seoul, Korea, in 2004. Hospital performance was measured by technical efficiency scores computed by data envelopment analysis for 2004. Multiple regression analysis models were applied to identify the internal and external factors that affected the extent of hospital specialization status as well as the efficiency of hospitals. The data envelopment analysis showed that input variables such as the number of beds, doctors and nurses were related to hospital efficiency. Hospitals had different levels of specialization in patient services, and more specialized hospitals were more likely to be efficient (odds ratio=25.95). Internal characteristics of providers had more significant effects on the extent of specialization than market conditions. These findings help to explain the relationship among hospitals, specialization, market conditions and provider performance. The study results related to the rearrangement of hospital services in a city. Further study including hospitals from other regions will increase the generalizability of results, and policy makers can use the information in making policy for the specialized hospital industry in Korea.
本研究的目的是解释病例组合专业化指数与住院医院护理服务效率之间的关系。医院专业化程度是使用2004年韩国首尔医院的诊断相关组数量构建的信息理论指数来衡量的。医院绩效是通过数据包络分析计算出的2004年技术效率得分来衡量的。应用多元回归分析模型来确定影响医院专业化程度以及医院效率的内部和外部因素。数据包络分析表明，诸如床位、医生和护士数量等输入变量与医院效率相关。医院在患者服务方面具有不同程度的专业化，且专业化程度更高的医院更有可能高效（优势比=25.95）。提供者的内部特征对专业化程度的影响比市场条件更为显著。这些发现有助于解释医院、专业化、市场条件和提供者绩效之间的关系。该研究结果与城市医院服务的重新安排有关。纳入其他地区医院的进一步研究将提高结果的普遍性，政策制定者可以利用这些信息为韩国专科医院行业制定政策。
