Kim Han-Sung, Kim Young-Hoon, Woo Jung-Sik, Hyun Sook-Jung
Dept. of Healthcare Informatics, Korea Polytechnics, Seoul, Korea.
Dept. of Healthcare Management, Graduate School, Eulji University, Gyeonggi, Korea.
PLoS One. 2015 Jul 28;10(7):e0132257. doi: 10.1371/journal.pone.0132257. eCollection 2015.
Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized.
This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care.
The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.
医院正在研究集中式工厂概念,并试图通过提高专业化程度在竞争激烈的行业中增强自身实力。
本研究使用信息理论指数(ITI)和赫芬达尔-赫希曼指数(HHI)来分析接受国家医疗保险报销的韩国医院的专业化程度。采用分层回归分析来评估医院专业化对运营绩效的以下四个方面的影响:生产率、盈利能力、效率和护理质量。
结果表明,集中式战略(高HHI)通过有效利用人力资源提高了每位专科医生的收入和调整后的患者数量。然而,多元化战略(高ITI)提高了医院利用率、每张床位的收入和每张床位调整后的患者数量(控制床位等物质资源)。此外,随着集中度指数的增加,病例组合死亡率和转诊率下降,表明专业化与护理质量呈正相关。