Department of Surgery, Edward Via College of Osteopathic Medicine, Spartanburg, SC, USA.
J Osteopath Med. 2022 Mar 31;122(7):339-345. doi: 10.1515/jom-2022-0028.
Surgical volume is correlated with increased hospital profitability, yet many Critical Access Hospitals (CAHs) offer few or no inpatient surgical services.
This study aims to investigate the impact of the presence of different inpatient surgical services on CAH profitability.
The study design was a cross-sectional analysis of financial data from the most recent fiscal year (FY) of 1299 CAHs. Multiple linear regression was utilized to assess how the operating margin was affected by the number of different inpatient surgical services offered per hospital. Covariates known to be associated with hospital profitability included occupancy rate, case mix index (CMI), system affiliation, ownership status (public, private, or nonprofit), and geographic region.
The regression model for the CAH operating margin returned an R value of 0.18. Each additional inpatient surgical service corresponded to a 1.5% increase in operating margin (p=0.0413). Each 10% increase in occupancy rate and 0.1 increase in CMI corresponded to a 0.9% increase in operating margin (p=0.0032 and p=0.0176, respectively). The number of surgical services offered per CAH showed positive correlations with occupancy rate (r=0.23, p<0.0001) and CMI (r=0.59, p<0.0001).
A positive correlation exists between operating margin and the diversity of inpatient surgical specialties available at CAHs. Furthermore, providing surgery allows CAHs to accommodate higher occupancy rates and case mixes, both of which are significantly and positively correlated with CAH operating margin.
手术量与医院盈利能力呈正相关，但许多基层医疗机构（CAHs）提供的住院手术服务很少或没有。
本研究旨在探讨不同住院手术服务的存在对 CAH 盈利能力的影响。
研究设计是对 1299 家 CAHs 最近一个财政年度（FY）的财务数据进行横断面分析。采用多元线性回归分析评估每家医院提供的不同住院手术服务数量对医院运营利润率的影响。与医院盈利能力相关的已知协变量包括入住率、病例组合指数（CMI）、系统隶属关系、所有制状况（公有制、私有制或非营利性）和地理位置。
CAH 运营利润率的回归模型的 R 值为 0.18。每增加一项住院手术服务，运营利润率增加 1.5%（p=0.0413）。入住率每增加 10%，CMI 每增加 0.1，运营利润率分别增加 0.9%（p=0.0032 和 p=0.0176）。CAH 提供的手术服务数量与入住率（r=0.23，p<0.0001）和 CMI（r=0.59，p<0.0001）呈正相关。
CAHs 提供的住院手术专业种类的多样性与运营利润率呈正相关。此外，提供手术服务使 CAHs 能够容纳更高的入住率和病例组合，这两者与 CAH 运营利润率呈显著正相关。
