Vogel Justus, Hollenbach Johannes, Haering Alexander, Augurzky Boris, Geissler Alexander
Chair of Health Economics, Policy and Management, School of Medicine, University of St. Gallen, St. Jakob-Strasse 21, CH-9000 St. Gallen, Switzerland.
RWI - Leibniz-Institut für Wirtschaftsforschung e.V., Hohenzollernstr. 1-3, D-45128 Essen, Germany.
Health Policy. 2024 Apr;142:105012. doi: 10.1016/j.healthpol.2024.105012. Epub 2024 Feb 11.
German hospitals largely rely on public investments for digitization. As these have been insufficient, hospitals had to use own profits to foster digital transformation. Thus, we assess if profitability affects digital maturity, and what other factors might be influential.
We use digital maturity data from the DigitalRadar (DR) project (2021) and financial statement data from the Hospital Rating Report from 2017 to 2019 (n = 860). We run linear regressions with the DR-score (continuous variable from 0 to 100) as dependent and three-year average EBITDA margin as independent variable. Besides, we conduct subgroup analyses stratifying by chain size.
A one percentage point EBITDA margin increase is associated with a 0.359 points DR-score increase (p<0.01). This relationship holds in significance and holds or increases in magnitude for all specifications except when adding chain beds (0.212 point DR-score increase, p<0.05). Besides, chain membership and chain size are positively and significantly associated with hospitals' DR-score. EBITDA margins of the subgroups "large chains" and "Big 3″, i.e., the three largest chains, were strongly associated with the DR-score (2.685 and 3.197 points DR-score increase respectively, p<0.01).
Higher profitability is associated with higher digital maturity. Larger chains are digitally more mature, because (1) they might follow a chain-wide IT-strategy, (2) can standardize IT-architecture, and policies and (3) might cross-finance investments.
德国医院在数字化方面很大程度上依赖公共投资。由于这些投资不足，医院不得不利用自身利润来推动数字转型。因此，我们评估盈利能力是否会影响数字成熟度，以及其他哪些因素可能具有影响力。
我们使用了来自DigitalRadar（DR）项目（2021年）的数字成熟度数据以及2017年至2019年医院评级报告中的财务报表数据（n = 860）。我们进行线性回归，将DR评分（0至100的连续变量）作为因变量，将三年平均息税折旧摊销前利润率作为自变量。此外，我们按连锁规模进行分层的亚组分析。
息税折旧摊销前利润率每提高一个百分点，DR评分相应提高0.359分（p<0.01）。这种关系具有显著性，并且在所有设定中都成立或强度增加，但添加连锁床位时除外（DR评分提高0.212分，p<0.05）。此外，连锁成员身份和连锁规模与医院的DR评分呈正相关且具有显著性。“大型连锁”和“三大连锁”（即最大的三个连锁）亚组的息税折旧摊销前利润率与DR评分密切相关（分别使DR评分提高2.685分和3.197分，p<0.01）。
更高的盈利能力与更高水平的数字成熟度相关。规模更大的连锁在数字化方面更成熟，原因在于：（1）它们可能遵循全连锁的信息技术战略；（2）能够使信息技术架构、政策标准化；（3）可能交叉融资进行投资。
