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轻症患者对三级医院的利用情况分析:旅行成本法分析

Understanding the Utilization of Tertiary Hospitals by Mild Disease Patients: Travel Cost Method Analysis.

作者信息

Ji Seokmin, Park Sewon, Choi Mankyu, Lee Munjae

机构信息

Department of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea.

Department of Medical Science, Ajou University School of Medicine, Suwon, South Korea.

出版信息

Risk Manag Healthc Policy. 2025 May 26;18:1747-1760. doi: 10.2147/RMHP.S506111. eCollection 2025.

Abstract

PURPOSE

Tertiary hospital utilization for patients with mild diseases creates inefficiencies in medical utilization for medical consumers and providers, collapses the healthcare delivery system, and has negative consequences for the public health system. This study aims to identify the factors that lead to the selection of tertiary hospitals and the medical needs of patients with mild diseases. We evaluate the value of using medical institutions by comparing and analyzing regional and individual patient characteristics.

METHODS

The travel cost method based on the travel cost incurred according to the consumer's temporal choice, was used to evaluate the medical use. We considered data from Ajou University Hospital from 2017 to 2022. The variables used for travel costs are travel costs, time costs, and medical costs. The Quantum Geographic Information System(QGIS) network analysis was used to calculate travel costs and time costs, and independent sample -tests and analysis of variance (ANOVA) were used to compare the evaluated values between groups.

RESULTS

The analysis revealed that travel costs were the highest for patients with diabetes. Regarding personal characteristics, men exhibited higher rates than women, and individuals under 65 years of age and those receiving type 2 medical benefits demonstrated higher travel costs. Travel costs and outpatient visit rates for mild diseases exhibited a direct proportional relationship. We compared the total economic value assessed for each type of mild disease and found the highest value for diabetes patients with the highest number of outpatient visits.

CONCLUSION

These findings highlight the importance of incorporating patient segmentation into policy formulation to alleviate the overcrowding of patients with mild diseases in tertiary care hospitals. Furthermore, they advocate adopting a primary care-centered approach to enhance the healthcare delivery system and address imbalances in community healthcare resources.

摘要

目的

轻症患者对三级医院的利用给医疗消费者和提供者带来了医疗利用效率低下的问题,破坏了医疗服务提供系统,并对公共卫生系统产生负面影响。本研究旨在确定导致患者选择三级医院的因素以及轻症患者的医疗需求。我们通过比较和分析地区及个体患者特征来评估医疗机构的利用价值。

方法

基于消费者时间选择所产生的旅行成本的旅行成本法被用于评估医疗利用情况。我们考虑了2017年至2022年阿朱大学医院的数据。用于旅行成本的变量包括旅行成本、时间成本和医疗成本。使用量子地理信息系统(QGIS)网络分析来计算旅行成本和时间成本,并使用独立样本检验和方差分析(ANOVA)来比较组间的评估值。

结果

分析显示,糖尿病患者的旅行成本最高。就个人特征而言,男性的比例高于女性,65岁以下以及享受二类医疗福利的人群旅行成本更高。轻症疾病的旅行成本和门诊就诊率呈现直接的正比关系。我们比较了每种轻症疾病评估的总经济价值,发现门诊就诊次数最多的糖尿病患者价值最高。

结论

这些发现凸显了在政策制定中纳入患者细分以缓解三级医院轻症患者过度拥挤情况的重要性。此外,它们主张采用以初级保健为中心的方法来加强医疗服务提供系统,并解决社区医疗资源的不平衡问题。

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