The effect of competition on the relationship between the introduction of the DRG system and quality of care in Korea
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| Titel: | The effect of competition on the relationship between the introduction of the DRG system and quality of care in Korea |
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| Autoren: | Euna Han, Sung In Jang, Seung Ju Kim, Tae Hyun Kim, Kyu Tae Han, Eun Cheol Park, Sun Jung Kim |
| Weitere Verfasser: | Graduate School of Public Health, Seung Ju Kim, Eun-Cheol Park, Sun Jung Kim, Kyu-Tae Han, Euna Han, Sung-In Jang, Tae Hyun Kim, Kim, Tae Hyun, Park, Eun Chul, Jang, Sung In |
| Quelle: | The European Journal of Public Health. 26:42-47 |
| Verlagsinformationen: | Oxford University Press (OUP), 2015. |
| Publikationsjahr: | 2015 |
| Schlagwörter: | Adult, Male, Health Care/statistics & numerical data, National Health Programs, Patient Readmission, Insurance Claim Review, 03 medical and health sciences, 0302 clinical medicine, National Health Programs/statistics & numerical data, Republic of Korea, Quality of Health Care/statistics & numerical data, Humans, Diagnosis-Related Groups, Quality Indicators, Health Care, Quality of Health Care, Economic Competition, Length of Stay, Middle Aged, 3. Good health, Diagnosis-Related Groups/statistics & numerical data, Length of Stay/statistics & numerical data, Economic Competition/statistics & numerical data, Quality Indicators, Female, Patient Readmission/statistics & numerical data |
| Beschreibung: | The diagnosis-related group-based prospective payment programme was introduced in Korea in 1997 as a pilot programme to control health spending. In July 2013, the programme was implemented throughout the nation. The aim of our study is to evaluate the relationship between quality of care and market competition following the introduction of the new payment system in Korea.We conduct an observational analysis using National Health Insurance claim data from 2011 to 2014. We analyse data on readmission within 30 days, length of stay, and number of outpatient visits for 1742 hospitals and 821 912 cases. We use a generalized estimating equation model to evaluate readmission within 30 days and number of outpatient visits and a multi-level regression model to assess length of stay.Total readmission within 30 days is 10 727 (1.3%). High competition areas present a lower risk of readmission [odds ratio (OR): 0.95, P: 0.0277], a longer length of stay (1%, P < 0.0001), and an increased number of outpatient visits (Relative Risk: 1.11, P: 0.0011) as compared with moderate competition areas. Risk of readmission is higher in low competition areas as compared with moderate competition areas (OR: 1.21, P < 0.0001).The effects of the introduction of the new payment system differed by degree of market competition. Thus, evaluation about the effect of new payment system on hospital performance should be measured in combination with the degree of hospital market structure. |
| Publikationsart: | Article |
| Dateibeschreibung: | 42~47 |
| Sprache: | English |
| ISSN: | 1464-360X 1101-1262 |
| DOI: | 10.1093/eurpub/ckv162 |
| Zugangs-URL: | https://academic.oup.com/eurpub/article-pdf/26/1/42/14085155/ckv162.pdf https://pubmed.ncbi.nlm.nih.gov/26370438 https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/146337/1/T201600251.pdf https://core.ac.uk/display/84407750 https://yonsei.pure.elsevier.com/en/publications/the-effect-of-competition-on-the-relationship-between-the-introdu https://academic.oup.com/eurpub/article/26/1/42/2467449 https://www.ncbi.nlm.nih.gov/pubmed/26370438 https://ir.ymlib.yonsei.ac.kr/handle/22282913/146337 |
| Rights: | CC BY NC ND |
| Dokumentencode: | edsair.doi.dedup.....f820cd198b169c61c42c438863db906d |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | The diagnosis-related group-based prospective payment programme was introduced in Korea in 1997 as a pilot programme to control health spending. In July 2013, the programme was implemented throughout the nation. The aim of our study is to evaluate the relationship between quality of care and market competition following the introduction of the new payment system in Korea.We conduct an observational analysis using National Health Insurance claim data from 2011 to 2014. We analyse data on readmission within 30 days, length of stay, and number of outpatient visits for 1742 hospitals and 821 912 cases. We use a generalized estimating equation model to evaluate readmission within 30 days and number of outpatient visits and a multi-level regression model to assess length of stay.Total readmission within 30 days is 10 727 (1.3%). High competition areas present a lower risk of readmission [odds ratio (OR): 0.95, P: 0.0277], a longer length of stay (1%, P < 0.0001), and an increased number of outpatient visits (Relative Risk: 1.11, P: 0.0011) as compared with moderate competition areas. Risk of readmission is higher in low competition areas as compared with moderate competition areas (OR: 1.21, P < 0.0001).The effects of the introduction of the new payment system differed by degree of market competition. Thus, evaluation about the effect of new payment system on hospital performance should be measured in combination with the degree of hospital market structure. |
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| ISSN: | 1464360X 11011262 |
| DOI: | 10.1093/eurpub/ckv162 |