Analysis of hospital volume and factors influencing economic outcomes in cancer surgery: Results from a population-based study in Korea

Jung A. Lee, So Young Kim, Keeho Park, Eun Cheol Park, Jong Hyock Park

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. Methods: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. Results: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. Conclusion: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals' cost of care and risk-adjusted mortality.

Original languageEnglish
Pages (from-to)34-46
Number of pages13
JournalOsong Public Health and Research Perspectives
Volume8
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Korea
Length of Stay
Economics
Cystectomy
Costs and Cost Analysis
Population
Neoplasms
Hospital Costs
High-Volume Hospitals
Esophagectomy
Pneumonectomy
Colectomy
Ownership
Public Hospitals
Mastectomy
National Health Programs
Health Insurance
Teaching Hospitals
Emergencies
Demography

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

@article{8544759d02bb46a8a6105026859b9471,
title = "Analysis of hospital volume and factors influencing economic outcomes in cancer surgery: Results from a population-based study in Korea",
abstract = "Objectives: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. Methods: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. Results: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. Conclusion: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals' cost of care and risk-adjusted mortality.",
author = "Lee, {Jung A.} and Kim, {So Young} and Keeho Park and Park, {Eun Cheol} and Park, {Jong Hyock}",
year = "2017",
month = "1",
day = "1",
doi = "10.24171/j.phrp.2017.8.1.05",
language = "English",
volume = "8",
pages = "34--46",
journal = "Osong Public Health and Research Perspectives",
issn = "2210-9099",
publisher = "Elsevier Korea",
number = "1",

}

Analysis of hospital volume and factors influencing economic outcomes in cancer surgery : Results from a population-based study in Korea. / Lee, Jung A.; Kim, So Young; Park, Keeho; Park, Eun Cheol; Park, Jong Hyock.

In: Osong Public Health and Research Perspectives, Vol. 8, No. 1, 01.01.2017, p. 34-46.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of hospital volume and factors influencing economic outcomes in cancer surgery

T2 - Results from a population-based study in Korea

AU - Lee, Jung A.

AU - Kim, So Young

AU - Park, Keeho

AU - Park, Eun Cheol

AU - Park, Jong Hyock

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. Methods: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. Results: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. Conclusion: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals' cost of care and risk-adjusted mortality.

AB - Objectives: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. Methods: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy. Hospital volumes were divided into quartiles. Results: Independent predictors of high costs and long LOS included old age, low health insurance contribution, non-metropolitan residents, emergency admission, Charlson score > 2, public hospital ownership, and teaching hospitals. After adjusting for relevant factors, there was an inverse relationship between volume and costs/LOS. The highest volume hospitals had the lowest procedure costs and LOS. However, this was not observed for cystectomy. Conclusion: Our findings suggest an association between patient and clinical factors and greater costs and LOS per surgical oncologic procedure, with the exception of cystectomy. Yet, there were no clear associations between hospitals' cost of care and risk-adjusted mortality.

UR - http://www.scopus.com/inward/record.url?scp=85020936138&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020936138&partnerID=8YFLogxK

U2 - 10.24171/j.phrp.2017.8.1.05

DO - 10.24171/j.phrp.2017.8.1.05

M3 - Article

AN - SCOPUS:85020936138

VL - 8

SP - 34

EP - 46

JO - Osong Public Health and Research Perspectives

JF - Osong Public Health and Research Perspectives

SN - 2210-9099

IS - 1

ER -