Hospital characteristics related to the hospital length of stay among inpatients receiving invasive cervical discectomy due to road traffic accidents under automobile insurance in South Korea

Kyoung Won Shin, Hyo Jung Lee, Chung Mo Nam, Ki Tae Moon, Eun Cheol Park

Research output: Contribution to journalArticle

Abstract

Background: In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Methods: Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. Results: The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1% increase, 95% confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95% CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95% CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95% CI: 0.876-0.987) were associated with a shorter LOS. Conclusions: Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.

Original languageEnglish
Article number567
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
Publication statusPublished - 2017 Aug 16

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Diskectomy
Automobiles
Republic of Korea
Traffic Accidents
Insurance
Inpatients
Length of Stay
Confidence Intervals
Delivery of Health Care
Low-Volume Hospitals
High-Volume Hospitals
Compensation and Redress
Accidents
Orthopedics
Regression Analysis
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

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title = "Hospital characteristics related to the hospital length of stay among inpatients receiving invasive cervical discectomy due to road traffic accidents under automobile insurance in South Korea",
abstract = "Background: In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Methods: Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. Results: The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1{\%} increase, 95{\%} confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95{\%} CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95{\%} CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95{\%} CI: 0.876-0.987) were associated with a shorter LOS. Conclusions: Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.",
author = "Shin, {Kyoung Won} and Lee, {Hyo Jung} and Nam, {Chung Mo} and Moon, {Ki Tae} and Park, {Eun Cheol}",
year = "2017",
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T1 - Hospital characteristics related to the hospital length of stay among inpatients receiving invasive cervical discectomy due to road traffic accidents under automobile insurance in South Korea

AU - Shin, Kyoung Won

AU - Lee, Hyo Jung

AU - Nam, Chung Mo

AU - Moon, Ki Tae

AU - Park, Eun Cheol

PY - 2017/8/16

Y1 - 2017/8/16

N2 - Background: In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Methods: Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. Results: The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1% increase, 95% confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95% CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95% CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95% CI: 0.876-0.987) were associated with a shorter LOS. Conclusions: Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.

AB - Background: In South Korea, people injured in road traffic accidents receive compensation for medical costs through their automobile insurance. However, the automobile insurance system appears to manage health care inefficiently. This study aimed to investigate the factors associated with the hospital length of stay (LOS), which was used as an indicator of healthcare utilization, for inpatients covered by automobile insurance and undergoing invasive cervical discectomy. Methods: Insurance claims data from 158 hospitals were used. The study included 850 inpatients who were involved in automobile accidents in 2014 and 2015 and who underwent invasive cervical discectomy. Poisson regression analysis was performed to examine the associations between the LOS and hospital-level characteristics. Results: The mean LOS for inpatients covered by automobile insurance was 25.75 days. A higher proportion of inpatients with automobile insurance were associated with a longer LOS (rate ratio [RR]: 1.027 per 1% increase, 95% confidence interval [CI]: 1.012-1.042). A higher hospital volume of invasive cervical discectomy (RR: 0.970 per 10 case increase, 95% CI: 0.945-0.997), bed turnover rate (RR: 0.988 per 1 increase, 95% CI: 0.979-0.997), and number of neurosurgeons or orthopedic specialists (RR: 0.930 per 1/100 beds increase, 95% CI: 0.876-0.987) were associated with a shorter LOS. Conclusions: Our findings suggest that inpatients covered by automobile insurance were associated with a longer LOS when treated at small-sized, low-provider, and low-volume hospitals with high proportions of such patients. Based on these findings, policymakers and healthcare professionals ought to consider improved strategies for efficient management of automobile insurance for inpatients in small-sized hospitals.

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U2 - 10.1186/s12913-017-2518-3

DO - 10.1186/s12913-017-2518-3

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