In addition, this study also investigated the effect of designation as a ‘specialty’ hospital selleckbio on hospital operating efficiency. Data and methods Database and data collection In order to investigate the designation effect of specialty hospitals and to measure their performance, we collected all nationwide claims for inpatients diagnosed with spine diseases from categories used to determine the spine specialty hospital designation by the Ministry of Health and Welfare. Treatments for spine-related diseases included surgical procedures
(discectomy, excision of intraspinal lesion, spinal fusion with deformity, spinal fusion, amputation, radical excision of malignant bone tumour, osteotomy and external fixation of extremity, etc) and medical procedures specific to spinal disorders and injuries, osteomyelitis, connective tissue malignancy, connective tissue disorders, other musculoskeletal disorders, etc. We were able to access claims reported during
the 7 months after the government began to designate specialty hospitals on 1 November 2011 (1 November 2011 to 31 May 2012) and included claims reported in the same 7-month period 1 year prior (1 November 2010 to 31 May 2011). Among nearly 1600 hospitals included in the database, only those that admitted more than one spinal-related inpatient case were included. Our analysis encompassed 645 449 patients hospitalised for spine-related illnesses nationwide during the study period, and 823 hospitals including 17 spine specialty hospitals. Outcome measures Inpatient charges per case are the sum of fee-for-services (FFS) claims for each patient’s hospitalisation. LOS is measured as the number of inpatient days during each episode of hospitalisation. We also calculated inpatient charge per day by dividing inpatient charges per case by the LOS. In Korea, the FFS schedule is negotiated by the government, medical
providers and other stakeholders every year. In 2012, the FFS catalogue increased by 1.9%, but there were no increases in 2010 and 2011. Hence, we discounted 2012 inpatient Drug_discovery charges to 2010–2011 levels. The average foreign exchange rate in 2011 was US$1=1108.09 KRW. Using the claim sample, we also calculated readmission within 30 days of discharge and mortality within 30 days of admission date as a binary variable if a patient was rehospitalised soon after discharge or died during hospitalisation. Covariates This data set contained inpatient claim details, including patient ID, disease diagnosed, admission/discharge date, sex, age, complexity of illness and the hospital to which each patient was admitted.