Yonsei Med J.  2015 May;56(3):853-861. 10.3349/ymj.2015.56.3.853.

Mortality, Length of Stay, and Inpatient Charges for Heart Failure Patients at Public versus Private Hospitals in South Korea

Affiliations
  • 1Department of Health Administration, Namseoul University, Cheonan, Korea.
  • 2Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea. leevan@yuhs.ac
  • 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea.
  • 5Department of Medicine, University of Wisconsin School of Medicine and Public Health, Milwaukee, WI, USA.
  • 6Center for Senior Health and Longevity, Aurora Health Care, Milwaukee, WI, USA.

Abstract

PURPOSE
This study compared in-hospital mortality within 30 days of admission, lengths of stay, and inpatient charges among patients with heart failure admitted to public and private hospitals in South Korea.
MATERIALS AND METHODS
We obtained health insurance claims data for all heart failure inpatients nationwide between November 1, 2011 and May 31, 2012. These data were then matched with hospital-level data, and multi-level regression models were examined. A total of 8406 patients from 253 hospitals, including 31 public hospitals, were analyzed.
RESULTS
The in-hospital mortality rate within 30 days of admission was 0.92% greater and the mean length of stay was 1.94 days longer at public hospitals than at private hospitals (mortality: 5.18% and 4.26%, respectively; LOS: 12.08 and 10.14 days, respectively). The inpatient charges were 11.4% lower per case and 24.5% lower per day at public hospitals than at private hospitals. After adjusting for patient- and hospital-level confounders, public hospitals had a 1.62-fold higher in-hospital mortality rate, a 16.5% longer length of stay, and an 11.7% higher inpatient charge per case than private hospitals, although the charges of private hospitals were greater in univariate analysis.
CONCLUSION
We recommend that government agencies and policy makers continue to monitor quality of care, lengths of stay in the hospital, and expenditures according to type of hospital ownership to improve healthcare outcomes and reduce spending.

Keyword

Public hospitals; mortality; fees and charges; length of stay

MeSH Terms

Aged
Female
Heart Failure/economics/*mortality/therapy
Hospital Charges/*statistics & numerical data
Hospital Mortality
Hospitalization/economics
Hospitals, Private/*economics
Hospitals, Public/*economics
Humans
Inpatients/*statistics & numerical data
Length of Stay/economics/*statistics & numerical data
Logistic Models
Male
Middle Aged
Multivariate Analysis
Outcome Assessment (Health Care)/economics
Patient Discharge/economics/statistics & numerical data
Republic of Korea/epidemiology
Survival Analysis
Time Factors

Figure

  • Fig. 1 The difference of outcome variables between public vs. private hospitals. Data is shown as mean±SD. *Significant (p<0.001).


Cited by  1 articles

Effects of Physician Volume on Readmission and Mortality in Elderly Patients with Heart Failure: Nationwide Cohort Study
Joo Eun Lee, Eun-Cheol Park, Suk-Yong Jang, Sang Ah Lee, Yoon Soo Choy, Tae Hyun Kim
Yonsei Med J. 2018;59(2):243-251.    doi: 10.3349/ymj.2018.59.2.243.


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