title: Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea.
abstract: OBJECTIVE
  Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital.
  
  
  METHODS
  Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed.
  
  
  RESULTS
  Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges.
  
  
  CONCLUSIONS
  Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.
authors.affiliation: Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Korea.
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.|Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.|Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.|Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea. ecpark@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000191:economics / Q000628:therapy*; D003108:Colonic Diseases / Q000191:economics / Q000628:therapy*; D017598:Efficiency, Organizational; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000458:organization & administration; D006782:Hospitals, Special / Q000458:organization & administration; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D012002:Rectal Diseases / Q000191:economics / Q000628:therapy*; D056910:Republic of Korea
keywords: Specialty hospital; colorectal-anal disease; fees and charges; length of stay