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Keeho Park 1 Article
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
Osong Public Health Res Perspect. 2017;8(1):34-46.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.05
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AbstractAbstract PDF
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.


PHRP : Osong Public Health and Research Perspectives