Socio-demographic patient profiles and hospital efficiency: does patient mix affect a hos…

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Economic evaluations of maintaining patient safety systems in teaching hospitals.

Health Policy. 2008 Dec;88(2-3):381-91

Authors: Fukuda H, Imanaka Y, Hirose M, Hayashida K

OBJECTIVE: The aim of this study was to assess the status and the cost of hospital patient safety systems. METHODS: We conducted a national questionnaire survey of all the 1039 teaching hospitals in Japan. The study was constructed to evaluate the costs of the systems for patient safety focused on staff assignment, meetings and conferences, internal audit, staff education and training, incident reporting, infection surveillance, infectious disposal, management of medication use, clinical engineering, and patient counseling. RESULTS: The status to maintain patient safety systems might be at least as decent. The mean estimated total cost of systems for patient safety was US$ 20,449 (95% confidence interval [CI], 19,632-21,266) per 100 bed-months or US$ 8.52 (95% CI, 8.18-8.86) per inpatient-day. The ratio of costs to revenue was 1.68% (95% CI, 1.61-1.75). The annual necessary costs occurring in hospitals where the costs of patient safety were under the average level across all the 1032 teaching hospitals in Japan was US$ 259.7 million. CONCLUSIONS: Our results show that hospital-wide activities for patient safety pose significant costs to hospitals and national healthcare systems. Our data may provide financial information for designing and improving patient safety systems.

PMID: 18514966 [PubMed - indexed for MEDLINE]

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Reforming the hospital service structure to improve efficiency: urban hospital specialization.

Health Policy. 2008 Jul;87(1):41-9

Authors: Lee KS, Chun KH, Lee JS

The objective of this study is to explain the relationship between the case-mix specialization index and efficiency of inpatient hospital care services. Hospital specialization was measured using the information theory index constructed from diagnosis-related group numbers of hospitals in Seoul, Korea, in 2004. Hospital performance was measured by technical efficiency scores computed by data envelopment analysis for 2004. Multiple regression analysis models were applied to identify the internal and external factors that affected the extent of hospital specialization status as well as the efficiency of hospitals. The data envelopment analysis showed that input variables such as the number of beds, doctors and nurses were related to hospital efficiency. Hospitals had different levels of specialization in patient services, and more specialized hospitals were more likely to be efficient (odds ratio=25.95). Internal characteristics of providers had more significant effects on the extent of specialization than market conditions. These findings help to explain the relationship among hospitals, specialization, market conditions and provider performance. The study results related to the rearrangement of hospital services in a city. Further study including hospitals from other regions will increase the generalizability of results, and policy makers can use the information in making policy for the specialized hospital industry in Korea.

PMID: 18023913 [PubMed - indexed for MEDLINE]

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