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Association between re-admission rate and hospital characteristics for ischemic heart disease
Yeong Jun Ju1,2, Eun-Cheol Park2,3, Jaeyong Shin2,3
1a Department of Public Health , Graduate School, Yonsei University , Seoul , Republic of Korea.
Insights
The Korean Diagnosis Procedure Combination (KDPC) payment system was associated with higher 30-day unplanned hospital re-admission rates for ischemic heart disease compared to the fee-for-service (FFS) system.
Area of Science:
- Health Services Research
- Healthcare Economics
- Cardiology
Background:
- Hospital re-admission rates are key indicators of patient outcomes and healthcare system efficiency.
- Korea implemented the Korean Diagnosis Procedure Combination (KDPC) payment system in public hospitals in 2012.
- Understanding the impact of different payment systems on re-admission rates is crucial for healthcare policy.
Purpose of the Study:
- To investigate the association between the KDPC hospital payment system and 30-day re-admission rates.
- To compare re-admission rates for ischemic heart disease patients under KDPC versus fee-for-service (FFS) systems.
- To assess the impact of payment models on healthcare quality and patient outcomes in Korea.
Main Methods:
- A cross-sectional study utilizing national claims data from 2013.
- Analysis of patients diagnosed with ischemic heart disease admitted to large general hospitals (≥500 beds) in Korea.
- Comparison of re-admission rates between two public hospitals under KDPC and six private hospitals under FFS using multiple logistic regression.
Main Results:
- The study analyzed 4,290 cases (889 KDPC, 3,401 FFS).
- The 30-day unplanned re-admission rate was higher in the KDPC group (7.9%) compared to the FFS group (5.6%).
- The odds ratio for unplanned re-admission in KDPC hospitals was 1.74, indicating a significantly higher risk.
Conclusions:
- The KDPC payment system demonstrated higher 30-day unplanned re-admission rates compared to the FFS system for ischemic heart disease.
- Findings suggest potential implications for patient care quality and healthcare system performance under the KDPC model.
- Further research may be needed to explore the underlying reasons for increased re-admissions in KDPC-based hospitals.
Objective:
Hospital re-admission is considered an important marker of patient health outcomes and healthcare system performance. Korea introduced the Korean Diagnosis Procedure Combination (KDPC) for all regional public hospitals in July 2012. This study examined re-admission rates within 30 days to assess whether the hospital payment system is associated with the re-admission rate, focusing on ischemic heart disease.
Methods:
A cross-sectional study was conducted using national claims data for 2013. We analyzed data of patients with a major diagnosis of ischemic heart disease who were admitted to general hospitals with more than 500 beds in Korea. Of the eight general hospitals, two that have been operating under the new Korean payment system were public hospitals using the KDPC, and the remaining six were private general hospitals with fee for service (FFS) systems. Multiple logistic regression analysis was used to identify associations between re-admission rate and hospital characteristics.
Results:
The study analyzed 4,290 cases (889 cases in KDPC and 3,401 cases in FFS). The 30-day unplanned re-admission rate was higher in KDPC than in FFS (7.9% vs 5.6%, respectively). The unplanned re-admission odds ratios of KDPC was 1.74.
Conclusions:
KDPC had higher 30-day unplanned re-admissions rates than did FFS.