Death within 30 days of admission also was lowest in specialty ho

Death within 30 days of admission also was lowest in specialty hospitals; however, cases of death were very rare in all types of hospitals because spinal procedures typically are not based on life-threatening conditions. Lower charges per case, charges per day and reduced LOS were observed among

www.selleckchem.com/products/Enzastaurin.html specialty hospitals during the postdesignation period. Table 3 Univariate analysis of dependent variables by hospital types The results of our multilevel GEE regression analysis are presented in table 4. Although spine specialty hospitals had a 2.8% higher inpatient charge per case than small general hospitals, the difference was not statistically significant. An effect of the official ‘specialty’ designation was found with regard to inpatient charge per case, with charges per case decreasing 8.8% after specialty status was conferred. Spine specialty hospitals charged an average of 27.4% more than small general hospitals on a per-day basis, although the LOS at spine specialty hospitals was 23.5% shorter. Moreover, charges per case decreased 7.6% and LOS was reduced by 1% after specialty status was conferred. The OR of readmission was OR=0.796 for the spine specialty hospitals compared with small general hospitals; however, the ORs of mortality were not statistically

significant. This ‘designation effect’ was not noted for either readmission or mortality

outcome. Efficient hospitals were more likely to follow the trend of spine specialty hospitals in terms of charging and LOS. Males were associated with higher charges per case and per day, but shorter LOS. Patients with higher CCL scores had higher charges per case and longer LOS. Hospitals located in metropolitan areas had higher charges per case and shorter LOS. Teaching hospitals had higher charges per case but no significant difference in charge per day or LOS when compared with non-teaching hospitals. Hospital structural factors Entinostat also were associated with outcome variables; however, the effects were minimal. Table 4 Multilevel GEE regression analysis of inpatient charges per case, inpatient charges per day, LOS, readmission and mortality Discussion In this study, we investigated the performance and efficiency of spine specialty hospitals versus general hospitals and examined the effect of ‘specialty’ hospital designation on hospital operating efficiency. Our data set included spine specialty hospital designation criteria and nationwide inpatient claims in South Korea. Our univariate results showed that charges per inpatient case were lower and LOS were much shorter for specialty hospitals; however, per day charges were higher than other hospitals with the exception of tertiary hospitals.

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