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Estimation of cost by unnecessary readmission of the tertiary hospitals

불필요한 재입원 비용 추정에 관한 연구

  • Shin, Min Sun (Department of Healthcare Management, Gachon University) ;
  • Lee, Won Jae (Department of Healthcare Management, Gachon University)
  • 신민선 (가천대학교 헬스케어경영학과) ;
  • 이원재 (가천대학교 헬스케어경영학과)
  • Received : 2017.10.11
  • Accepted : 2017.12.20
  • Published : 2017.12.28

Abstract

Unnecessary readmissions could be the result of the inadequate and unnecessary treatments. Adequate quality indicators for readmission are important because they can identify inadequate spending by inpatients as well as quality screening. This study attempted to estimate the cost incurred by unnecessary readmissions. The Health Insurance Claims Data of 18 years or older who were admitted in the tertiary hospitals in 2014 were analyzed. Admissions and readmissions were sorted and readmissions were classified into planned and unplanned readmissions. We adopted 28 days as a criteria for the classification of the readmission. Proportion of the patients were higher in readmissions among cancer, accompanied diseases, and special rehabilitation patients. Cost of the readmissions were 50% of the total cost of the admission among the patients of same diseases, same departments, and same hospitals. Almost 1,000billion Won were used by the unnecessary readmissions. We need to reduce the readmissions in regions, departments, and diseases studying the pattern of the readmissions. National level efforts are required to improve quality of care and reduce cost by the unnecessary readmissions.

Keywords

readmission;unnecessary readmission;healthcare insurance;admission cost;convergence

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