Journal of the Korean Operations Research and Management Science Society (한국경영과학회지)

The Korean Operations Research and Management Science Society (한국경영과학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Rival Hospitals on the Number of Patients in a Tertiary Hospital

공간분석기법을 이용한 경쟁병원이 병원내원 환자 수에 미치는 영향 분석

  • 이광수 (연세대학교 보건과학대학 보건행정학과) ;
  • 최영진 (을지대학교 보건산업대학 의료경영학과)
  • Received : 2012.10.15
  • Accepted : 2012.11.30
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study purposed to evaluate the influences of rival hospitals on the number of patients who visited the a study territory hospital. Spatial analysis technique was used to measure the impact of rival hospitals in study region. Selected hospitals were all medical school affiliated hospitals which were located in Daejeon metropolitan city and Chungchungnamdo. Patient data was collected from the claims data of the study hospital, and the number of inpatient and outpatients who visited the study hospital between January and June in 2008 were calculated on the smallest administrative district, Eup, Myeon, and Dong, in study region. To control the differences of regional characteristics among Eup, Myeon, Dong, socio-economic variables (total population, number of people aged over 65, number of basic livelihood security recipients, distance from the study hospital to the centroid point of each Eup, Myeon, Dong, number of business, and number of employees) were included in analysis model. These variables were collected from the annual year book of city as well as county located in study region. Cluster analysis classified the study region into three groups by using the difference of between th actual number of inpatient/outpatient and the predicted number of inpatient/outpatient in Eup, Myeon, and Dong. Most areas around the rivalry hospitals were categorized into same group. Multiple regression analysis indicated that areas around rivalry hospitals had statistically significantly negative relationship with the number of inpatients and outpatients who visited the study hospital. As the buffer size was increased from 5Km to 10Km, the standardized regression coefficients were decreased. These study results confirmed that rivalry hospitals in region had negative impacts on the performance of hospitals. It suggests that hospitals will require not only to select their location to minimize the effects of rivalry hospitals, but also to establish their strategy to cope with the rivalry's threats in their region.

Keywords

References

  1. 김선희, GIS를 이용한 입원환자의 지리적 접근성 분석, 연세대학교 보건대학원, 2006.
  2. 김춘배, 우리나라 의사의 지역적 분포에 관한 연구, 연세대학교 대학원, 1996.
  3. 대한병원협회, 2011 전국명원명부, 대한병원협회, 서울
  4. 송지준, 논문작성에 필요한 SPSS/AMOS 통계분석방법, 21세기사, 2011.
  5. 배화수, 조대현, 석경하, 김병수, 최국렬, 이종언, 노세원, 이승철, 손용희, SAS Enterprise Miner를 이용한 데이터마이닝, 교우사, 서울, 2004.
  6. 양봉민, 보건경제학, 나남, 2007.
  7. 이건세, "지리적 접근성을 이용한 도시지역 보건지소의 입지선정", 예방의학회지, 제29권, 제2호(1996), pp.216-218.
  8. 이광수, 이정수, "공간분석 모델링을 이용한 병원의 적지평가 모형 개발", 한국콘텐츠학회, 제9권, 제10호(2009), pp.258-267.
  9. 이광수, 전기홍, 이정수, 황성완, 공간분석에 기초한 건강보험 병원서비스 이용권역 측정 모형 개발, 국민건강보험공단, 서울, 2011.
  10. 이광수, 홍상진, "한방병원의 입지특성과 내원 환자 규모 간의 관계에 관한 연구", 보건행정학회지, 제20권, 제4호(2010), pp.96-112.
  11. 조우현, 김한중, "소규모 지역간 의료이용 차이에 관한 문헌고찰," 보건행정학회지, 제1권, 제1호(1991), pp.42-53.
  12. 최용환, 의료서비스 이용자의 선호행태에 관한 연구, 성균관대학교 대학원, 2001.
  13. Anderson, J.G., "Demographic factors affecting health services utilization：a causal model," Medcare, Vol.11, No.2(1973), pp.104-120.
  14. Anderson, T.F. and G. Mooney, The challenges of medical practice variations, McGillan Press, London, 1990.
  15. Barney, J.B. and W.S. Hesterly, Strategic management and competitive advantage： concepts and cases, Pearson Education, New Jersey, 2010.
  16. Basu, J. and L.R. Mobley, "Impact of local resources on hospitalization patterns of Medicare beneficiaries and propensity to travel outside local markets," J Rural health, Vol. 26, No.1(2010), pp.20-29. https://doi.org/10.1111/j.1748-0361.2009.00261.x
  17. Benjamin, A.E., "Determinants of state variations in home health utilization and expenditures under Medicare," Med care, Vol.24, No.6(1986), pp.535-547. https://doi.org/10.1097/00005650-198606000-00008
  18. Bombardier, C., "Socioeconomic factors affecting the utilization of surgical operations," N Engl J Med, Vol.297, No.13(1977), pp.699-705. https://doi.org/10.1056/NEJM197709292971305
  19. Carey, K., J.F. Burgess, and G.J. Young, "Single specialty hospitals and service competition," Inquiry, Vol.46, No.2(2009), pp.162-171. https://doi.org/10.5034/inquiryjrnl_46.02.162
  20. Chassin, M.R., R.H. Brook, R.E. Park, J. Keesey, A. Fink, J. Kosecoff, K. Kahn, N. Merrick, and D.H. Solomon, "Variations in the use of medical and surgical services by the Medicare population," N Engl J Med, Vol.314, No.5(1986), pp.285-290. https://doi.org/10.1056/NEJM198601303140505
  21. Darthmouth Medical School Center for the Evaluative Clinical Sciences, The Dartmouth Atlas of the Health Care, Amer Hospital Pub. 1996.
  22. Feldstein, P.J., Health care economics, 3rd Ed. A Wiley Medical Publication, New York, 1988.
  23. Folland, S., A.C. Goodman, and M. Stano, The economics of health and health care, 2nd Ed. Prentice Hall, 1997.
  24. Ginsburg, P.B., "Wide variation in hospital and physician payment rates evidence of provider market power," Res Brief, No.16(2010), pp.1-11.
  25. Boscarino, J. and S.R. Steiber, "Hospital shopping and consumer choice," J Health care Mark, Vol.2, No.2(1982), pp.25-34.
  26. Lesser, C.S., P.B. Ginsburg, and K.J. Devers, "The end of an era：what became of the 'managed care revolution' in 2001?," Health Serv Res, Vol.38, No.1(2003), pp.337-355. https://doi.org/10.1111/1475-6773.00119
  27. Lindrooth, R.C., A.T. Lo Sasso, and G.J. Bazzoli, "The effect of urban hospital closure on markets," J Health Econ, Vol.22, No.5 (2003), pp.691-712. https://doi.org/10.1016/S0167-6296(03)00060-2
  28. Luke, R.D., "Spatial competition and cooperation in local hospital markets," Med Care Rev, Vol.48, No.2(1992), pp.207-237.
  29. Luke, R.D., Y.A. Ozcan, and P.C. Olden, "Local markets and systems：hospital consolidation in metropolitan areas," Health Serv Res, Vol.30, No.4(1995), pp.555-575.
  30. Mccue, M.J. and M.L. Diana, "Assessing the performance of freestanding hospitals," J Healthc Manag, Vol.52, No.5(2007), pp.299-307. https://doi.org/10.1097/00115514-200709000-00005
  31. McLaughlin, C.G., "HMO growth and hospital expenses and use：a simultaneous-equation approach," Health Serv Res, Vol.22, No.2 (1987), pp.183-205.
  32. Mitropoulos, P., I. Mitropoulos, I. Giannikos, and A. Sissouras, "A biojective model for the locational planning of hospitals and health centers," Health Care Manag Sci, Vol.9, No.2 (2006), pp.171-179. https://doi.org/10.1007/s10729-006-7664-9
  33. Pham, H.H., K.J. Devers, S. Kuo, and R. Berenson, "Health care market trends and the evolution of hospitalist use and roles," J Gen Intern Med, Vol.20, No.2(2005), pp.101-107. https://doi.org/10.1111/j.1525-1497.2005.40184.x
  34. Porter, M.E, "How competitive forces shape strategy," Harv Bus Rev, Vol.57(1979), pp. 137-156.
  35. Porter, M.E., Competitive strategy：techniques for analyzing industries and competitors. The Free Press, New York, 1980.
  36. Wennberg, J.E. and A. Gittelsohn, "Small area variations in health care delivery," Science, Vol.182, No.4117(1973), pp.1102-1108. https://doi.org/10.1126/science.182.4117.1102
  37. Wilson, P., "Hospital use by the aging population," Inquiry, Vol.18, No.4(1981), pp.332-344.
  38. Wilson, P. and P. Tedeschi, "Community correlates of hospital use," Health Serv Res, Vol.19, No.3(1984), pp.333-355.
  39. Zwanziger, J. and C. Mooney, "Has competition lowered hospital prices?," Inquiry, Vol. 42, No.1(2005), pp.73-85. https://doi.org/10.5034/inquiryjrnl_42.1.73

Cited by

  1. Complex relationship between Hospital management performance and the degree of the regional competition (Focusing on the Regional Public Hospital) vol.13, pp.10, 2015, https://doi.org/10.14400/JDC.2015.13.10.405