한국의료질향상학회지 (Quality Improvement in Health Care)

  • 제24권2호
  • /
  • Pages.62-75
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  • 2018
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  • 1225-7613(pISSN)
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  • 2288-078X(eISSN)
한국의료질향상학회 (Korean Society for Quality in Health Care)
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Public Reporting of Hospital Level Surgical Volumes: Its Influence on Patient Behavior

  • Han, Kyu-Tae (Division of Cancer Management, National Cancer Center) ;
  • Park, Eun-Cheol (Institute of Health Services Research, Yonsei University College of Medicine) ;
  • Nam, Chung-Mo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Tae-Hyun (Institute of Health Services Research, Yonsei University College of Medicine) ;
  • Hahm, Myung-Il (Department of Health Administration and Management, Soonchunhyang University) ;
  • Lee, Sang-Gyu (Institute of Health Services Research, Yonsei University College of Medicine)
  • 투고 : 2018.11.28
  • 심사 : 2018.12.30
  • 발행 : 2018.12.31
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초록

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

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참고문헌

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