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- Predicting hospital bankruptcy in Korea.
- M S Lee, Y J Seo
- Korean J Prev Med. 1998;31(3):490-502.
- 2,388 View
- 35 Download
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Abstract
PDF - This study purports to find the predictor of hospital bankruptcy in Korea and to examine the predictive power of the discriminant function model of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 31 bankrupt and 31 profitable hospitals of 1, 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the discriminant function model of hospital bankruptcy was developed. The major findings are as follows : 1. As for profitability indicators, net worth to total assets, operating profit to total capital, operating profit ratio to gross revenues, normal profit to total assets, normal profit to gross revenues, net profit to total assets were significantly different in mean comparison test in 1, 2, and 3 years before hospital bankruptcy. With regard to liquidity indicators, current ratio and quick ratio were signifiant in 1 year before bankruptcy. For activity indicators, patients receivable turnover was significant in 2 and 3 years before bankruptcy and added value per adjusted inpatient days was significant in 3 years before bankruptcy. 2. The discriminant function in 1, 2, and 3 years before bankruptcy were; Z=-0.0166Xquick ratio - 0.1356Xnormal profit to total assets - 1.545 x total assets turnarounds in 1 year before bankruptcy, Z=-0.0119Xquick ratio - 0.1433Xoperating profit to total assets - 0.0227Xvalue added to total assets in 2 years before bankruptcy, and Z=-0.3533Xnet profit to total assets - 0.1336Xpatients receivables turnrounds - 0.04301Xadded value per adjusted patient + 0.00119Xaverage daily inpatient census in 3 years before bankruptcy.3. The discriminant function's discriminant power in 1, 2, and 3 years before bankruptcy was 77.42, 79.03, 82.25% respectively.
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Summary
- A methodological study on simplifying claims review system in medical insurance.
- Suk Il Kim, Hyung Gon Kang, Han Joong Kim, Young Moon Chae, Myongsei Sohn, Myung Keun Lee
- Korean J Prev Med. 1995;28(3):640-650.
- 2,371 View
- 22 Download
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Abstract
PDF
- After the introduction of National Medical Insurance in 1989, the medical demand has rapidly increased. The impact of increased medical demand was followed by an increase in the number of claims in need of review. We studied a new, fair method for reducing the number of claims reviewed. we analysed 90,583 outpatient claims submitted between september and october; claims were made for services given August of 1994. We finally suggested a screening system for claims review using a statistical method of discriminant analysis of the medical costs. The results were as follows. 1. In the cut-off group, age, days of medication, number of hospital or clinic visits, and total change were significantly high The cut-off rates according to the hospital-type and existence of accompanied disease were significantly different. 2. According to ICD, the cut-off rate was highest in peripheral enthesopathies and allied syndromes(20.76%), lowest in acute sinusitis(0.93%). The mean charges were significantly different according to ICD and existence of cut-off. 3. we build discriminant functions by ICD with such discriminant variables as patient age, sex, existence of accompanied disease, number of hospital or clinic visits, and 9 detailed hospital or clinic charges included in claim. 4. we applied the discriminant function for screening those claims that were expected to be cut-off. The sensitivities comprised from 40% to 70%, and specificities from 70% to 95% by ICD. Acute rhinitis had highest sensitivity(100.00%)and other local infections of skin and subcutaneous tissue had highest specificity(98.45%). The excepted number of cut-off was 17,762(19.61%). The total sensitivity was 49.62%, the total specificity was 82.57% and the error rate was 19.66%. We lacked economic analysis such as cost-benefit analysis. But, if the few method of screening claims using discriminant analysis were applied, the number of claims in need of review will reduce considerably.
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