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J Prev Med Public Health > Volume 43(6); 2010 > Article
Journal of Preventive Medicine and Public Health 2010;43(6): 523-534. doi: https://doi.org/10.3961/jpmph.2010.43.6.523
The Change in Readmission Rate, Length of Stay and Hospital Charge after Performance Reporting of Hip Hemiarthroplasty.
Won Mo Jang, Sang Jun Eun, Pilyoung Sagong, Chae Eun Lee, Moo Kyung Oh, Juhwan Oh, Yoon Kim
1Department of Health Policy and Management, Seoul National University College of Medicine, Korea. yoonkim@snu.ac.kr
2Department of Preventive Medicine, Keimyoung University College of Medicine, Korea.
3Institute of Health Policy and Management, Medical Research Center, Seoul National University, Korea.
ABSTRACT
OBJECTIVES: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. METHODS: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume(over 16 operations in a year) and low volume institutions, after performance reporting (december 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. RESULTS: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p=0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25-0.95) and 10% (beta=-0.102 p<0.01) and cost was not changed (beta=-0.01, p<0.27). The high volume institutions were more decreased than low volume in length of stay. CONCLUSIONS: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginal shifted from low volume institutions to high volume institutions.
Key words: Performance reporting; Hip arthroplasty program evaluation; Quality of healthcare
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