The Relationship between Medical Operating Income and Volume of Medical Services Provided at General Hospitals in Korea

종합병원에서 진료량과 의료이익의 관계

  • Lim, Min Kyoung (Health Insurance Research Institute, National Health Insurance Service) ;
  • Kim, Jeongha (Health Insurance Research Institute, National Health Insurance Service) ;
  • Kim, Sunjea (Health Insurance Research Institute, National Health Insurance Service)
  • 임민경 (국민건강보험공단 건강보험연구원) ;
  • 김정하 (국민건강보험공단 건강보험연구원) ;
  • 김선제 (국민건강보험공단 건강보험연구원)
  • Received : 2021.05.25
  • Accepted : 2021.08.31
  • Published : 2021.09.30

Abstract

Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.

Keywords

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