Factors Affecting of Relevance Index of the Regional Public Hospital: Focused on Refined Diagnosis-Related Group Impacts / 보건행정학회지

ABSTRACT

BACKGROUND@#An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI.@*METHODS@#Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects.@*RESULTS@#The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=−2.554, p<0.05), and the population of regional public hospital location (t=−2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=−1.322, total effect=−0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05).@*CONCLUSION@#It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.