Association between re-admission rate and hospital characteristics for ischemic heart disease

OBJECTIVE: Hospital re-admission is considered an important marker of patient health outcomes and healthcare system performance. Korea introduced the Korean Diagnosis Procedure Combination (KDPC) for all regional public hospitals in July 2012. This study examined re-admission rates within 30 days to assess whether the hospital payment system is associated with the re-admission rate, focusing on ischemic heart disease. METHODS: A cross-sectional study was conducted using national claims data for 2013. We analyzed data of patients with a major diagnosis of ischemic heart disease who were admitted to general hospitals with more than 500 beds in Korea. Of the eight general hospitals, two that have been operating under the new Korean payment system were public hospitals using the KDPC, and the remaining six were private general hospitals with fee for service (FFS) systems. Multiple logistic regression analysis was used to identify associations between re-admission rate and hospital characteristics. RESULTS: The study analyzed 4,290 cases (889 cases in KDPC and 3,401 cases in FFS). The 30-day unplanned re-admission rate was higher in KDPC than in FFS (7.9% vs 5.6%, respectively). The unplanned re-admission odds ratios of KDPC was 1.74. CONCLUSIONS: KDPC had higher 30-day unplanned re-admissions rates than did FFS.