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How the separation reform impact on outpatient visits to tertiary hospital in Korea

Tae-Yong Sohn, PhD1, Jong-Deuk Baek, PH D2, Yunho Jeon, MS1, and Dong-Young Cho, MS3. (1) School of Public Health, Health Services Policy and Management, University of South Carolina, 800 Sumter, Columbia, SC 29208, (2) Health Services Policy and Management, University of South Carolina, 800 Sumter, columbia, SC 29208, 803-777-2772, baekj@mailbox.sc.edu, (3) Samsung Medical Center, 50 ilwon-dong kangnam-gu, Seoul, 135-710, South Korea

Purpose: The purpose of this study is to see if there are changes in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare policy that divides the roles of doctors from those of pharmacists and try to investigate its implication to the financial performance of tertiary hospitals.

Data: Two tertiary care hospitals with large capacity of 1200 beds and two tertiary care hospitals with middle capacity of 600-700 beds were randomly selected from hospitals in Seoul and Kyunggi province. The outpatient visits from March-May 2000, before the healthcare reform was implemented, were compared with those from March-May 2001, after the reform.

Methods: Descriptive Analyses are used to summarize outpatient visits before and after the reforms in terms of socio-demographic variables. Changes in major acute and chronic diseases are investigated to see the number of patients by the disease categories. Several variables about prescription, an outpatient prescription rate and an antibiotic prescription rate, are calculated to see the change in the pattern of prescription. Finally variables about outpatient profit per day per patient are analyzed to see the profit change due to the reform.

Results: Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. The re-visits are decreased much more than the first visits. Female patients are less likely to have outpatient visits than their counterpart. Those who actively participated in economic activities with age ranged from 25 to 44 showed a large decline in outpatient visits to tertiary hospitals. Additionally, outpatient revenue of tertiary hospitals has dropped by 14.7% due to the decline of outpatient income, the lost of pharmaceutical income, and the resell price system that has caused the hospital financial deficits. While the reform has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs.

Recommendation and Implication: It may be too early to see the real change in outpatient visits but the findings of this study provides an implication on the initial impact of the reform and can be a reference to other studies.

Learning Objectives:

Presenting author's disclosure statement:

Not Answered

Contemporary Issues in Health Care Reform

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA