4% higher; however, the higher per day charge was balanced by 23.5% shorter LOS. Following ‘specialty’ hospital designation, inpatient charges per case declined by 6.6%, because of shorter LOS (1.0%) and lower per day charges (7.6%) than general hospitals of comparable size. Although this study considered only short-term effects of the ‘specialty’ designation, www.selleckchem.com/products/ABT-263.html spine specialty hospitals appeared

to be motivated to reduce their charges. This effect suggests that spine specialty hospitals increased their efficiencies because of their spine specialisation and resulting positive volume outcome relationship.23 24 Therefore, these hospitals were able to reduce overall costs and charge less than other hospitals. This finding also indicates that the ‘specialty hospital’ designation influenced spine specialty hospitals to reduce the financial burden on their patients. Our findings also revealed that specialty hospitals had much shorter LOS for each spine inpatient. This result supports the premise that specialty hospital physicians have more experience due to their sheer volume, which also allows the specialty hospital

to emphasise efficiency by reducing LOS. Shorter LOS for the specialty hospitals was superior to small, mid-sized general hospitals and also was better than tertiary hospitals. However, higher per day charges indicated that specialty hospitals ensure financial viability via high volume and bed turnover. In order to be designated a specialty hospital in Korea, an institution must meet strict institutional requirements, including having a certain number of beds and physicians in addition to operating a specialty medical service department. This process requires a substantial investment by the institution. Since no additional reimbursements or financial subsidies for specialty hospitals exist,

this might only be a marketing strategy, ensuring the institution’s financial viability by increasing its efficiency. In addition, the results of our study also provide empirical research confirming the arguments of opponents of specialty hospitals, who contend that specialty hospitals may provide healthcare services at greater profit or cherry pick patients more than traditional hospitals.6 17 18 20 A higher proportion of low CCL patients and surgery rate may support propositions of opponents. Furthermore, specialty hospitals are most commonly located in metropolitan areas and therefore incur high rent, payroll and other operating costs. Therefore, the Dacomitinib overall operating costs for specialty hospitals are often higher than those for hospitals that are located in non-metropolitan areas.25 This demographic would suggest that specialty hospitals offset their high operating costs by charging more per day for a shorter LOS, thus increasing patient volume and bed turnover. DEA results also indicated that in order for hospitals to achieve operational efficiency, they might have shorter LOS (24.1%) and higher charge per day (22.