INFLUENCE OF OUTPATIENTS WITH MILD DISEASES TO THE PERFORMANCE OF LARGE HOSPITALS
Method(s): The data used in the analysis were derived from the health insurance claim of medical expenses of outpatients collected from 84 hospitals with more than 200 beds belonging to National Hospital Organization. Totally 106,496 outpatient visits of the hospitals on September 30, October 2 and 4 in 2013 were analyzed. Outpatients (2,119,357 individuals) who visited between April 1 in 2013 and March 31 in 2014 were also analyzed. In this study, ‘patients with mild diseases’ were defined as patients whose treatment items were restricted within injections, medication, prescription, rehabilitation and psychiatric treatment, excluding the medication of anticancer drugs.
Result(s): 1) According to the consultation based analysis, consultations with mild diseases shared 39,458 (37.05%) and those not restricted within mild diseases shared 67,038 (62.95%). From the viewpoint of hospital size, consultation with mild diseases shared 42.0% among hospitals of 200-299 beds, while 34.7% and 34.5% among hospitals of 400-499 and 500- beds, respectively, showing statistically significant difference (p<0.05). The total amount of income from patients with mild diseases were 219,823,520 yen, constituting 13.4% of the total income.
2) According to the individual based analysis, the average times of consultations in a year was 4.11 (SD=5.53) and the patients whose number of all consultations were less than or equal to 12 were 94.76%. The patients reached 15.91% whose consultations were all those of mild diseases. There was no significant association between the number of all consultations and the number of mild disease consultations.
Conclusion(s): Consultation based analysis revealed approximately 40% of consultations were those of mild diseases without significant contribution to the income of hospitals. Viewing from individual base, 16% of the patients were those whose consultations were restricted within mild diseases. It was suggested that large hospitals can concentrate more on inpatients by the decrease of the numbers of outpatients realized by the enhancement of hospital-clinic coordination without significant reduction of income.