农村医院服务项目:随时间推移的变化及其对盈利能力的影响。

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Journal of Healthcare Management Pub Date : 2024-09-01 Epub Date: 2024-09-06 DOI:10.1097/JHM-D-24-00012
Brian E Whitacre, Claudia A Rhoades, Alison F Davis
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引用次数: 0

摘要

目标:记录 2010 年至 2021 年间乡镇医院服务项目的变化,并评估其对医院盈利能力的影响:我们使用了所有在 2010 年至 2021 年间未改变支付分类的乡镇医院的年度医疗保险成本报告数据。我们记录了提供数据中 37 个住院或辅助服务项目的医院所占百分比的变化。然后,我们使用面板事件研究来评估在此期间变化最显著的特定服务项目对医院营业利润的影响:在我们的分析期间,有 12 个服务项目的变化幅度超过了 5%。主要发现:在我们的分析期间,有 12 项服务项目的变化幅度超过了 5%,其中最突出的是医院增加了农村医疗诊所(+32%)和 CT 扫描(+20%),取消了产房(-21%)和专业护理设施(-19%)。小组事件研究表明,增加或减少大多数服务项目对医院未来的经营利润率并无统计学意义上的显著影响。值得注意的例外情况是增加了农村医疗诊所和取消了分娩服务,这两项都对未来的运营利润率产生了积极影响。增加职业治疗服务对近期运营利润率有积极影响,但增加核磁共振成像服务则有消极影响:实际应用:研究发现,只有少数服务项目的改变对医院的运营利润率产生了有意义的影响,这表明医院领导者在实施此类改变作为改善财务可行性的手段时应保持警惕。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rural Hospital Service Lines: Changes Over Time and Impacts on Profitability.

Goal: To document shifts in rural hospital service line offerings between 2010 and 2021 and to assess the resulting impacts on hospital profitability.

Methods: We used annual Medicare cost report data for all rural hospitals that did not change payment classifications between 2010 and 2021. We documented changes in the percentages of hospitals offering each of the 37 inpatient or ancillary service lines included in the data. We then used panel event studies to assess effects on hospital operating margin for specific service lines that changed most prominently during this period.

Principal findings: Twelve service lines changed by more than 5% during our period of analysis. These are highlighted by hospitals adding rural health clinics (+32%) and CT scans (+20%) and removing delivery rooms (-21%) and skilled nursing facilities (-19%). Panel event studies demonstrated that the addition or subtraction of most services did not have statistically significant impacts on future hospital operating margins. Notable exceptions were the addition of rural health clinics and the removal of delivery services, both of which positively affected future operating margins. The addition of occupational therapy services had a positive effect on operating margin in the near term, but adding MRI services had a negative effect.

Practical applications: The finding that only a select few service line changes resulted in meaningful impacts to hospital operating margins suggests that hospital leaders should be wary of implementing such changes as a means of improving financial viability.

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来源期刊
Journal of Healthcare Management
Journal of Healthcare Management HEALTH POLICY & SERVICES-
CiteScore
2.00
自引率
5.60%
发文量
68
期刊介绍: The Journal of Healthcare Management is the official journal of the American College of Healthcare Executives. Six times per year, JHM offers timely healthcare management articles that inform and guide executives, managers, educators, and researchers. JHM also contains regular columns written by experts and practitioners in the field that discuss management-related topics and industry trends. Each issue presents an interview with a leading executive.
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