소아청소년과 의원의 수익 감소가 폐업에 미치는 영향 (The Impact of Declining Profits on Closures of Pediatric Clinics)

서지정보

· 발행기관 : 한국보건행정학회
· 수록지 정보 : 보건행정학회지 / 34권 / 1호 / 38 ~ 47페이지
· 저자명 : 오정윤, 조수진, 변현정, 박춘선, 조진숙

초록

Background: Korea’s population of children and adolescents has decreased by 2.88 million over the past decade and is expected to declinefurther due to the unprecedented low birth rate. In the fee-for-service compensation system, the decline in the pediatric population relatesdirectly to the profit decrease in the pediatric clinics. This study analyzed whether the worsening profits of pediatric clinics impacted their closure.
Methods: We built annual data for pediatric and other department clinics (internal medicine, otolaryngology, and family medicine) using thestatus of medical institute and health insurance claims data from 2012 to 2022. Then, we analyzed whether institutional variables such as annualprofit and regional variables (Herfindahl-Hirschman index, the number of clinics per 100,000, etc.) affected the closure of clinics. The methods usedin this study are descriptive statistics and chi-square analysis. Odds ratios for each variable were estimated by generalized estimating equations (GEE).
Results: The closure rate of pediatric clinics was 2.66%–7.04% in 2012–2022, which was consistently higher than those of internal medicine,otolaryngology, and family medicine clinics. The profit gap per institution between the pediatric and the other clinics grew from 126 million won in2012 to 245 million won in 2019. In the GEE analysis, profit decrease compared to the previous year with lower profit was the main factor thatincreased the closure of pediatric and other department clinics. After adjusting profit-related variables, the decrease in the pediatric populationitself did not relate to the closure of pediatric clinics. The number of pediatric clinics or monopolies also did not affect the closure of pediatric clinics.
Conclusion: The worsening profit is the crucial factor for the closure of pediatric clinics, while the pediatric population is decreasing. For thisreason, it is necessary to actively seek ways to maintain a stable treatment system for children and adolescents.

영어초록

Background: Korea’s population of children and adolescents has decreased by 2.88 million over the past decade and is expected to declinefurther due to the unprecedented low birth rate. In the fee-for-service compensation system, the decline in the pediatric population relatesdirectly to the profit decrease in the pediatric clinics. This study analyzed whether the worsening profits of pediatric clinics impacted their closure.
Methods: We built annual data for pediatric and other department clinics (internal medicine, otolaryngology, and family medicine) using thestatus of medical institute and health insurance claims data from 2012 to 2022. Then, we analyzed whether institutional variables such as annualprofit and regional variables (Herfindahl-Hirschman index, the number of clinics per 100,000, etc.) affected the closure of clinics. The methods usedin this study are descriptive statistics and chi-square analysis. Odds ratios for each variable were estimated by generalized estimating equations (GEE).
Results: The closure rate of pediatric clinics was 2.66%–7.04% in 2012–2022, which was consistently higher than those of internal medicine,otolaryngology, and family medicine clinics. The profit gap per institution between the pediatric and the other clinics grew from 126 million won in2012 to 245 million won in 2019. In the GEE analysis, profit decrease compared to the previous year with lower profit was the main factor thatincreased the closure of pediatric and other department clinics. After adjusting profit-related variables, the decrease in the pediatric populationitself did not relate to the closure of pediatric clinics. The number of pediatric clinics or monopolies also did not affect the closure of pediatric clinics.
Conclusion: The worsening profit is the crucial factor for the closure of pediatric clinics, while the pediatric population is decreasing. For thisreason, it is necessary to actively seek ways to maintain a stable treatment system for children and adolescents.

참고자료

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