Redefine Regional Health Care Competition Boundary: A Cluster Model of Hospital Utilization

• Main Authors: WU, CHUAN-SONG, 吳傳頌
• Other Authors: Liu, Chih-Kuang
• Format: Others
• Language: en_US
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/92740300048374791294

博士 === 輔仁大學 === 商學研究所博士班 === 105 === Objectives: The aim of this study is to redefine the regional competition boundary of medical care services area and calculate the HHI of hospital to explore the hospital utilization. Methods: This study used the Longitudinal Health Insurance Database 2005 between January 2000 and December 2002. First, we collected the locations of healthcare visits for patients to define the district by administrative region and NHI Branch. Second, we divide the locations of the medical institutions into medical center, district hospital, or reginal hospital. Third, we depended on GIS, GPS, and the average expenditures per year for each inpatient. Fourth, we distinguish several market areas of health care services by cluster analysis. Next, we analyze the data by cluster algorithm. And then, we used HHI to measure the hospital competition. Last, we test the different between the district and HHI. Results: In this year, 18 hospitals are medical center and 78 hospitals are regional hospital were included. Also, 352 administrative divisions in Taiwan have medical records which excluded Penghu, Lienchiang and Kinmen. We used 18 indices mentioned above to determine the number of clusters. The top 2 most voted clusters in each dissimilarity matrix and and also choose 6 clusters as general refer to primary medical area from Ministry of Health and Welfare (MOHW) of Taiwan were used to partitioning the service area.