Understanding the Utilization of Tertiary Hospitals by Mild Disease Patients: Travel Cost Method Analysis

Seokmin Ji,1,* Sewon Park,2,* Mankyu Choi,1,* Munjae Lee2,* 1Department of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea; 2Department of Medical Science, Ajou University School of Medicine, Suwon, South Korea*These authors contributed equally to this workCorrespondence: Mankyu Choi, Department of Health Policy & Management, College of Public Health Science and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, South Korea, Email [email protected] Munjae Lee, Department of Medical Science, Ajou University School of Medicine, Suwon, South Korea, Email [email protected]: Tertiary hospital utilization for patients with mild diseases creates inefficiencies in medical utilization for medical consumers and providers, collapses the healthcare delivery system, and has negative consequences for the public health system. This study aims to identify the factors that lead to the selection of tertiary hospitals and the medical needs of patients with mild diseases. We evaluate the value of using medical institutions by comparing and analyzing regional and individual patient characteristics.Methods: The travel cost method based on the travel cost incurred according to the consumer’s temporal choice, was used to evaluate the medical use. We considered data from Ajou University Hospital from 2017 to 2022. The variables used for travel costs are travel costs, time costs, and medical costs. The Quantum Geographic Information System(QGIS) network analysis was used to calculate travel costs and time costs, and independent sample t-tests and analysis of variance (ANOVA) were used to compare the evaluated values between groups.Results: The analysis revealed that travel costs were the highest for patients with diabetes. Regarding personal characteristics, men exhibited higher rates than women, and individuals under 65 years of age and those receiving type 2 medical benefits demonstrated higher travel costs. Travel costs and outpatient visit rates for mild diseases exhibited a direct proportional relationship. We compared the total economic value assessed for each type of mild disease and found the highest value for diabetes patients with the highest number of outpatient visits.Conclusion: These findings highlight the importance of incorporating patient segmentation into policy formulation to alleviate the overcrowding of patients with mild diseases in tertiary care hospitals. Furthermore, they advocate adopting a primary care-centered approach to enhance the healthcare delivery system and address imbalances in community healthcare resources.Keywords: tertiary hospitals, healthcare delivery system, healthcare utilization value, Travel cost method, experience demand curve