An Analysis of Hospital Characteristics Influencing Medical Dispute Costs

Purpose: This study aims to examine the influence of hospitals’ institutional characteristics on the occurrence and magnitude of medical dispute costs.Methods: A panel dataset of 285 hospitals was constructed using 2019–2022 data from the Health Insurance Review and Assessment Service and publicly disclosed financial statements. The dependent variable was medical dispute costs, measured at the hospital level (total costs) and the specialty level (costs per specialist). Independent variables included specialty characteristics, hospital quality grades, and competition indicators. Control variables included ownership type, hospital level, region, number of beds, and nursing grade. Due to the semi-continuous nature of the cost data, we applied a two-part model.Results: Medical specialties involving surgical or life-saving interventions were significantly associated with a higher occurrence of dispute costs, particularly in orthopedics (OR=1.11, <i>p</i><.05), obstetrics and gynecology (OR=1.08, <i>p</i><.05), and emergency medicine (OR=1.15, <i>p</i><.001). In emergency medicine, staffing sufficiency was negatively associated with the magnitude of dispute costs (β = −0.049, <i>p</i>=.006). After controlling for hospital size and adjusting dispute costs per specialist, higher grades in cancer care, patient experience, and nursing were associated with reduced magnitudes of dispute costs. Regionally, hospitals outside Seoul tended to have higher magnitudes of dispute costs, suggesting geographic disparities in healthcare quality.Conclusion: This study highlights a potential link between healthcare quality and medical dispute costs, as reflected in national evaluation metrics. Reducing regional disparities in staffing and facilities is essential for improving healthcare quality and mitigating disputes. These findings provide valuable evidence for future hospital operations and policy planning.