# Comparative Financial Implications of Outpatient and Inpatient Service of the Psychiatric Department in General Hospital during the COVID-19 Pandemic in Taiwan: Case Report

## TL;DR

This study examines how outpatient and inpatient psychiatric services in a Taiwanese hospital affected finances during the pandemic, finding that outpatient visits boosted profits while inpatient care increased costs.

## Contribution

The study provides empirical evidence on the financial impact of outpatient versus inpatient psychiatric services during the pandemic in a Taiwanese hospital setting.

## Key findings

- Outpatient visits increased medical revenue by 82 USD and gross profit by 72 USD per visit.
- Inpatient days increased medical revenue by 70 USD but also raised costs by 59 USD per day.
- Inpatient services led to higher costs and less profitability compared to outpatient services.

## Abstract

The COVID-19 pandemic has stressed global healthcare systems, with Taiwan’s National Health Insurance (NHI) playing a crucial role in prevention and treatment. Like other countries, Taiwan grappled with managing the virus alongside regular healthcare services, resulting in notable financial strain on hospitals after COVID-19 pandemic.

This study explores the financial implications of the psychiatric department at a medical center in Taiwan, highlighting the changing dynamics of healthcare costs and revenue during this period.

Data were collected monthly between January 2020 and September 2022, including the number of outpatient visits, inpatient patient-days, medical revenue, medical costs, and gross medical profit. Multivariate linear regression analysis confirmed the assumptions of the model and validated the findings.

Regression analysis revealed a significant correlation between the number of patients and financial indicators (USD1). Medical revenue (Table. 1), grew by 82 USD for each outpatient visit(p<0.001, 95% CI:41–122), and grew by 70 USD for each inpatient-days(p=0.001, 95% CI:31–108). Medical costs (Table. 2), increased by 59 USD for every inpatient-days (p=0.01, 95% CI:15–102). Finally, the gross medical profits (Table. 3) increased by 72 USD for each outpatient visit (p=0.003, 95% CI:27–117).Table 1.Multiple linear regression analysis of the impact of medical service on medical revenue.RevenueCoef.SEt
p
[95% Conf. Interval]Outpatient (Visits)82204.136.00041122Inpatient (Patient Days)70193.664.00131108

Table 2.Multiple linear regression analysis of the impact of medical service on medical cost.CostCoef.SEt
p
[95% Conf. Interval]Outpatient (Visits)9220.422.676-3655Inpatient (Patient Days)59212.757.01015102

Table 3.Multiple linear regression analysis of the impact of medical service on medical gross profit.Gross ProfitCoef.SEt
p
[95% Conf. Interval]Outpatient (Visits)72223.261.00327117Inpatient (Patient Days)11210.501.620-3354
1All values were converted from TWD to USD using the rate as of 2023/08/15.In summary, outpatient visits significantly augmented revenue and gross profit, whereas inpatient days led to heightened revenue and costs.

Multiple linear regression analysis of the impact of medical service on medical revenue.

Multiple linear regression analysis of the impact of medical service on medical cost.

Multiple linear regression analysis of the impact of medical service on medical gross profit.

1All values were converted from TWD to USD using the rate as of 2023/08/15.

In summary, outpatient visits significantly augmented revenue and gross profit, whereas inpatient days led to heightened revenue and costs.

During the COVID-19 outbreak, healthcare systems, including those in Taiwan, were tested for unparalleled service challenges. This study found that while outpatient services boosted profits, rising inpatient admissions strained finances, given their higher costs and staffing needs. After the pandemic, psychiatric departments should reconsider resource allocation to balance expenses and revenues. Effective management is crucial for patient outcomes, emphasizing the need for quality care and fiscal control. Future research must focus on fortifying healthcare resilience.

None Declared