Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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The Financial Performance of Hospitals Belonging to Multi-hospital System : A Comparative Study

네트워크 시스템 병원의 경영성과 : 비교 연구

  • Yoon, Young-Gyu (Korea Health Industry Development Institute) ;
  • Suh, Won-S. (Dep. of Global Healthcare Management, Gachon University)
  • 윤영규 (한국보건산업진흥원) ;
  • 서원식 (가천대학교 글로벌헬스케어경영학과)
  • Received : 2011.10.10
  • Accepted : 2012.03.22
  • Published : 2012.03.31
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Abstract

The purpose of this study is to analyze the performance difference between multi-hospitals and free-standing hospitals. Scholars in industrial economics argue that, due to economies of scale and integration, multi-hospital system may have a better performance compared to freestanding hospitals. The study overturned the hypothesis based on a theory. By analyzing 425 acute-care hospitals in Korea, this research shows that multi-hospital systems and market factors, which have been perceived to be strengths to hospitals, are negatively related to hospitals' financial performance. Specifically, the results showed a better performance of freestanding hospitals compared to multi-hospital systems. Higher labor and administrative cost by multi-hospital system may be the reason for the difference, and it means they are not more effective at cost control. Managers in multi-hospital system, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.

Keywords

References

  1. 건강보험심사평가원. 2009년 건강보험 요양기관 개폐업현황. Available from : URL : http://www.hira.or.kr/common/dummy.jsp?pgmid=HIRAA020045000000.
  2. 김지형, 하호욱, 이해종, 손태용. 종합병원 수익성에 미치는 영향요인 분석. 한국병원경영학회지 2005; 10(3): 45-66.
  3. 대한병원협회. 2008 전국병원명부. 대한병원협회; 2008.
  4. 메디컬투데이. 경기침체 장기화…중소형 병원 연간 4000개 이상 폐업. Available from : URL: http://www.mdtoday.co.kr/mdtoday/index.html?no=155808.
  5. 박재산. Are really multi-hospital organizations more profitable than general hospitals in Korea?. Proceedings of the International Hospital Federation (IHF) 35th World Hospital Congress; 2007.
  6. 서준호. 복합병원조직(Multi-hospital System)의 발전과정과 관리적 과제. 대한병원협회지 1992; 21(7,8): 4-13.
  7. 신영수. 복합병원조직(Multihospital System)의 개념과 전망. 한국가톨릭병원협회지 1985; 16(1): 7-23.
  8. 심재선, 권영대, 강성욱. 의료기관 네트워크의 유형별 성과 및 구축 의향. 보건경제와 정책연구 2006; 12(2): 1-18.
  9. 안희도. 미국 병원의 M&A -미국 의료기관의 복수병원체제와 공동사업을 중심으로-. 한국병원경영학회 추계학술대회 1998; 29-61.
  10. 유승흠. 병원 합동관리제도. 대한병원협회지 1986; 15(1.2): 8-18.
  11. 이윤태, 박재산. 병원경영지원회사(MSO)를 통한 의료기관 네트워크 활성화 방안 연구. 한국보건산업진흥원 2008; 19-138.
  12. 이윤태, 박재산, 김경미. 의료서비스산업 선진화를 위한 정책개발 연구: 의료기관 경쟁력 강화를 위한 효율적 서비스연계체계 방안. 한국보건산업진흥원 2009; 155-167.
  13. 장석철, 안희도, 김성환. 병원 공동사업 발전방안에 관한 연구<상>. 대한병원협회지 1994; 23(11): 31-41.
  14. 장석철, 안희도, 김성환. 병원 공동사업 발전방안에 관한 연구<하>. 대한병원협회지 1994; 23(12): 4-12.
  15. 장현기, 감신, 박재용, 박기수, 한창현, 차병준. 의료기관의 재무성과에 영향을 미치는 요인. 한국병원경영학회지 1999; 4(1):1 47-170.
  16. 조재협. 병원의 설립형태별 관리행태 비교연구[석사학위 논문]. 서울 : 서울대학교 대학원; 1998.
  17. 좌용권, 명희봉, 송태균, 강대욱, 박수범, 윤영규. 2008 병원경영분석. 한국보건산업진흥원 2009; 5-182.
  18. American Hospital Association(AHA). Fast facts on US hospitals. Health Forum 2010.
  19. Bazzoli GJ, Chan B, Shortell SM, D'Aunno T. The financial performance of hospitals belonging to health networks and systems. Inquiry 2000; Fall 37(3); 234-52.
  20. Becker ER, Sloan FA. Hospital ownership and performance. Economic Inquiry 1985; 23: 21-36. https://doi.org/10.1111/j.1465-7295.1985.tb01750.x
  21. Berry DE, Tucker T, Seavey J. Efficacy of system management or ownership as options for distressed small rural hospitals. Journal of Rural Health 1987; 3(2)61-75. https://doi.org/10.1111/j.1748-0361.1987.tb00168.x
  22. Christianson JB, Moscovice IS, Johnson J, Kralewski J, Grogan C. Evaluating rural hospital consortia. Health Affairs 1990; 9(1)135-147. https://doi.org/10.1377/hlthaff.9.1.135
  23. Clement JP, McCue MJ, Luke RD, Bramble JD, Rossiter LF, Ozcan YA, et al. Strategic hospital alliances: Impact of financial performance. Health Affairs 1997; 16(6)193-203. https://doi.org/10.1377/hlthaff.16.6.193
  24. Cleverley WO. Financial and operating performance of systems: Voluntary versus investor-owned. Topics in Health Care Financing 1992; 18(4)63-73.
  25. Coyne JS. Hospital performance in multihospital systems: A comparative study of system and independent hospitals. Health Services Research 1982; 17:303-29.
  26. Coyne JS. Assessing the financial characteristics of multi-instituti-onal organizations. Health Services Research 1985; 19: 701-15.
  27. D'Aunno TA, Zuckerman HS. The emergence of hospital federations: An integration of perspectives from organizational theory. Medical Care Review 1987a; 44: 323-343. https://doi.org/10.1177/107755878704400206
  28. D'Aunno TA, Zuckerman HS. A life-cycle model of organizational federations : The case of hospitals. Academy of Management Review 1987b; 12: 534-45.
  29. Ermann D, Gabel J. Multihospital systems: Issues and empirical findings. Health Affairs 1984; 3(spring)50-64.
  30. Grim SA. Win/Win: Urban and rural hospitals network for survival. Hospital & Health Services Administration 1986; 31(1)33-46.
  31. Halpern MT, Alexander JA, Fennell ML. Multihospital system affiliation as a survival strategy for rural hospitals under the prospective payment pystem. Journal of Rural Health 1992; 8: 93-105. https://doi.org/10.1111/j.1748-0361.1992.tb00334.x
  32. Lee S-YD, Alexander JA. Consequences of organizational change in U.S. hospitals. Med Care Res Rev 1999; 56(3)227-276. https://doi.org/10.1177/107755879905600301
  33. Manheim LM, Shortell SM, McFall S. The effect of investor-owned chain acquisition on hospital expenses and staffing. Health Services Research 1989; 24: 461-84.
  34. Menke, T.J. The effect of chain membership on hospital costs. Health Services Research, 1997; 32: 177-196.
  35. Morrisey MA, Alexander JA. Hospital participation in multihospital systems. Advances in Health Economics and Health Services Research 1987; 7: 59-81.
  36. Pfeffer, J., Salancik, G. The external control of organizations: A resource dependent perspective. 1978. New York: Harper & Law
  37. Renn SC, Schramm CJ, Watt JM, Derzon RA. The effects of ownership and system affiliation on the economic performance of hospitals. Inquiry 1985; 22: 219-36.
  38. Shortell SM. The evolution of hospital systems: Unfulfilled promises and self-fulfilling prophesies. Medical Care Review 1988; 45: 177-214. https://doi.org/10.1177/107755878804500202
  39. Simmons J. Integrating federal health care resources at the local level. Hospital & Health Services Administration 1989; 34(1)113-22.
  40. Smith HL, Piland NF. Strategic adaptations to PPS by rural hospitals: Implications for theory and research. Journal of Rural Health 1990; 6: 140-60. https://doi.org/10.1111/j.1748-0361.1990.tb00196.x
  41. Wegmiller DC. Management issues in the development and maturation of multihospital systems. Health Care Management Review 1985;10(2)9-17. https://doi.org/10.1097/00004010-198501020-00003
  42. Yonek J, Hines S, Joshi M. A guide to achieving high performance in multi-hospital health systems. Health Research & Educational Trust 2010.
  43. Zuckerman HS, Multi-institutional systems: Promise and Performance, Inquiry 1979; 16: 291-314.