We achieved both industrialization and democratization during the shortest period in the world. We also achieved good performance in national health insurance: universal coverage, solidarity in financing, equitable access of health care. However, national health insurance system has faced the problem of sustainability: various expenditure and financing problems. The problem of sustainablity has two facets of economic sustainability and fiscal sustainability. Economic sustainability refers to growth in health spending as a proportion of gross domestic product(GDP). Rapid increasing rate of health spending exceeds the growth rate of domestic product. Growth in health spending is more likely to threaten other areas of economic activity. Concern on fiscal sustainability relates to revenue and expenditure on health care. Health care financing face demographic and technical obstacles. Democratic obstacle is aging problem. Technical obstacle is collection of contribution. Expenditure of health care has various problems in benefit structure and efficiency of health care system. In this article, I suggest several policy reforms to enhance sustainability: generating additional revenue from value added tax, changing method of levying contribution, increasing efficiency of health care system by introducing the competition principle. restructuring of benefit scheme of health insurance. contracting with health care institutions to provide health care services.

The purpose of this study is to investigate the intention to utilize u-healthcare services in Korea. Specifically, this study attempted to identify the relationships among the intention to use u-healthcare, consumer's demographic characteristics, and personal information technology level. We conducted telephone interview and collected data from 406 householders 20 years old or older. The results showed significant differences in use intention of u-healthcare service by innovation, gender, and their interaction term. Residence area and average time of internet use had significant effect on the use intention of u-healthcare service. Also, the interaction term between innovation and education level had a significant effect on use intention. Based on the results we concluded that the consumer's characteristics and information technology level had a significant effect on the use intention of u-healthcare service.

This study provides an evidence on the determinants of the profitability of university hospital by analyzing university hospital-level data set of hospital performance during the year 2007 (32 university hospitals in total). For the study, a multiple regression model is employed in which profitability index obtained from the DEA computations, operating margin to total asset and gross revenue are used as the dependent variables, and a number of hospital operating characteristics are chosen as the independent variables such as ownership type, location, bed size, period of establishment, bed occupancy rate, admission ratio of outpatients, patients per medical specialist, personnel cost per patient, liabilities to total assets, current ratio, fixed ratio, total asset turnover, medical assistance rate and public indicator. First, the results indicate that the bed occupancy rate and liabilities to total assets are positively and significantly associated with operating margin to total asset. Second, number of beds, the bed occupancy rate and number of patients per medical specialist are positively and significantly associated with operating margin to gross revenue. Third, the bed occupancy rate, number of patients per medical specialist, liabilities to total assets, total asset turnover are positively and significantly associated with profitability index revealed from DEA.

The purposes of this study were to describe the effects of perception of organizational culture type and job satisfaction on university hospital nurses' innovation behavior. A survey was conducted with 418 respondents working in a university hospital in Cheonan City. Organizational culture types (developmental, group, rational, hierarchical), job satisfaction and individual characteristics were surveyed. The relationships between each variable and the innovation behavior were analyzed by univariate analysis and the independent effects of these variables were examined with multiple regression. The mean score of general employees innovation behavior was 3.33 (p=.58) and that of managers was 3.53(p=.64). For general employees, there were statistically significant differences in innovation behavior according to education level. For managers, there were statistically significant differences in innovation behavior for education level, marital status and duration of work. On multiple regression analysis, the factors affecting innovation behavior of general employees were developmental culture( =.297, ${\beta}$ p<.01), group culture (${\beta}$=.184, p<.01) and job satisfaction(${\beta}$=.148, p<.05). And the factors affecting innovation behavior of managers were developmental culture(${\beta}$=.181, p<.01), rational culture(${\beta}$=.171, p<.01) and group culture(${\beta}$=.408, p<.01), In conclusion, the results of this study show that organizational culture and job satisfaction influence hospital nurses'innovation behavior.

In this study, we examined the effects of healthcare staffs' perceived service quality(E-PSQ) on patients' perceived service quality(P-PSQ) leading to patients' satisfaction(P-CS) and the effects on guardians' perceived service quality(G-PSQ) also leading to guardians' satisfaction(G-CS). To investigate the causalities of the factors, we collected national wide samples of 144 hospitals, 721 healthcare staffs, 1456 patients, and 1455 guardians of the patients. Followed were contributions of this study. First, healthcare staffs and patients were commonly related by service quality, which meant the increase of healthcare staffs' perceived service quality led to increase of patients' perceived service quality. Second, healthcare staffs and guardians of patients were also related by perceived service quality. Third, patients' perceived service quality would lead to service satisfaction of patients, Fourth, guardians' perceived service quality would also lead to service satisfaction of guardians. The findings implied service managers of hospital settings should pay attention to healthcare staffs' perception of service quality as well as those of patients and guardians. With such strategy, hospitals could survive the drastically changing environments of current healthcare service area.

This work was researched by practical method in a subjectivity study accessible in-depth, in sloughing off old habit of functional quantity analysis about Reception Type on policy reception of public & health campaign. The perception pattern come out in this study were divided into four types in Q-methodology. The result is as follows ; it is that divided'1[(N=16): Policy Improvement Type], 2[(N=7) : Public-relation Utility Type], 3[(N=19): Financial-continuance Type], 4[(N=11) : Healthy-prevention Orientation Type]'. Like this, it found that is very different type all over. Hereafter, this study is to ascertain acceptance behavior about Reception Type on policy reception of public & health campaign ; to offer a developmental suggestion about it.

Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

Although word-of-mouth (WOM) has been regarded as one of the very important topics in consumer research, its effects on other aspects of consumer behavior have been scarcely investigated in the context of health-care service industry. The WOM literature also suggests that it is essential for medical care service organizations in fierce competition to adopt WOM communication as a competitive weapon so as to be able to stay ahead of competition. The goal of this research was set to empirically study various relationships between antecedent variables, WOM acceptance, and purchase of medical care services. Specifically, drawing on the WOM literature, eight antecedents to WOM acceptance were selected first. Based on the relevant literature, seven sets of hypotheses on the relationships among antecedents to WOM, WOM acceptance, purchase intention and purchase of medical services were developed. Data were collected via an on-line survey. A total of 571 out of 600 responses turned out to be usable. The major findings of this study can be summarized as follows: First, 6 out of 8 antecedent variables to WOM acceptance were found to be positively affect WOM acceptance. However, the effects of (1) "newness of technology" pertaining to medical care service characteristics and (2) "involvement in health", one of receiver characteristics, were found to be insignificant. Second, most moderating effects on the relationship between purchase and purchase intention of medical care services were found to be insignificant with one exception. That is, elapse of time was found to be a marginally significant moderator on the relationship between purchase and purchase intention of medical care services. Third, it was found that the higher the WOM acceptance, the higher the purchase intention of medical care services. Finally, the effect of WOM acceptance was found to be particularly strong when WOM contents were perceived as useful and positive. Overall, it seems essential for hospitals to actively adopt WOM communication as a competitive marketing tool if they plan to improve their business performance. In this respect, the current study may serve to improve the business performance of hospitals by way of providing theoretical and empirical evidence on the effects of WOM communication variables on WOM acceptance and medical care service purchase.

Objectives : This study was supposed to investigate factors which influence to preference of medical tourism products of Japanese tourists in Seoul, Korea. Methods : Data were collected from 228 Japanese tourists who visited' Seoul Center for Culture & Tourism' in Myeong-dong, Seoul, Korea. We measured factors which influence to preference for medical tourism. The data were analyzed by T-test, ANOVA, and multiple regression analysis. Results : The major findings were as follows ; Japanese tourists preferred medical products in the order of skin care, oriental medicine treatment, health screening, and scaling & teeth whitening. They considered technical level of medical staff most importantly, followed by safety of medical products, communication during diagnosis and treatment, follow-up service, modernization of medical facilities and equipment, and the reasonable medical expenses. Japanese tourists' preferred medical institutions in the order of a university hospital, a specialty clinic, a special hospital, They said they intend to pay 50,000 to 150,000 yen for medical tourism. The preference to medical tourism products are that single women group in their twenties and thirties for skin care, married people group aged over thirties preferred oriental medicine treatment, and married men aged over forties and high income earners favored health screening. Conclusions : It should be considered carefully that the preference exists on some factors especially for Japanese tourist. Further research about preference on medical tourism products for tourists from the other countries is required appropriately to fulfill the needs.

Revisioned labour law was confirmed by vote of National Assembly on 1st January 2010. Under revisions labour law the necessity was expressed to reconstruct and change the relationship between labour and management in hospital. This study was described to investigate the operational statement of labour union in general hospital and to investigate how the labour policy would be change and which form would be appear in labour union in hospital. The survey results which was operated targeting labour managers in hospital were as follows ; first, in the possibility of plural labour unions establishment, university hospital labour managers forecasted the possibility as high. but non-university hospital labour managers forecasted the possibility as low. second, even though the plural union labours would be established in hospitals there would be no difficulties in collective bargaining between labour and management. third, the labour union activities would not be shrink even though there would be wage pay prohibition for the full-time union laboures. As the wage pay prohibition acted on the full-time union labours, countermeasures are required as follows; first, there is a possibility that there will be diversity in the form of full-time union labours. It is need to make the criterion of hospital about the limit of full-time labour union members. It is need to make the criterion of labour activities of non-working hour exception. It is need to cope with the diverse demands of labour union which aim to solve the financial burdens. As the plural labour unions are permitted it is need to make countermeasures as follows ; To analyze whether there is a possibility by the establishment of new labour to be plural labour unions. To establish the countermeasures in short-term aspect to make the countermeasures to cope with the establishment of plural labour unions. In long-term aspect to establish labour and management strategies. Henceforth, found on the revisions labour law, it is need to provide in hospitals as follows; first, it is need to prepare labour management policies and substitutes which suitable for plural labour union period. Second, it is need to determine concretely on the related matters of the union labours and to develop the conclusion guidelines which preparing infective criteria. Third, to examine the effects on the hospital organization by organizational forms of labour union which is weak in financial aspect.