• Health Policy and Management
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• v.22 no.2
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• pp.249-262
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• 2012

The purpose of this study is to investigate the determinants of intent to use the medical-application(M-APP) of smart phone of nurses working at the nursing department of two university hospitals in Korea. The independent variables used in the study are performance expectancy, effort expectancy, social influence, facilitating condition, attitude toward using technology, self efficacy, anxiety, ability to use a smart phone easily and socio-demographic characteristics. The sample used in the study consisted of 378 nurses selected from two university hospitals located in Seoul and Wonju, Korea. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of this study revealed 5 independent variables of attitude toward using technology, self efficacy, anxiety, ability of using APP and interest in smart phone have the significant effect on the intent to use the M-APP. The results imply that the hospital administrators and nursing managers should try to give more chances to learn the skills of using M-APP, provide sufficient resources and establish the stable hospital information system in order for their employees to use the M-APP more easily at their working places.

• Health Policy and Management
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• v.22 no.3
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• pp.365-382
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• 2012

Background : Public hospitals suffer worsening shortage of physicians and face great pressure of recruiting doctors. This study is aim to identify the factors associated with retention of physicians who are working in public hospitals. Methods : We conducted a cross-sectional and self-administered questionnaire survey in July, 2011. A total of 333 physicians responded from the 31 public hospitals. We analyzed the difference of job retention across the variables among doctors stratified as salaried and public health doctors. We used chi-square test and multiple logistic regression analysis. Results : To the salaried doctor, longer work period(OR=2.04 in 3rd quartile), professional autonomy(OR=2.69), and positive attitude toward public health(OR=2.39) affect to the higher job retention whereas complain of low income(OR=0.33) and complain of poor clinical environment(OR=0.26) affects to the lower job retention. To the public health doctors, community connections such as hometown(OR=6.27), spouse factors(OR=3.49), and positive attitude toward public health(OR=3.19) affect to the higher job retention. But longer work period(OR=0.17 in 3rd quartile) affects to the lower job retention. Conclusions : Associated factors of job retention vary across physician's status. Professional autonomy has major impact on the job retention to the salaried doctor. And familial factors as well as community relationship have greatest impact to the public health doctor. Positive attitude toward public health is associated with the higher job retention to the both of salaried and public health doctors.

• Health Policy and Management
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• v.22 no.1
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• pp.129-144
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• 2012

Purpose : The purpose of this study was to investigate the level of emotional labor and to identify affecting factors on emotional labor among one university hospital employees. Material and Method : This study was based on cross-sectional, self-administered, and Internet-based survey. The survey was conducted from Mar. 2 to Mar. 28. 2011. Total subjects were 812 employees working in one university hospital. Total response rate was 61.5%. Modified evaluation tool was used, which was originally developed by Morris and Feldman, to measure the level of emotional labor among hospital personnel. In order to identify the affecting factors on high level of emotional labor, we conducted logistic regression. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were 2-sided and a p-value<0.05 was considered statistically significant. Results : Average score of emotional labor was 3.06. Employees(3.39) who are working at the emergency department and hemodialysis room indicated the highest level of emotional labor, followed by wards(3.14), department of administration(3.14), department of ambulatory cares(3.06). The factors affecting on the high level of emotional labor were the highest level of schooling, types of department, and types of personality(p<0.05). Conclusion : The survey results showed that there was significant level of emotional labors among hospital employees. Therefore, the efforts to reduce the level of emotional labors are needed.

• Health Policy and Management
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• v.26 no.4
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• pp.373-381
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• 2016

Background: The purpose of this study is to evaluate the outcomes of clinical education program for nurses in regional public hospital, utilizing the Kirkpatrick's model. Methods: Kirkpatrik's 4-level model was applied to this study. Trainees were asked to fill out questionnaires in the middle and at the end of the program. Also administrators of excellent trainees were asked to fill out the questionnaires regarding nursing management performance after 1-2 months from the end of the training course. Results: All trainees had positive reactions to the clinical education program. Not only the results of individual level (satisfaction and achievement scores, academic achievement scores, practical application rate, and educational transition factors) but also the scores of organization level (nursing management performance scores) are improved. Conclusion: By showing a correlation between the effectiveness factors we need to verify the relationship between these factors in a future study. In addition, development of quantitative and qualitative performance indicators are needed. To establish a long-term education system, it is required to applying the excellent trainee's successful experiences.

• Health Policy and Management
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• v.29 no.4
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• pp.445-453
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• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Health Policy and Management
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• v.12 no.4
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• pp.1-17
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• 2002

This study was attempted to identify the liquidity trends and determinants of private hospitals in Korea different. Data used in this study were collected from 98 hospitals with complete general data of present conditions as well as financial statements(balance sheets, income statements). They were chosen from hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variables in this study were used current ration and quick ratio as a proxy indicator for liquidity. The independent variables were ownership type, hospital type, location, bed size, period of establishment, short-term liabilities to total assets, long-term liabilities to total assets, borrowings to total assets, fixed asset ration, net profit to total assets, operating margin to gross revenue, growth rate of net worth to total assets, total asset turnover, and business risk(volatility of profit). The major findings of this study were as follows. Trends of liquidity(current ratio, quick ratio) had been continuously decreased. Especially, There were very distinct decreasing trends of personal hospitals and less than 300beds, which weakened liquidity. The factors had significant effect on current ratio were short-term debt to total assets(-), fixed asset ratio(-), business risk(+). High short-term debt to total assets, high fixed asset ratio and high business risk significantly decreased in liquidity. The factors that significantly affected on quick ratio were short-term debt to total assets(-), borrowings to total assets(+), fixed asset ratio(-), business risk(+).

• Health Policy and Management
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• v.10 no.4
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• pp.116-143
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• 2000

Considerable attention has been devoted in the accounting literature to identify the factors that cause or drive the costs of overhead activities. This paper extends recent cost driver research to the health care provider. In various case studies, it has been suggested that overhead costs are driven by volume and complexity variables. This paper investigates the significance of these variables in determining hospital overhead costs, how they are structurally related and how the cost impacts of these variables can be estimated in practice. This paper analyzes the determinants of hospital costs using the sample of South Korea hospitals for seven year during the period 1952－1997. The paper focuses on the extent to which hospital overhead costs depend on complexity, efficiency in addition to depending on more conventional volume based measures of hospital activity. The results of regression analysis suggest that volume and complexity factors positively and significantly affect overhead costs in the hospital industry. The results show that the complexity-related cost drivers strongly affected on the overhead costs in tile health care provider industry more than manufacturing industry which is mainly affected by volume-related cost drivers. That means each Industry may have different cost structures. Therefore it Is Important to find their proper cost structures and cost drivers and use them. Futhermore identification of overhead or indirect cost drivers is likely to be particularly useful in heath care. The identification of cost drivers can be of benefit to all health care stakeholders because these facilitates more efficient management of the national resources devoted to health care. While this study has documented that the level of service complexity is a significant determinant of hospital overhead costs, caution should be exercised in interpreting this as supportive of the cost accounting procedures associated with ABC. It is an open question whether even a well-designed ABC system will provide suitable proxies for marginal costs for decision making purposes.

• Health Policy and Management
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• v.16 no.1
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• pp.117-139
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• 2006

The role of medical service quality to provide patients enhances influence on the hospital performance under being severe competition among the large size hospitals and increasing the right of patients. When a large hospital perceived factors of quality that a customer expects and feels value of care and it invests its resources to improve the factors of quality, it can get successful performances. Therefore, the purpose of the study explores the factors of quality affecting the trust of care and the patient satisfaction, and tests relationship among the trust of care, patient satisfaction and revisit intention. When considering the factors, a large size hospital can increase the trust of care and the patient satisfaction, through this process the hospital can assure patients' revisit and increase its revenue. This study uses interview data on outpatients visiting clinics in about 1000 beds sized training hospital located in Seoul. This study uses casual relationship model for the analysis. This study finds that 1) the trust of care and the procedure of care significantly influence the value of care felt by patients, 2) the trust of care, quality of doctors' care, procedure of care significantly influence the patient satisfaction, 3) the trust of care increases the patient satisfaction, and 4) the value of care and the patient satisfaction increase revisit intention.

• Health Policy and Management
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• v.12 no.4
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• pp.18-33
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• 2002

This study was planned to investigate the difference in the choice of services between western and oriental medicine. Data were collected from 493 outpatients who visited the D hospital by structured questionnare. The results were as follows; The older aged groups, there were the more oriental medicine visitors, significantly Oriental medicine visitor had more experience to use the complementary food than western medicine visitor. In comparison of reason for service choice, the proportion of oriental medicine visitors was higher than western medicine visitor in considering of specialty of institution. In contrast, western medicine visitor had interest to 'newly-developed facility and equipment' and 'convenience and accessibility of service' as factor of service choice. In analysis of evaluation the service experiences, oriental medicine visitors evaluated the oriental medicine highly in 'therapeutic efficacy' and ' less side effect'. But western medicine visitor evaluated the western medicine highly in 'quick effect of therapy' and ' scientific apprach'. We concluded from result that there were difference in service choice behavior between western and oriental medicine visitor. We hope that these information will be applied to planning of consumer-oriented marketing strategy of hospital.