• Health Policy and Management
• /
• v.17 no.2
• /
• pp.68-90
• /
• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• Health Policy and Management
• /
• v.19 no.1
• /
• pp.81-96
• /
• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• Korea Journal of Hospital Management
• /
• v.3 no.1
• /
• pp.100-120
• /
• 1998

Tertiary been increasing rapidly. There has been shortage of beds in hospitals and effective management of beds had to b considered. For the efficient utilization of the exsisting hospital beds, bed turnover rate ha to be high and their length of stay in hospital has to be shortened. The sample of this study was in-patients admitted in 13 clinical departments of a tertiar hospital in Wonju. Daily medical fees through length of stay in hospital were observed an we analyzed the increase of hospital revenues per bed for the shortening of length of stay. The results of the analysis were as follows: 1. The average length of stay by dept. was 11.0 in dept. of internal medicine. 12.4 in dept. of general surgery, 7.1 in dept. of gynecoloty, 6.8 in dept. of pediatrics, 26.1 in dept. of nervous surgery, 21.6 in dept. of orthopedic surgery, 25.5 in dept. of plastic sersury, 7.6 in dept. of ophthalmology, 7.1 in dept. of E.N.T, 8.1 in dept. dermatoloty, 9.0 in dept. urology. 2. The trend of daily medical fees of in-patients was the highest from the first day to the third day. Because most necessary examination and various treatment or operation took place in these period. 3. The estimative model for medical fees by the length of stay at each clinical department was inferred. 4. The increased revenue per bed by shortening the length of stay was calculated by the estimative model. Shortening one day would increase 305,999 thousand won in dept. of internal medicine 232,138 thousand won in dept. of general surgery., 177,795 thousand won in dept. of gynecology medicine, 69,031 thousand won in dept. of pediatrics 360,381 thousand won in dept. of nervous surgery 211.339 thousand won in dept. of orthopedic surgery, 100,249 thousand won in dept of plastic surgery, 10,569 thousand won in dept. of ophthalmology -814,122 thousand won in dept. of E.N.T, 1,582 thousand won in dept. of dermatology, -5,821 thousand won in dept. of urology. It is expected that they can improve their profitability by shortening the length of stay of the in-patients.

• Journal of the Korean Operations Research and Management Science Society
• /
• v.33 no.2
• /
• pp.17-26
• /
• 2008

The traveling salesman problem is to find tours through all cities at minimum cost ; simply visiting the cities only once that a salesman wants to visit. As such, the traveling salesman problem is a NP-complete problem ; an heuristic algorithm is preferred to an exact algorithm. In this paper, we suggest an effective cost relaxation using a candidate arc set which is obtained from a regression function for the traveling salesman problem. The proposed method sufficiently consider the characteristics of cost of arcs compared to existing methods that randomly choose the arcs for relaxation. For test beds, we used 31 instances over 100 cities existing from TSPLIB and randomly generated 100 instances from well-known instance generators. For almost every instances, the proposed method has found efficiently better solutions than the existing method.

• Health Policy and Management
• /
• v.19 no.4
• /
• pp.121-139
• /
• 2009

Objectives : The purpose of this study was to investigate regional commitment index(RGI) of hospital in Korea, and the relationship RGI and hospital characteristics, such as foundation, region, size. Therefore, we are to suggest fundamental information to make and evaluate healthcare resource policy in hospital- and government-level. Methods : The 'Patient Survey 2002(administered by Ministry of Health and Social Welfare(MOHW)' was analyzed. We selected the patient data of the hospitals above 100 beds. Then, we calculated the RGI, number of same cases divided by all cases in each hospital. By using SPSS/win ver 14.0, statistical analysis such as t-test, ANOVA, correlational and regression analysis was carried out. Results : The results are as follows. 1. Overall mean and standard deviation of RGI were revealed as 0.805${\pm}$0.225 in inpatients, and 0.871${\pm}$0.184 in outpatient. The median of inpatients' and outpatients' RGI were 0.890 and 0.933. The RGI of inpatients of private hospitals were revealed significantly higher than that of the public(public: 0.727, private: 0.822). However, outpatients' RGI was not revealed as significantly different. 2. The RGI of general specialty hospitals were significantly lower than others, therefore we could think that more inpatients and outpatients of general specialty hospitals flowed in from others province or metropolitan cities than other hospital types. 3. The RGI of hospitals holding above 400 beds were significantly lower than others in inpatients and outpatients. 5. The RGI of hospitals were significantly different among sixteen province and metropolitan cities. The RGI inpatients of Gwangju and Daejon metropolitan city were lowest sub-group(0.659, 0.664), and the RGI inpatients of Jeju was revealed as highest, 0.979. 6. Available beds, total doctors, and total employees were negatively correlated with RGI of inpatients and outpatients. 7. The significant influencing factors to RGI of inpatients and outpatients were appeared samely such as available beds, wide healthcare region, hospital size, and foundation type. Conclusions : It is considered that RGI of hospital represent competitive power in healthcare market. Also, the competitive advantage and quality of hospital clustered by characteristics could made out by RGI. Therefore, the results of this study would be useful to develop and evaluate hospital policy of individual hospital or local government.

• Health Policy and Management
• /
• v.4 no.2
• /
• pp.77-110
• /
• 1994

This study is an empiriacl analysis of effects of government intervention on the health care delivery system in Korea. The purposes of this study are to find out the effects of government intervention on the per capita national health expenditure(per capita NHE), crude mortality rate(CMR), and institutional efficiency. Here, the institutional efficiency is defined as a formula shown below: log$\frac{100-curde mortality rate }{per capita NHE}$$\times$100. The formula indicates that the instiutional efficiency increases if the CMR and/or per capita NHE goes down. In the meantime the government intervention is measured by six independent variables: I) the degree of social developments, ii) the numberr of physicians per 100, 000 population, iii) the proportion of specialists among the total physicians, iv) the proportion of public expenditure among the NHE, v) the proportion of public beds to the total number of beds, vi) the proportion of physicians working at the public sector to the total number of physicians. In the above six independent variables iv), v) and vi) are the ones that reflect the degree of government intervention. In actual calculation, the two independent variables v) and vi) are integrated into a new variable based on one to one correspondence. The materials used are the time-series data from 1970 through 1990 in Korea. A path analysis and the time-series regression analysis were adopted to estimate and examine the causal relationship between variables involved. And decomposition of the effect of causal relationship is made to find net effect, direct and indirect effect. The major findings are as follows; 1. The effect of public expenditure, number of physicians per 100, 000 population, the proportion of specialists among the total physicians and social development shows a positive relationship with per capita NHE. Only if the government intervention would be counted, the effects of the number of physicians and the proportion of specialists succeed in containing per capita NHE. 2. In additionn to the above four variables, one additional variable, per capita NHE, was also responsible for the reduction of CMR. The factor of social development found to be the most potent predictor of the CMR reduction. However, the CMR reduction due to government intervention was negligible. 3. Meanwhile, the above four variables were found to was have negative effects on the institutional efficiency. The reverse is true when the government intervention is counted. For example, the number of physicians and the proportion of specialists have played a positive role in raising institutional efficiency via goverment intervention. This comes from the factual effect that the increment of institutional efficiency via the reduction of per capita NHE is bigger than via the reduction of CMR.

• Journal of Soil and Groundwater Environment
• /
• v.17 no.6
• /
• pp.112-118
• /
• 2012

Fine suspended solids from mine drainage draw attentions due to their potential adverse influences on the water quality, such as increasing turbidity and degrading aesthetic landscape. Currently, sand filter beds are adapted in some mine drainage treating systems. However, more efficient system is in demand, as the existing sand beds reveal some problems, such as frequent maintenance intervals. Various filtering mediums including fly ash, mine tailing aggregates and the sand were tested for improving the current system, using column experimental set-up. Mine drainage samples were collected from the current treating systems in the abandoned H coal mine. The experiment was run for 7 days. Suspended solids recorded as 100.9 mg/L and the value exceeds the current standard, 30 mg/L. Sand was proved to still be the optimum medium for the fine suspended solids, compared to fly ash and fly ash + sand. Mine tailing aggregates were placed at the exit of the columns, substituting gravels. The tailing aggregates is made by mine tailings and clay. Sand bed filters can also be improved by mixing granular activated carbon, which was found to be economical and efficient in the batch experiment, conducted at the same time.

• Economic and Environmental Geology
• /
• v.13 no.3
• /
• pp.159-166
• /
• 1980

A model study was conducted for the investigation of apparent resistivity variation along with electric resistivity variation of host rock and dip variation of bed. Experiments were carried out for the cases of horizontal and dipping beds in a water tank by using Wenner and Schlumberger arrays and by changing salinity of water. The ratios of resistivity values of the bed to that of brine were 1 : 10, 1 : 50, 1 : 100 and 1 : 500. Natural coally-shale of $55cm{\times}35cm{\times}3.5cm$ was used as a bed for experimental model, and brine as a host rock. Equi-resistivity curves and characteristic curves were obtained for each case of the experiment. The equi-resistivity curve was drawn both on the cross section parallel to strike of bed and longitudinal section perpendicular to it. The characteristic curve was drawn on the cross section. In the case of dipping bed of different dips, the curves are parallel to the boundary of the bed in the upper part of the bed, and are inclined to the opposite direction with the same angle of the dip of bed in the lower part. We can deduce, from the equi-resistivity curves, the location, shape and dip of the bed. It is shown in the characteristic curves that when the ratio of resistivity value of bed to that of host rock increases, the slope of curves becomes steeper, location of low-resistivity zone lower, and the width of it narrower. The slope of curves also becomes steeper when dip of bed increases. We can deduce, from the characteristic curves, the ratio of resistivity values between adjacent beds. It was found out from the experiments that electric resistivity method could be applicable to prospecting for underground geology with an electric resistivity contrast of 1 : 10. This fact strongly suggests that distinction of coal from coally-shale could be possible in a certain field condition.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.7 no.1
• /
• pp.83-93
• /
• 2000

This study was conducted to provide the data for the improvement of cerebral ischemia patient nursing services through the investigation of burden and hospital service satisfaction by family caregivers who were nursing the cerebral ischemia inpatients. The study subjects consisted of 125 family caregivers who were enrolled in four university hospitals with over 300 beds and one Chinese medicine hospital with over 100 beds. The Data were collected from all of the personal subjects using standardized questionnaires by interview from March 1 to March 30 in 2000. Data were analyzed by using t-test, ANOVA. Scheffe's multiple comparison, and Pearson's Correlation Coefficients. The results were as follows: 1. The mean score of burden felt by family caregivers who were nursing the stroke patient was 2.18. In relation to the characteristics of patients, higher scores were shown in male patients who were over 80 years old, and patients who had from 4 to 12 days care giving, over three month duration of admission, from one month to three month duration of illness. The burden felt by family caregivers revealed higher score of dependency in the Activities of Daily Living. 2. The mean score of hospital service satisfaction perceived by family caregivers was 3.35. The highest hospital service satisfaction score was shown in female caregivers, and caregivers whose patients graduated from element school, and treatment method was Chinese medicine, the duration of admission was under 1 month. As a result. the family caregivers' burden was seemed to be high when the patients who were old, male and as care giving time, duration of admission, duration of illness were getting longer. In conclution, hospital service satisfaction was good, but the satisfaction was tend to decrease that family caregivers who were male, higher education background and duration of patients' admission getting longer.

• Korea Journal of Hospital Management
• /
• v.9 no.2
• /
• pp.102-127
• /
• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.