Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.
Purpose : The purpose of this study is to analyze the elements that affect the energy consumption of general hospitals in Korea. Methods : Factors affecting energy consumption in general hospitals include facility elements and operating elements. The effects of these elements on energy consumption of general hospitals were analyzed by statistical methods such as t-test, anova, correlation analysis, and regression analysis. Results : Total floor area, number of operating rooms, number of MRI, number of staffs, and number of outpatients can be said as useful variables that can explain energy consumption in general hospitals. Implication : It is possible to save energy consumption in general hospitals by adjusting major variables that affect the energy consumption of general hospitals.
Objectives : This study compared Value added to personnel expenses between 12 private general hospitals and 12 regional public hospitals, based on location and size, to examine industry competitiveness in terms of management. Methods : From 2011 to 2015, the value added and value added to personnel expenses were calculated by year. and a SPSS statistical program was used to determine and influential factors between private general hospitals and regional public hospitals. Results : The total value added to personnel expenses was 26.85 percent lower than general hospitals compared to regional public hospitals. The product category most influenced by the value added to personnel expenses was Stationeries & expendables at general hospitals and Outsourcing at regional public hospitals. Conclusions : Regional public hospitals have relatively low value added to personnel expenses compared to the general hospitals. Therefore, it is necessary for hospital management to reexamine gross revenue relative to total manpower.
The purposes of this research were to identify nursing interventions performed by Korean nurses and to compare the interventions performed by nurses working in the oriental medicine hospitals and with those performed by nurses working in the general hospitals. The samples consisted of 144 Korean nurses working in three hospitals, 70 nurses working in the oriental medicine hospitals and 74 nurses working in the general hospitals. The Nursing Interventions Classification (NIC) Use Questionnaire developed by the Iowa Intervention Project team was translated to Korean and verified using the method of back-translation. The questionnaire consists of 433 intervention labels and definition. Thirteen interventions were used at least daily by nurses working in the oriental medicine hospitals, while twenty-one interventions were used at least daily by nurses working in the general hospitals. The most frequently used interventions by nurses working in the oriental medicine hospitals were Documentation, Shift Report Vital Signs Monitoring, Pressure Ulcer Prevention, Positioning, Fall Prevention, Exercise Promotion, Intravenous (IV) Therapy, Pressure Ulcer care, and Bed Rest Care in that crder. For nurses working in the general hospitals the most frequent intervention was Analgesic Administration, followed by the interventions of Medication Administration : Parenteral and Intravenous Therapy (IV) Therapy, Documentation, Intravenous(IV) Insertion, Shift Report, Fall Prevention, Vital Signs Monitoring, Medication Adnninistraction : and, Fluid Monitoring, and Medication Maragement in that order. The interventions performed least often by nurses working in the oriental medicine hospitals were Hemodialysis Therapy and Bleeding Reduction : Antepartum Uterus, while the interventions performed least often by nurses working in the general hospitals were Rape Trauma Treatment and Contact Lens Care. The nurses working in the oriental medicine hospitals performed the interventions in the Physiological : Complex domain significantly more often than the nurses working in the general hospitals, while the nurses working in the general hospitals performed the intervention in the Behavior domain significantly more often than the nurses working in the oriental medicine hospitals. This study suggests that further study will be needed to developed and validate more interventions sensitive to Korean culture.
Objective: The aim of this study is to present a solution to problems in the services provided by the general hospitals by creating a user-centric environment through analyzing the User Journey Map and the User Context. Background: The rapid growth in aging population and the monopolization of superior medical staffs by the general hospitals increased demand for the general hospitals in Korea. But, often services provided by the general hospitals are provider-centric and low quality. Method: This study examines problems in the services provided by the general hospitals by analyzing the User Journey Map through stakeholder interviews(contextual interviews) and on-site observation. Based on the contextual analysis of the user(i.e. the patient), this study proposes new and improved user-centric services to be provided by the general hospitals. Results: Ten new user-centric services proposed by this study are: (1) "Booklet on Success Story", (2) "FAQs by Doctor", (3) "Designated Nurse", (4) "Patient Interview Record Card", (5) "Close relationship between doctor & patient", (6) "Thank You Notice Board", (7) "Step by Step", (8) "Green Cap", (9) "Patient Kit", (10) "RFID Direction Display System". Conclusion: The service design for the general hospitals proposed by this study is an important case-study on improving the environment of the general hospitals from provider(medical staffs)-centric to user(patents and its family)-centric. Application: This study is expected to be used in various areas to improve existing system(products and/or services) to be more user-centric.
Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.
The objective of this study is to examine the effectiveness of the strategy of hospital specialization by analyzing the differences in expected and perceived services, perceived service quality, satisfaction, and intentions to revisit and recommend the hospital to others between general and specialty hospitals. Data were collected using self-administered questionnaire from patients admitted to four study hospitals: two speciality and two general hospitals. The questionnaire was developed based on SERVQUAL to measure five dimensions of service quality. Four hundreds questionnaires were distributed to inpatients or their guardians and 282 returned questionnaires were used in the analyses. The significance of the differences in study variables between specialty and general hospitals were tested by t-test and $x^2$-test. The factor analysis result confirmed the construct validity of 28 questions asked to measure service quality and resulted in four dimensions of service quality: reliability, assurance, tangible and empathy/responsiveness. Cronbach's Alpha ranged from .9013 to .9358, that confirmed the internal consistency of answers. The study results indicated that patients who used specialty hospitals had higher levels of expected and perceived service, a higher level of perceived service quality, and higher levels of service satisfaction than patients who used general hospitals. Percents of patients who had the intention to revisit the hospital and to recommend the hospital to others were higher among patients in specialty hospitals. The most frequent reason to choose the hospital was the excellence of doctors in both general(29.9%) and specialty(43.8%) hospitals, that was followed by convenient transportation(15.3%) and someone know works at the hospital(15.3%) in general hospitals and other's recommendation(14.6%), and nice amenities(13.1%) in specialty hospitals. Although there were no significant differences in clinical department, age, and sex of patients between general and specialty hospitals, patients who visited speciality hospitals had higher levels of education and income than their counter part in general hospitals. These results suggested that specialty hospitals performed better than general hospitals. Specialization could be a viable strategy to tide over recent financial difficulties experienced by hospitals, particularly small- and medium-sized hospitals.
The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows : (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and in-patient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity (3) In case of physician's inpatient and adjusted-patient service, nurses' role is greater than nursing aides'. Therefore, more extensive utilization of nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.
Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.
The purpose of this study was to investigate current status of 19 general hospitals which performed the hospital social responsibility (HSR) to global health issues. The survey focused on the global healthcare supporting system & activity (including the administration, information, materials, finance, and human resources, et al.), and the government's policy in Korea. Based on the analysis of survey data, the main global health issues of general hospitals were activities of overseas volunteers (56%) and aids of the developing countries (19%). Also, general hospitals have mainly supported into eastern Asia (49%). And then, the most important goal of general hospitals related these activities kept the founding principle of a hospital for global health issues (53%). The second ranking was the social responsibility (32%) and the interchange between Korean and foreign hospitals (32%). There were many differences between general hospitals about the global healthcare supporting system & activities for HSR to global health issues. In conclusion, we suggest that most of general hospitals in Korea would be gotten prior setting the global issues for unmet-need of the developing countries around the world in the near future. This study also served as the effective way by partnership on global health issues of general hospitals for recognizing the HSR as hospital governance.
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