• 가정∙방문간호학회지
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• 제28권2호
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• pp.111-123
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• 2021

Purpose: This study aimed to present the management strategies necessary to improve the operational efficiency of visiting nurse centers and evaluate their effectiveness. Methods: The subjects of this study were visiting nurse centers registered as long-term care centers. Based on value chain analysis, cost information analysis, and data envelope analysis, the study was carried out according to the Magerison's management consulting procedure, for six months. This procedure comprised eight sub-steps of approach and application. Results: The following management strategies were agreed upon: establishment of a cooperative network with other visiting care centers, creation of high satisfaction of external customers by providing practical training to care workers, and making rehabilitation and exercise services as the core nursing activities to be focused on. Conclusion: The management consulting process and analysis method applied in this study can referred to as a useful methodological framework for revitalizing visiting nursing centers in the future.

• 보건행정학회지
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• 제23권4호
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• pp.326-342
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• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• 보건행정학회지
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• 제11권4호
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• pp.129-151
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• 2001

This study was conducted to describe trends of health services research (HSR) in Korea since 1968 and analyse the relevance of HSR to changes in health policy. Research methods are as follows: firstly, HSR articles were selected from 4 HSR related journals implicitly. Secondly, classification system of HSR was developed and then applied to previously selected papers in order to describe research trends. Finally, the frequency rankings of articles in research areas were compared with rankings in order of the importance of research area rated by experts. As a resesult, HSR articles have increased with time and three main research areas are health programme, health care financing, and health care organization/management. And many articles have been related to the efficiency and quality of health care since 1990. It seems HSR articles had little relevance to changes in health policy and policy environment. Especially, the recently disputed policy topic, namely the separation of prescription from disposing, has not received little attention since 1990. These findings suggest there is an urgent need for the reflection on HSR direction in Korea.

• 한국의료질향상학회지
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• 제22권1호
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.

• 보건행정학회지
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• 제9권4호
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• pp.87-119
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• 1999

The main purpose of this research is to measure and analyze how productive the health centers are and how much inputs(or outputs) in the inefficient health centers should be decreased(or increased) for efficiency. The evaluation of the performance of health centers gives a strong incentive to improve resource allocation in regional health planning. It has been, however, implemented very rarely until now. In this regard, this paper measures the performance of the health centers with a single indicator for multiple-outputs in terms of productivity(technical efficiency), based on Data Envelopment method. The 20 Kyungnam health centers which provide clinic services and specific primary health care services were analyzed. The results show that 50.0% of 20 health centers were productive with respective to overall technical efficiency, 65.0% were productive for pure technical efficiency, and 50.0% for scale efficiency. The inefficient group includes Geoje, Mahsan, Miryang, Sahchun, Tongyoung, Gosung, Nahmhae, Euryang, Hahmahn, Hahbchun health centers. The worst case was identified as Tongyoung health center which represented a 47.5% efficiency, compared with productive health centers. The empirical results for input-output analysis indicates that the low-productive health centers have excessive manpower in administration department, producing low outputs in clinical services and vaccination program. These findings imply that a systemic evaluation of the performance of the Korean health centers and the subsequent structural reform are strongly required.

• 한국산학기술학회논문지
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• 제16권11호
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• pp.7463-7473
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• 2015

본 연구는 장기요양 1등급 건강보험가입자를 대상으로 장기요양서비스 이용자와 미이용자의 의료비 지출 차이를 비교하고, 의료비 지출에 미치는 영향 요인을 규명해 보고자 시도하였다. 연구 대상은 건강보험가입자로 2009년 1월 1일부터 12월 31일까지 1등급 판정을 받은 21,213명 전수를 대상으로 국민건강보험공단의 장기요양급여, 건강보험급여 자료를 활용하였다. 연구결과 2007년부터 2009년의 연간 총 진료비 변화량의 경우 서비스 이용자에 비해 미이용자는 5,337천원 증가하였으며, 연간 요양병원 진료비 변화량은 5,449천원 증가하였다. 연간 총 입원일 변화량의 경우 서비스 이용자에 비해 미이용자는 87.31일 증가하였으며, 요양병원 입원일 변화량은 79.47일 증가한 것으로 나타났다. 이 같은 결과는 장기요양 서비스 미이용자의 의료이용, 특히 요양병원의 의료이용이 높게 나타남에 따라 미이용자에 대한 적정의료와 요양서비스 지원 정책을 통해 장기요양과 의료서비스의 효율적 연계가 필요로 된다.

• 한국치위생학회지
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• 제17권5호
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• pp.705-719
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• 2017

Objectives: The purpose of this study is to look into the health insurance systems and application in Korea and Japan in order to improve elderly people's quality of life. Their quality of life can be improved by upgrading the long term care systems; and extending treatment and prevention. Methods: This study is to examine long term care systems articles through content analysis in the National Health Insurance Service. Data were collected from the printed Internet and analyzed. Results: A part-time dentist system in elderly care facilities has trouble in taking care of old people's oral health due to both lack of time and operational difficulties. It is urgent to arrange dental experts who can permanently stay in care facilities and to build systems which can be managed periodically and continually. Conclusions: As having staff training for the efficiency and using the manpower in care facilities (care workers), it is necessary to solve the unequal medical service in oral health care for the elderly in Korea.

• 한국치위생학회지
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• 제14권2호
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• pp.147-154
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• 2014

Objectives : The purpose of the study is to identify the efficiency of total dental care(TDC) internship program. Methods : Dental hygiene students participated in the total dental care(TDC) internship program for 4 weeks in dental clinics practice. A self-reported questionnaire was filled out from June to July in 2012. The questionnaire consisted of oral health condition and dental care services by the students, dentists, and dental hygienists after TDC internship program. Results : Satisfaction degree of the students was $3.92{\pm}0.68$ points. The patients satisfied with TDC internship program and it was helpful to their dental health care(4.0 points). There were significant changes in tooth brushing method, frequency and O'Leary plaque index. Satisfaction degree of the dentists was 4.09 points and that of the dental hygienists was 3.80 points. Conclusions : TDC internship program is very helpful for the students not only to play an outstanding role in their dental care activities after employment but also to establish the real identity of the dental hygienist.

• 보건의료산업학회지
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• 제8권2호
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• pp.101-113
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• 2014

This paper examined the effects of private health insurance(PHI) on the health care utilization among the Korean. The used data was the three waves of Korea Health Panel (2008, 2009, 2010), and the number of subjects was 13,951 persons. Authors employed two-stage least square panel model where the instrument variables for controlling for endogeneity of PHI were number of insurance planner per 100,000 in resident area and whether subject worked on financial profession. The results showed that healthcare expenditure of outpatients who purchasing PHI was higher than that of outpatients without PHI, and there was no difference in admission between the two groups. This article recommended the Korean government to monitor the effects of PHI on the health care utilization in order to improve the efficiency of health care finance.

• 보건행정학회지
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• 제10권4호
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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.