• 보건의료산업학회지
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• 제10권1호
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• pp.1-11
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• 2016

Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

• 한국병원경영학회지
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• 제15권3호
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• pp.143-169
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• 2010

This is a case study of Seoul St. Mary's Hospital applying a real-time enterprise (RTE) strategy to improve customer satisfaction and operational efficiency with the main process of medical institutions. The hospital is applying an RTE strategy to get real-time information on occurrences at each contact point of the main process of the medical institution from reservation to discharge through dashboard and to resolve issues through rapid decision-making. The RTE strategy of the hospital has some summaries: First, the hospital has linked a hospital management strategy to the RTE strategy to build a patient-centered treatment process. Second, the hospital has operated a control tower for change management and implementation monitoring in the process of implementing the RTE strategy. Third, the hospital has built systematic RTE-based environment as an application program in which the nU System is linked to Business Processor Renovation (BPR) promoted from 2006 on. Fourth, the hospital is applying a strategy to improve efficiency in operating the hospital by increasing customer satisfaction, removing inefficiency and variability, and managing medical resources efficiently through the RTE strategy. Fifth, it has established an information-sharing system through authority management for each user in terms of RTE information. Sixth, it has supplemented limitations of short-term information of the RTE strategy by linking the key performance index to the cost information system in order to improve performance of the RTE strategy. Seventh, it has improved customer satisfaction and achieved higher performance in improving operational efficiency, as compared with rival hospitals, through the RTE strategy.

• 보건행정학회지
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• 제6권1호
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• pp.191-210
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• 1996

This study purported to acquire information necessary to improve the operational efficiency of general hospitals. It tried to determine major indices which represent managerial performance of general hospitals and to identify the managerial characteristics of general hospital which affect the major financial indices. 201 hospitals which were subject to standardization audit by the Korean Hospital Association were investigated and 80 hospitals were finally chosen for this study. Their financial and managerial data during the period between January 1991 and December 1991 were collected. Considering financial indices in this study were the ration of net income to total asset, income growth rate, and quick ration. The results of study are summarized as followings. First. The ration of net income to total assets and quick ration were highly related to managerial characteristics of general hospitals. Therefore, the standardization of three financial indices should be needed to systematically check the operational efficiency of general hospitals. Second, the sample hospitals can be classified as four groups on the basis of their financial indices' level. 4 of those hospitals(5.0%) showed high level of performance in terms of three financial indices and 27 of them(33.7%) showed that they are highly related to only two financial indices. 34 hospitals(42.5%) showed they have high level of relationship with only one indices and 15 hospitals(18.8%) showed very weak performance level with three indices. In addition, there is no hospitals to show mid-range level of managerial performance in relation to all three financial indices. Third, there is no significant relationship between three financial indices and the managerial characteristics of hospitals such as the number of beds, type of operation, location of hospitals, and etc. However, in the case of hospitals which have high level of managerial performance, they have more specialists and medical support personnel in comparison to low performance hospitals. They also have high level of bed occupancy rate and average length of stay(ALOS). In conclusion, the study showed the standardization of 3 financial indices are necessary to systematically evaluate the managerial performance of general hospitals and provide more accurate operational information for each hospital. To do so, it is necessary to focus on management side of hospital such as the effective human resource management and quality enhancement of medical treatment.

• 보건의료산업학회지
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• 제11권2호
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• pp.1-15
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• 2017

Objectives : This study aimed to identify the perception of quality improvement in health care and operational performance after the implementation of the Healthcare Accreditation. Methods : Data were collected from 5 hospitals that have experienced the 2th Healthcare Accreditation in Busan, South Korea. A Likert 5-point scale was used to measure the research variables and a structured questionnaire was used. Finally, 206 valid cases were analyzed using SPSS win 18.0. For hypothesis testing, hierarchical multiple regression analysis were performed. Results : The perception of quality improvement in health care after the implementation of the Healthcare Accreditation was higher than the operational performance. In the customer orientation and job performance, the perception of quality improvement in health care and operational performance had a significant influence. Conclusions : It is necessary to use the Healthcare Accreditation as a virtuous cycle of management that can ensure enforcement of workplace regulations and improve the members'ability to provide high quality medical services.

• 보건행정학회지
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• 제13권2호
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• pp.101-124
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• 2003

Performance of public hospitals is difficult to define and measure because not only their managerial or financial performance but also their role as a public entity is important. The purpose of this paper is to examine the internal and external factors that influence the performance of local government hospitals. A multiple regression was performed to analyze the effects of the environmental, organizational, operational, and cost-related factors on the return on total assets(ROA), operating margin(OM), and the ratio of Medicaid patients. Empirical results show that financial performance (ROA and OM) are more influenced by operational or cost-related factors, while the ratio of Medicaid patients is more affected by environmental or organizational characteristics. It is noteworthy that competition and the contract with private sector management have negative effects on the ratio of Medicaid patients that local government hospitals treat.

• 한국병원경영학회지
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• 제25권3호
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• pp.53-66
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• 2020

This study is aimed at investigated and compared the differences in the affect of hospital specialization according to hospital size using claims data of the Health Insurance and Review Assessment National Inpatient Sample in 2018 for diseases of the musculoskeletal system and connective tissue. To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 106,599 patients discharged after diseases of the musculoskeletal system and connective tissue from 734 hospitals. Multivariate results indicate that patients who were discharged with diseases of the musculoskeletal system and connective tissue from specialized hospitals with 200 beds or less stayed shorter and paid less inpatient charge than those who were discharged from less specialized hospitals. But for hospitals with 201-300 beds, no positive impact relationship was found between hospital specialization and operational performance. This finding may be limited evidence that the affect of a hospital's specialization strategy may vary depending on the size of the hospital. We discussed several managerial and health policy implications below.

• 보건행정학회지
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• 제11권4호
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• pp.38-53
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• 2001

The price of the hospitals' services is regulated by the governmental health insurance reimbursement schedule in Korea. On the other hand, the emphasis on the quality of care of hospitals service is ever increasing. Under the environment, hospitals have to understand the effects of the activities to improve quality of care on efficiency and on financial performance so that they develop a management strategy that allows quality of care, operational efficiency, and financial achievement simultaneously. This study investigates the relationship among the concepts. The sample for the study includes 23 hospitals that have more than 300 beds. The concept of quality of care is measured by the score reported by the Hospital Standardization Survey (HSS) instituted by Korean Hospital Association. Efficiency is measured by the ratio of number of employee to the number of patients served. Financial performance is measured by the financial ratios indicating the profitability of a hospital. An analysis is performed using the multiple regression. The results show significant positive relationships between the HSS score and efficiency indicators, md between the HSS score and profit measures. However, the significant positive relationship between the HSS score and profit measures disappeared when efficiency indicators were introduced to the model. This study concludes that the structural quality of a hospital has a positive effect on efficiency of the hospital and that the structural qualify indirectly affects the financial performance of a hospital through the improvement of efficiency. Based on the findings, the implications on hospital management and health policy are discussed.

• 대한영양사협회학술지
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• 제18권4호
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• pp.326-343
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• 2012

This study has attempted to collect actual spot's opinions and analyze importance-performance of indicators for the evaluation of hospital nutrition department. The results of this research were as follows: first, the average score of self-estimated performance was 3.75 based on a 5-point scale. The degrees of importance of hospital foodservice and nutrition department management were in the range of 3.71~4.85 out of 5.0 and the mean importance degree score was 4.37. Second, the average score of self-estimated performance in each category was significantly higher in the case of general special hospital compared to general hospital. Especially average performance score of nutrition management in the general special hospital was higher than that of general hospital (P<0.001). The average performance score of the hospital with more beds was significantly higher than that with less beds. Contract managed hospital's score was significantly higher than that of self-operated hospital in two categories, "facilities management" and "nutrition management" (P<0.05, P<0.01). In foodservice and nutrition management of task-separated hospitals, the average performance scores were significantly higher than those of not-separated hospitals (P<0.01, P<0.001). Third, according to the importance-performance analysis of recognition about indicators for the hospital nutrition department's operations evaluation, 'foodservice facilities management' and 'foodservice sanitation management' were in 'doing great', 'nutritional management' and 'operational management' were in 'low priority', and 'other foodservice management' was in 'overdone'. In conclusion, there's a need for institutional specific standards of sanitation for Korean hospital foodservice.

• 한국병원경영학회지
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• 제8권1호
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• pp.64-80
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• 2003

The separation policy of prescription and drug dispensing which has been implemented since the 1st of July, 2000, has brought about great changes in patients flow within the healthcare delivery system. The changes in the patients flow, in turn, resulted in the change in the distribution of financial resources among the participating entities in the healthcare delivery system: pharmacies, clinics, small hospitals, general hospitals, and teaching hospitals. The purpose of this study is to shed some light in the change in the financial performance of teaching hospitals under the separation policy that has created environmental changes such as the decrease in the number of out patients visits, the increase in the capital expenditures, the rapid increase in labor costs and so on. For the purpose, this study has compared and analyzed the balance sheets, the income statements and other operational data of three teaching hospitals located in D area. The data include two periods: before(year 1999) and after(year 2001) the implementation of the separation policy. The analysis was conducted with an emphasis on the changes in the financial ratios such as liquidity, turnover ratio, performance ratio. and capitalization ratio. The results show that the financial performances of the hospitals under study were weaker than before the implementation of the separation policy, and that, while the operating expenses have increased remarkably, there was no tendency to corresponding increase in revenue. And the result of analysis of other operational indicators also show that the performance of the hospitals is getting worse. Based on the results, this study has suggested the directions of the healthcare policies. This study suggests to improve the current model of separation of prescription and drug dispensing, to grant subsidies for the training of residents in teaching hospitals, and to lower the rate of patients' out of porket payment in teaching hospitals.

• 한국지진공학회논문집
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• 제20권7_spc호
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• pp.509-516
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• 2016

Secure operation of hospitals during and right after earthquake is essential. Past lessons from earthquake damages have shown that most of the injured and the death occurred within 30 minutes after earthquake and the portion of nonstructural damage has become significant. However, hospital buildings in Korea have not prepared fully to address such rising issues. This paper is to study what type of damage patterns are related to hospital buildings and how to develop a preparedness plan to keep hospitals operational at all earthquakes if possible. This paper first reviews on past earthquake damages reported as critical to hospital buildings while classifying them into four groups: (1) structural element; (2) architectural-nostructural element; (3) medical equipments and contents; and (4) utility facility. Upon such classification, some detailed concerns can be specified under each group explicitly. Then a hierarchy for hospital building is also developed for the classified groups, which enables us to identify required things for the enhancement of seismic performance of hospital building that consists of heterogeneous elements. To upgrade the level of seismic performance for existing hospital buildings, the concept of performance-based approach can be adopted to address the heterogeneous problems in a systematic and stepwise manner. Finally a conceptual framework for the seismic risk assessment for hospital building is proposed toward the seismic enhancement of hospital buildings using performance-based approach.