Unlike profit-seeking businesses, hospitals provide medical services to promote the public good in a way, and they need a reform of management to ensure sustainable growth in fast-changing medical environments. The key to the managerial reform is enhancing efficiency, and inefficient managerial practices and factors affecting that should be grasped first of all to boost the efficiency of hospital management. But evaluation methods that are prevalent in the private sector are hardly applicable to hospitals. The purpose of this study was to assess hospital efficiency by using a data envelopment analysis(DEA). The 2006 data on 74 residency training hospitals with 500 beds or more were analyzed. The selected input variables included the number of bed, the number of doctors, the number of nurses, the number of medical technicians, personnel expenses, management cost and materials cost. And the selected output variables were the yearly number of outpatients, the yearly number of inpatients, the number of operation cases and earnings. In addition, the influence of the type of hospital establishment, location, the year of foundation and the type of hospital on hospital efficiency was checked as well.
This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.
This study was performed to identify effects of hospital selection factors on patient satisfaction and reuse intention. For this purpose, a survey was performed subject to outpatients and inpatients in 10 hospitals located in Busan district from March 7, 2013 to June 21, 2013 and total 447 copies were used as final study data. As results of this study, it was found that among the hospital selection factors of outpatients, internal conditions and medical service gave effects to patient satisfaction and internal conditions, service of medical staffs and medical service gave effects to reuse intention. It was found also that among the hospital selections factors of inpatients, internal conditions, service of medical staffs and medical service gave effects to patient satisfaction and external conditions, internal conditions, service of medical staffs and medical service gave effects to reuse intention. It was suggested that in the effect of patient satisfaction on reuse intention, both inpatients and outpatients gave the effect and thus higher patient satisfaction was related to higher reuse intention. Therefore, instead of hospital-centered medical treatments, hospitals should restructure its medical and service systems that are patient-centered. Also, it is necessary for the hospital managers to recognize that patient satisfaction is an important factor in increasing its profit.
Kim, Yejin;Yoo, Shin Hye;Choi, Wonho;Kim, Min Sun;Park, Hye Yoon;Keam, Bhumsuk
Journal of Hospice and Palliative Care
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v.23
no.3
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pp.126-138
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2020
Purpose: In Korea, since the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life was implemented in February 2018, advance directives (ADs) have become legally effective and should be documented after sufficient explanation by a registered counselor. However, little is known regarding the adequacy of current AD counseling. This qualitative study aimed to explore the barriers to AD counseling based on counselors' experiences. Methods: We conducted focus group interviews using purposive sampling. Seven counselors working at hospitals, community health institutions, and non-profit organizations participated in this study. They were asked about the challenges and problems they encountered during AD counseling. Results: Three themes emerged from this study; 1) issues regarding consistency in AD counseling, 2) issues regarding AD counselors' competency and work environment, and 3) issues regarding the adequacy of the service system. The interviewees stated that the lack of a manual for standardized service made AD counseling inconsistent. The limited competency and poor work environment of counselors were pointed out as major barriers. The interviewees also stated that a proper service system considering individual circumstances is absent. Conclusion: The goals of AD counseling should be clarified and guidance should be implemented for providing standardized services. Further efforts to enhance the competency of AD counselors and to improve their working conditions are needed. Establishing an integrated framework for an adequate service system is also essential to overcome systematic barriers to AD counseling.
The purposes of this study were to a) measure the service quality attributes of foodservice type such as school foodservice, hospital foodservice and business & industry(B&I) foodservice, managed by contract management company(CMC), b) compare with service quality attributes by CMC scale, c) analyze overall customer satisfaction(CS) by the foodservice type and the CMC scale, and d) identify the effect of service quality attributes on an overall CS by the foodservice type and the CMC scale. The questionnaires were handed out to 6,620 customers of 207 school, 38 hospital, and 86 B&I foodservices in 108 CMCs. The statistical data analysis was completed using SPSS Win(ver 12.0) for descriptive analysis, t-test, reliability analysis, and multiple linear regression analysis. From an analysis on service quality attributes, 'proper arrangement of table and chair at hall distribution(3.53)', 'operation of nutrition education(3.50)' were highly perceived to student, 'correctable serving(4.08)', 'serve at fixed distribution time(4.08)', 'kindness of serving employee(4.04)' were highly perceived to patient, 'employee's kindness(3.84)' were highly perceived to customer of B&I. In comparison of service quality attributes by CMC scale, most scores of large enterprise(LE) were significantly higher than small and medium sized enterprise(SME) in school foodservice, hospital foodservice and B&I foodservice. Overall CS levels were 3.53 out of a maximum 5 on B&I, 3.46 on school, and 3.44 on hospital and were evaluated differently CS score by CMC scale. Finally, regression results for the effects of service quality attributes on overall CS by each of foodservice type were identified significantly different service quality attributes by foodservice type such as school, hospital, B&I(p<.001) and by CMC scale. For considering the goal of enterprise on profit-making through CS and the needs of customer on CS at moment of truth(MOT), the findings should be applied to the CMC and the foodservice industry.
Lee, Ye Ji;Jeong, Kyeong Hye;Kim, Young Nam;Kim, Eun Young
Korean Journal of Clinical Pharmacy
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v.26
no.3
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pp.230-237
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2016
Background: Since the use of opioid analgesics is frequent in operation rooms (OR), the risk of medication error is high; however the use of medication in the OR has been operating independently with the hospital pharmacy. Therefore, the assessment on management of medication use in operation and the pharmacist's role is needed. Methods: We conducted the literature review and survey from anesthesiologists, operating nurses at Chung-Ang Hospital on management of medication for operation use, awareness on need for medication management efficiency, need for satellite pharmacy in the operating room and its effect. Results: 56% of medical staffs responded that management of medication in the operating room is efficient; however, 82.6% responded that they felt the inconvenience in medication delivery to the OR when additional prescription was ordered. 51.5% also responded that extra time was required for management of narcotics and inventory/record keeping. 80% agreed that there could be lost costs due to prescription missed. Medical staffs responded improving the drug management system could increase the OR efficiency (87%), and eventually bring the increase in hospital revenue (80.4%). Those who responded that implementation of OR satellite pharmacy was needed include physicians (84.6%), nurses (63.6%), and also responded that it'd bring more profit to the hospital by increasing the efficiency in OR (60.9%). Conclusion: For efficient management of medications, implementation of OR satellite pharmacy would lead to improved drug management and increased efficiency in OR and reduced cost and improved patient care.
Objective: To explore the feasibility of pulmonary lobectomy combined with pulmonary arterioplasty by complete video-assisted thoracic surgery (VATS) in patients with lung cancer, and summarize its surgical methods. Materials and Methods: Twenty-one patients with lung cancer in Beijing Chest Hospital Affiliated to Capital Medical University from Feb., 2010 to Jun., 2013 were selected, males and females accounting for 15 and 6 cases, respectively. Ten underwent right upper lobectomy, 5 right lower lobectomy, 4 left upper lobectomy (in which left upper sleeve lobectomy was conducted for 2) and 2 left lower lobectomy. At the same time, local resection of pulmonary arterioplasty was performed for 12 patients, and sleeve resection of pulmonary arterioplasty for 9. Results: Twenty-one patients recovered well after surgery. Thoracic drainage tube was maintained for 3-8 days, with an average of 4.9 days, and hospital stays were 8-15 days, with an average of 11 days. There were no deaths in the perioperative period, and the complications like pulmonary embolism, bronchopleural fistula, chest infection and pulmonary atelectasis did not occur after surgery. Conclusions: Performance of pulmonary lobectomy and pulmonary arterioplasty together by complete VATS is a safe and effective surgical method, which can expand the indications of patients with lung cancer undergoing thoracoscopic pulmonary lobectomy, and make more patients profit from such minimally invasive treatment.
The purpose of this research which was conducted by surveying the transfer consultation records from 360 medical institutions such as general hospitals, hospitals, clinics to the Emergency Medical Center at E University Hospital for six months(Jan. 1, 2000 - Jun. 30, 2000) are to standardize & complete transfer consultation record of hospitals at the 1st & 2nd referral level and to give patients transferred emergency medical center medical information services on a better quality. The conclusions and suggestions from this study were summarized as follows; (1) Examing the distribution of the referral medical consultation(transfer) sheet type, surgery part local clinic sheet types were 34.4%, medical part local clinic sheet types were 26.7%, undifferentiated local clinic sheet types were 23.9% and hospital level sheet types were 15.0%. (2) The items of the transfer consultation records had been standardized more than 75% in the order of patient's name, date, doctor's name, diagnosis, patient's status, impressions. (3) That the degree of recording completion on these items is in the order of patient's name, date, diagnosis, impressions was revealed. (4) Because the standardization and the degree of recording completion are very low in the patient's gender, age, address, electronic recording system was needed for more perfect input of initial patient informations. (5) This standardizing & complete recording on examination and medication will prevent re-examination and abuse of medication for patients transferred emergency medical center. (6) EMT Transfer System should be fixed in all medical institute for the standardizing & complete recording on care period and departure time will give many emergency patients the proper treatments at the proper time. (7) It was revealed that developing new standardized transfer consultation record & using electronic recording system are needed. (8) The complete recording & Fast Track System were needed for higher rate of bed operation at emergency medical center and more hospital profit.
Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.
This research is intended to inquire any discrepancy depending on the variables such as types, geography and size of hospitals of Korea in order to develop differentiated marketing strategy and to investigate how the aforementioned variables affect the management performance such as the increase in the number of foreign patients, their willingness to re-visit, the increase in profit and etc. The survey for this research was conducted for five weeks from July 10th 2014 to August 30th 2014 with 251 participants in charge of foreign patient attraction for 161 domestic hospitals. As the method of the research, a hypothesis was first established based on previous studies, followed by the incorporation of self-administered questionnaire to confirm the formulated hypothesis. Frequency analysis and ANOVA analysis were used to analyze the result of the survey. The outcome of the research and the implications are as follows. First, according to the demography of the persons-in-charge of foreign patient attraction, the proportion of female was superbly high by 76.5%. As for the age, those in their 30s were highest in proportion. Finally, for the education level, college graduates took up the largest portion by 46.5%. Second, in respect to the hypothesis assuming the difference in performance depending on the types of hospitals, national university-affiliated hospitals showed the highest level of the increase in foreign patients by the average of 3.25. Third, in respect to the hypothesis assuming the difference in performance based on geographical position, it was confirmed that hospitals in Ulsan City experienced the largest growth in the number in foreign patients. Fourth, in respect to the sizes of hospitals, those with 201 to 300 sickbeds showed the highest increase by the average of 3.45. The implication of the above research outcome indicates that while the number of foreign patients visiting Korea for medical purposes is on the rise, the number of professionals in place with necessary knowledge and capacity is insufficient and requires improvement.
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