• 한국병원경영학회지
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• 제3권1호
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• pp.238-260
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• 1998

This article describes the theoretical foundations of government policy for hospitals in terms of correcting market failure and enhancing equity. It then discusses the characteristics that desirable payment systems should have, and the effects of the DRG-based prospective payment system on hospital behavior, its financial performance, hospital industry, and health care expenditure. The rationales and impacts of other public policies for hospitals such as antitrust and fair trade regulation, dissemination of practice guidelines and hospital mortality information, regulation of hospital capital investment, and tax policy are also discussed.

• 보건행정학회지
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• 제23권1호
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• pp.19-34
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• 2013

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

• 한국병원경영학회지
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• 제7권2호
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• pp.37-51
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• 2002

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

• 보건행정학회지
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• 제10권2호
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• pp.1-21
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• 2000

This study reviewde various parametic and nonparametic method for forexasting hospital closures in Korea. We compared multivariate discriminant analysis, multivartiate logistic regression, classfication and regression tree, and neural network method based on hit ratio of each model for forecasting hospital closure. Like other studies in the literture, neural metwork analysis showed highest average hit ratio. For policy and business purposes, we combined the four analytical method and constructed a foreasting model that can be easily used to predict the probabolity of hospital closure given financial information of a hospital.

• 보건행정학회지
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• 제27권2호
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• 보건행정학회지
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• 제22권3호
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• pp.297-314
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• 2012

Purpose : The purpose of this study was to analyze the trend of the number of nursing staffs and skill mix and to assess the effectiveness of hospital nurse expansion policies in Korea. Methods : The trend of the number of nursing staffs and skill mix were analyzed using time series data, which composed of yearly series data from 1975 to 2009. The impact of hospital nurse expansion policies was estimated by autoregressive integrated moving average(ARIMA) intervention model. Results : The number of general hospital and hospital nurses per 100 beds was decreased in late 1980s and late 1990s due to rapid growth of beds. As a result of the number of nurse aids per 100 beds decreased, skill mix became high in general hospital but nurse ratio among hospital nursing staffs was about 50%. Expansion of new nurse and revised differentiated inpatient fee were only effective in expansion of hospital nursing staffs. But they had no effect in general hospitals. Conclusion : In Korea, a few policies related to expansion of hospital nurses have an effect on increasing the number of hospital nurse. Nevertheless, level of hospital nursing staffs is inferior to that of general hospital.

• 한국병원경영학회지
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• 제13권4호
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• pp.119-145
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• 2008

The objectives of this study were to inspect how the law effected on hospital employment system and which policy and strategy are needed to cope with the present situation as the law regarding irregular workers law has enacted for a year. To grasp the changes of employment style in hospital, 56 hospitals among 311 general hospitals were questioned in this study. And employment policy and strategy were developed by referencing examples of developed nations and other industries. The survey showed that the wage and welfare level of irregular workers in hospitals was improved compared to that in the other industries. But there were still much discrimination between regular and irregular workers. The policy direction of government is, first of all, to follow the principle of equal treatment to equal value of labour. The first feasible policy is to enforce social security. The second one is an employment promotion policy which reduces or exempts hospitals employing irregular workers from tax and insurance fee. The third one is to extend employment contract period to 3 years. and finally there are policies to permit more dispatched jobs and to expand the social insurance coverage. The strategies to solve the problem of irregular workers are as follows; 1) performance wage system, 2) guaranteeing employment by unlimited contract, 3) creating new category of workers, 4) the wage system of management by object, 5) the method of job classification. This study has a meaning in the point that it was studied on hospital which is special industrial part and analyzed the changes after enacting irregular workers law and presented management strategy for countermeaure program. In this study, it was expected to contribute to decisions-making in hospital management, especially when using human resources.

• 보건행정학회지
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• 제27권3호
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• pp.211-218
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• 2017

Background: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. Methods: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. Results: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. Conclusion: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.

• 디지털정책학회지
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• 1권1호
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• pp.21-26
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• 2022

본 연구에서는 요양병원이 입원비 지출 발생에 기여도가 큰점을 주목하여, 요양병원의 입원정책을 살펴보고, 불필요한 입원비발생을 유발한 점이 있다면, 해외사례를 참조하여 개선방안을 제안하고자 한다. 본 연구는 건강보험공단과 건강보험심사평가원에서 발행한 건강보험통계연보, 건강보험 주요통계를 주로 활용하여 연구를 진행하였다. 이를 바탕으로 요양병원이 입원비 발생에 가장 큰 기여를 한다는 것을 추론하였다. 본 연구 결과 요양병원의 입원규정이 명문화 되지 않았다는 문제점을 발견하였고, 명문화 되지않은 입원 기준이 불필요한 입원비 발생해 기여 할수 있다는 점을 발견하였고, 이를 극복하기 위한 개선방안을 우리보다 먼저 고령화를 경험한 미국의 사례에서 제안해보았다. 본연구를 시작으로 요양병원에서의 불필요한 입원비 지출을 줄인 보다 많은 외국의 사례들을 찾아야 할 것이다.

• 보건교육건강증진학회지
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• 제26권1호
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• pp.159-170
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• 2009

The purpose of this study was to review national mental health policy goal in Korea and America, and to suggest strategies for advancing the national mental health policy in Korea. Objectives: First, the review of nation mental health policy in Korea. Second, the review of nation mental health policy in America. Third, the development of nation mental health plan in Korea. Methods: To achieve this objectives, review the books, journals, and national published papers and so on. Results: First, 15 goals are planned for mental health promotion in Korea Health Plan 2010. Second, 14 goals and multiple strategies are planned for mental health promotion in America Healthy People 2010. Third, 3 plans are suggested for mental health promotion in Korea. Conclusion: Mental Health is essential dimension in holistic health. And mental health promotion has been increasingly emphasized in national health plan. Therefore, effective nation mental health policy establishment would be needed continuously.