• Quality Improvement in Health Care
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• v.27 no.2
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• pp.2-17
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• 2021

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

• Health Policy and Management
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• v.14 no.2
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• pp.1-16
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• 2004

The study purpose was to find which factors affect selection of hospital network types. This study used the 1998 American Hospital Association Annual Survey Database from Health Forum. Among these U.S. hospitals, the researcher selected hospitals located in Metropolitan Statistical Areas. Therefore the final observation cases for analysis are 1,971 Metropolitan Statistical Area hospitals in the United States. To identify significant variables influencing hospital network types, the study used proportional odds logistics regression model on population size, Health Maintenance Organization penetration rate, and market competition rate of area including a hospital, types of hospital ownership, hospital bed size, proportion of Medicare patients and Medicaid patients in total hospital patients, and occupancy rate. Contrary to conventional wisdom, selection of hospital network types was influenced by population size of area which a hospital located, types of ownership, hospital bed size, and proportion of medicare patients rather than Health Maintenance Organization penetration. Population size 1,000,000-2,499,999 had the highest probability of selecting type IV (clinical-vertical integration) from an independent hospital, and a religious group owned hospitals and for-profit owned hospitals had the highest probability of selecting Type IV (clinical-vertical integration) from an independent hospital. A bed size had positive relation on selecting Type IV (clinical-vertical integration) from an independent hospital. Unlikely general belief that the selecting types of hospital network was determined by the change of health insurance policy such as Health Maintenance Organizations and Preferred Provider Organizations, the types of hospital network were influenced by community characteristics such as population size, and hospital characteristics.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.1-12
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• 2021

Purpose: This study aims to examine the effect of the copayment reduction policy on the health care utilization of patients under age 15 after the policy started in 2017. (이하는 아래 methodoloty로 이동) Methodology: Data on the ALOS, the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age from 2015 to 2019 were obtained from the National Health Insurance database. Policy effects were measured by analyzing three dependent variables before and after policy: the average length of stay (ALOS), the average admission cost, and the out-of-pocket expenditure for patients under 15 years of age. The collected data were analyzed using the SAS package, and the analysis methods used in this study were the mean difference test and linear regression analysis. Findings: The study results reveal that, after the copayment reduction policy in the year 2017, the ALOS and the out-of-pocket expenditure were significantly decreased, but the average admission cost was significantly increased. Practical Implications: These results imply that the policy of copayment reduction for the patients under the age of 15 has contributed to mitigating the patients' financial burden with little concern about growing medical utilization.

• Health Policy and Management
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• v.4 no.1
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• pp.123-137
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• 1994

The objectives of this research is to find the factors which determined hospital profitability. The unit of analysis is hospital, and the data is collected from two sources. One source is derived from Ministry of Health and Social Affairs(4 years' data from 134 hospitals), and another source is derived from Sam-II Accounting Co.(1 year's data from 37 hospitals). Hospital profitability, which is dependent variable in our research, is measured with financial ration, such as ROI(reture on investment). The major findings are as follows; 1) The hospital profitability is determined with not hospital type itself but management-incentives associated with hospital type. 2) The maximum profitability is obtained in 775 bed-size. 3) The hospital location isn't a factor to determine profitability 4) The internal control and management, such as account receivables, inventory, fixed assert investment, is major factor to hospital profitability.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.76-91
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• 1998

Background : The purpose of this study was to understand general attitudes of physicians toward hospital quality improvement activities who have been members of QA committee in 32 Korean university hospitals. Methods : A postal survey about opinions of hospital quality improvement activities and desirable policy directions was sent to 328 QA committee member physicians. The questionnaires were composed of 48 items. In total 152 physicians responded to this survey(response rate: 49.3%). This study was carried out from January to February 1996. Results : Most physicians(97.5%) recognized the necessity of hospital QA activities. The most dominant supporting reason for quality activities was to improve clinical outcome. Two thirds of physicians regarded their own hospital activities for quality improvement as inactive. They considered that the obstacles were too little concern(33.6%), unclear objectives(28.9%), lack of human resources(14.3%), and insufficient education and training for quality improvement(10.1%). The most favoring policy among respondents was to give health care providers economic incentives. Provision of education and training for implementing quality improvement was the next to it. Physicians revealed their preferences for professional society, government, health insurance societies, consumer groups, hospital labor unions, and mass media in sequence as sponsoring agencies for hospital accreditation program. Conclusion : These study suggested that the concrete means for motivating physicians and promoting constructive partnership among related parties should be developed in order to activate current hospital quality activities in Korea.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.137-147
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• 2013

Objectives : This study aims to report current trend of Mibyeong health policy and service in China from interview of China Technology Research Group. Methods : China Technology Research Group visited Guanganmen hospital, Yanhuang Dongfang Company, Xinjingzhen health center, and Shanghai Shuguang hospital. With an interpreter, We had interviews about Mibyeong health service and policy trend, medical instrument, and research issue. Results :Mibyeong health service was performed based on KY3H system and collaboration with traditional Chinese medicine hospital. Mibyeong health service consists of diagnosis with nine constitutional type, health guide and preventive treatment. Community health center also provide Mibyeong health service, with cooperative treatment of traditional Chinese medicine and western medicine. China's Mibyeong health policy is established by Top-down decision, even though there is not enough evidence for providing health service to consumer. Through constitutional diagnosis, examinations, and treatment, huge data have been stacked; however, assessment and research based on these data are not processed well. Cooperative treatment of traditional Chinese medicine and western medicine is widely provided to patients, and their works are relatively well classified. Conclusions : China plays leading role in Mibyeong service and it seems to be developed more than Korea's. Further study is necessary to establish Mibyeong policy and health service in Korea.

• Health Policy and Management
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• v.25 no.3
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• pp.197-206
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• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• Korea Journal of Hospital Management
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• v.19 no.1
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• pp.68-72
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• 2014

• Korea Journal of Hospital Management
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• v.21 no.3
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• pp.11-21
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• 2016

The purpose of this study is to investigate the degree of difficulty and turnover of nurses working in the field and to derive clinical work activation and supply policy improvements. Data was collected from December, 2014 to January, 2015, from 23 hospitals, and participants were 3,887 nurses working in the field, Survey details : the difficulty of the clinical work of nurses working in hospitals, turnover intentions status and policy proposals for clinical research work enabled General characteristics, difficulties in clinical working, turnover intention and clinical work plan activation are frequency analysis. The difference between each of the variables in accordance with the general characteristics are one-way ANOVA analysis, Correlation analysis of the variables is also a Pearson correlation coefficients. 'difficulties in clinical working' was a statistically significant difference depending on the type of hospital, nursing class, number of beds, location, age, position, employment, gender, working form, working department, salary, career, and degree level. 'turnover intention' was a statistically significant difference depending on nursing rate, number of beds, region, age, position, sex, shifts, departments, annual income, and career. 'policy recommendation' was a statistically significant difference depending on type of hospital, nursing rate, age, position, employ, shifts, departments, annual income, degree level and career 'difficulties in clinical working' is 'turnover intention' (p<.001), 'policy recommendations' (p<.001) and had a significant positive correlation. and 'turnover intention' had a "policy recommendation" significant positive correlation with the relationship (p<.001) The most difficulties point of the nurses working in the field are the environment, such as shift, urgent and dangerous. Major policy proposals are improve treatment such as wages, and welfare.

• Health Policy and Management
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• v.22 no.1
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• pp.109-128
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• 2012

The purpose of this study is to analyze the performance difference between multi-hospitals and free-standing hospitals. Scholars in industrial economics argue that, due to economies of scale and integration, multi-hospital system may have a better performance compared to freestanding hospitals. The study overturned the hypothesis based on a theory. By analyzing 425 acute-care hospitals in Korea, this research shows that multi-hospital systems and market factors, which have been perceived to be strengths to hospitals, are negatively related to hospitals' financial performance. Specifically, the results showed a better performance of freestanding hospitals compared to multi-hospital systems. Higher labor and administrative cost by multi-hospital system may be the reason for the difference, and it means they are not more effective at cost control. Managers in multi-hospital system, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.