• Korea Journal of Hospital Management
• /
• v.17 no.1
• /
• pp.23-42
• /
• 2012

The purpose of this study is to identify the inpatient service quality at mental hospitals and to examine the effect of service quality on patient's overall satisfaction and customer loyalty. Data collection was done through conducting a survey of inpatients in three mental hospitals located in Chungnam, Korea using self administered questionnaire. The questionnaire included the modified version of 'service satisfaction scale for psychiatric patients' invented by Chul Kwon Kim and other members, which consists of five dimension of service quality: staff attitude, treatment quality, ward environment, access/cost and ward rule. Total 236 questionnaires were gathered and 219 were used for analysis. The data was analyzed by using version SAS9.2 and path analysis model was applied to test our hypothesis. As a result, the four factors of service (staff attitude, treatment quality, ward environment and ward rule) were extracted, which counted for 62.89% of the common variance. Moreover, Cronbach Alpha showed relatively high internal consistency of answer, all exceeding 0.6. According to the study, ward environment and treatment quality turned out to have direct influence on the patient's satisfaction. In addition, staff attitude and overall satisfaction directly influenced the customer loyalty while ward environment and ward rule indirectly had influence using overall satisfaction as a medium. In conclusion, in order to enhance the satisfaction and customer loyalty in mental hospitals, efforts in improving environmental service quality in particular is highly demanded.

• Health Policy and Management
• /
• v.27 no.1
• /
• pp.30-38
• /
• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

• Health Policy and Management
• /
• v.18 no.1
• /
• pp.21-42
• /
• 2008

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

• Journal of Preventive Medicine and Public Health
• /
• v.26 no.3 s.43
• /
• pp.442-456
• /
• 1993

Financial stability is the foremost prerequisite for the continuous growth and development of hospitals. The present study aimed at developing a deterministic model using the factors which affect the hospitals profitability and at discovering which factor affected the hospital profitability. The study conducted questionnaire surveys on all general hospitals, with the exception of special hospitals, with over eighty hospital beds. Of the 274 subject hospitals, 136 of them, consituting 49.6% of the whole, were used in the study. The results are as follows. 1. In the deterministic model, outpatient revenue was affected more by the number of physician visits than by outpatient service intensity. Inpatient revenue was found to be affected more by the number of discharged patients than by inpatient service intensity. However, the increase rate of the service intensity not only contributed in stepping up the operating margin by $4{\sim}8%$ in outpatient and $3{\sim}6%$ in inpatient, but it was statistically significant. 2. Among the factors which determined the operating cost within the deterministic model, the number of patients had a greater impact on the operating cost than the resource consumption per patient. 3. The resource consumption per patient were proved to have the greatest effect on the profitability within the probabilistic model. The management cost per adjusted patient, in particular, was proven to have a statistically significant effect on the profitability in all hospitals.

• The Journal of the Korea Contents Association
• /
• v.20 no.9
• /
• pp.672-680
• /
• 2020

This study aimed to elucidate the differences in nursing service experience according to the participants' characteristics and experience of hospitalization and to identify the relation between nursing service experience and perceptions of the health system. It analyzed the data from a "Survey of health care service experience" conducted among 574 participants who had been hospitalized. The results showed that the mean nursing service experience of participants who had never used other hospitals before hospitalization with over ten days of hospital stay was higher compared with the other participants. Moreover, those who used other hospitals before hospitalization reported lower nursing service experience scores. In the classification based on the change of the inpatient room, the difference in the nurse service experience according to the number of hospitalization days was significant only in patients who had no change in the inpatient room in the multi-person room. The nursing service experience scores were positively related to general satisfaction with the hospitalization experience, health system satisfaction, and trust in the health system. This finding implies that the nursing service experience should be interpreted by separating the inpatient experience, and the strategies to improve the nursing service are needed. In addition, the survey should include items related to the characteristics of medical institutions such as nurse staffing, to identify factors affecting the experience of nursing services.

• Korean Journal of Community Nutrition
• /
• v.10 no.6
• /
• pp.943-951
• /
• 2005

The purposes of this study were to analyze the gap between foodservice personnel and inpatients, to urge foodservice providers to reconsider by identifying the problems in service delivery for customer satisfaction, and to deduce the priority for foodservice quality improvement. The results of this study can be summarized as follows : the average perception score of personnel (4.32 out of 5) was higher than that of customers (3.90). In particular, the customers' perceptions of 17 attributes, which included 'removal service of tray by foodservice personnel', 'nutrition and health-related information service', 'handling inpatient's complaint ASAP', 'delicious meals' and 'salty enough meals' and so on, was significantly lower than personnel's. Both service providers and customers perceived that 'personnel attitude' was the highest and 'meal quality' was the lowest among the 4 factors, but there was significant difference on 'meal quality'(p < .001), 'customer reception' (p < .001) and 'personnel attitude' (p < .05) between the two groups. As a results of quadrant analysis, 'removal service of tray by foodservice personnel', 'handling inpatient's complaints ASAP' and 'meal service according to doctor's orders were categorized into Quadrant A with meaning of high personnel's perceptions and low customers'. Therefore service providers have to perceive the gap between the two viewpoints and grant priority to these attributes in improving foodservice qualify. (Korean J Community Nutrition 10(6) $943\∼951$, 2005)

• The Journal of the Korea Contents Association
• /
• v.22 no.10
• /
• pp.22-38
• /
• 2022

Recently, due to the temporary closure and isolation of facilities for developmental disabilities due to the prolonged COVID-19, the pain suffered by consumers is getting worse, and there is no clear solution due to the lack of information on inpatient services. Therefore, there is a need for a service system that can prevent institutional and psychological problems for consumers. The purpose of this study is to provide systematic inpatient treatment guides, post-discharge management, and correct education for children with developmental disabilities and their guardians. After deriving the needs and improvement factors of consumers through domestic service case analysis, we conducted co-creation with end-users using the double diamond methodology. A possible service concept was derived. Accordingly, a collaborative sharing app service was proposed, and the usefulness of the service was confirmed through the usability evaluation and verification of various stakeholders. It is expected that the results of this study will be utilized in the development of an assistance system for the developmental disability ward based on user experience.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.11
• /
• pp.7463-7473
• /
• 2015

This study aims to analyze the effect of long-term care utilization on health care utilization of the national health insurance elderly. This study is a secondary data analysis of the long-term care insurance data that comprised of total 21,213 long-term care insurance with the level 1 elders who received either service or non-service. This study evaluated the impact of long-term care service on the probability of health care utilization experience and costs of health care utilization. The total medical cost, geriatric hospital's medical cost, inpatient day and geriatric hospital's inpatient day by 2007-2009 were significant factor influencing the long-term care utilization. This study suggests long term care system should proper medical service linkage system. The current long-term care insurance system should more resource allocation on long-term care utilization to increase the efficiency of insurance system.

• Health Policy and Management
• /
• v.22 no.4
• /
• pp.497-521
• /
• 2012

Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.

• Health Policy and Management
• /
• v.32 no.2
• /
• pp.154-163
• /
• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.