• 한국산학기술학회논문지
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• 제16권7호
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• pp.4641-4650
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• 2015

본 연구는 지방의료원의 고객세분화를 통하여 향후 전문화된 의료기관으로 진료전문성을 강화하여 경쟁력을 확보할 수 있는 진료전문화 전략을 제시하는데 목적이 있다. 조사기간은 2013년 1월부터 12월까지 입원한 환자 26,658명을 연구대상을 선정하였다. 분석방법은 군집분석과 의사결정나무분석을 이용하였다. 결론을 보면, 성별은 여자, 연령은 60세 이상, 질환별로는 근 골격계 및 결합조직의 질환이 충성고객으로 선정되었다. 이들은 지방의료원의 고객관리측면에서 향후 구전의 효과가 높은 고객 군으로 금전적인 소비규모가 높은 점을 고려하여 이들에게 제공된 의료서비스에 대한 모니터링과 커뮤니케이션을 통해 지속적인 관계를 유지하는 것이 중요하다. 앞으로 전문 분야의 전문의와 전문적 시설 확보 등의 적합한 조직구조와 환경을 갖추는 것이 중요하며, 지역 내 개원의, 유관기관간의 전략적 제휴 통한 진료협력 및 의뢰, 의료서비스 범위의 집중화가 필요하다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권2호
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.47-60
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• 2019

Purpose: Regional public hospitals have implemented functional reinforcement projects, and the facilities to accommodate them have increased in size. Nevertheless users in hospital are concerned about space shortage and area imbalances. Therefore I will trace the factors and trends that influence the size, and derive the relationship between these and the uses' critical opinion. Methods: Among the indicators for determining the size of medical facilities, the number of beds and total floor area are the essential indicators that directly affect the composition of space and allocation of area inside the medical facility. The purpose of this study is to investigate the change and the factors of change on the these two indicators in regional public hospitals and analyze the trend of changes. Results: In accordance with support undertaking, regional public hospitals have been increased the number of chronic-based beds and expanded additional facilities such as O.P.D specialized centers, emergency centers and funeral homes for reflecting the needs of the regions and times. However, as a result of analyzing the area, regional public hospitals are growing in size mainly on the ward and O.P.D is only expanded the scope of functional reinforcement division but total area level of O.P.D is lower than the recent level. In addition, the levels of D&T, Supply, mechanical/electrical equipment area related to medical support and control environment quality are very low. This is because the functional reinforcement projects have been done without concerning diagnose the whole facility. Implications: If functional reinforcement projects are conducted, to cope with problems of space shortage and imbalance of area, it is judged that an architectural planning that comprehensively analyzes existing facilities and related departments should be included.

• 한국산학기술학회논문지
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• 제21권8호
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• pp.512-520
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• 2020

본 연구의 목적은 지방의료원의 상대적 운영효율성과 영향요인을 측정하고 비효율적인 지방의료원에 대해 효율성 제고를 위한 벤치마킹 포인트를 제시하는데 있다. 조사대상은 2014년부터 2018년까지 최근 5년간 국내 34개 지방의료원을 대상으로 내부자원과 경영실적 자료를 수집 활용하였다. 조사대상 기간 중간인 2015년에 개원한 진안군의료원은 제외하고 최종 33개 지방의료원을 조사하였다. 분석방법으로 일반적 특성과 투입·산출 변수는 빈도분석과 기술통계량 분석을, 운영효율성 지수 측정 및 상대비교를 위해 자료포락분석을 실시하였다. 연구결과, 효율병원은 11개소로 33.3%, 비효율병원은 22개소로 66.7%를 보였다. 비효율병원 22개소 중에서 규모의 확대가 필요한 IRS(규모수익체증)는 13개 소, 규모의 축소 또는 재조정이 필요한 DRS(규모수익체감)는 9개소로 나타났다. 본 연구의 의의는 상대적 효율성과 영향요인 분석을 통해 지방의료원의 성장과 지속가능 경영 및 공공성 확대를 위해 효율성 제고에 도움을 줄 수 있는 구체적인 대안이나 방향성을 제시하였다는 점이다.

• 보건행정학회지
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• 제23권1호
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• pp.78-89
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• 2013

This study empirically analyze efficiency and productivity changes of public hospitals of Korea using data envelopment analysis/Window model and global Malmquist indices model. We use the ten-year data from 2001 to 2010 of 30 regional public hospitals listed database from the Association of Korean Regional Public Hospitals. The main focuses are to reveal whether the technical inefficiency are improved as time goes by, and efficiency and productivity are affected by environmental factors. The results can be summarized as follows. First, the efficiencies of public hospitals rise in trend as time passes. Second, regional public hospitals show the different average efficiencies according to their regional type, hospital type, operational type, medicaid type, and demand and supply conditions by Mann-Whitney U-tests. Third, technical efficiency changes mainly contribute to 4.4% annual average growth rate of productivity of regional public hospitals during that period. Our findings have some policy implications. It is confirmed that there exist some environmental inefficiencies, and those inefficiencies can not be overcome through just improving the inner management system. Thus, policy and institutional changes are necessary for regional public hospitals to improve efficiency and productivity overall.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권1호
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• pp.23-30
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• 2022

Purpose: Health examination centers of regional public hospitals are essential facilities for strengthening preventive medical services in local communities. This study is to organize architectural planning data related to function, space, and area composition of health examination center by the size of the regional public hospitals. Methods: The literature review on the function and spatial composition of the health examination center and the drawings of the regional public hospitals were analyzed. Results: The result of this study can be summarized into several points. 1) The function of the health examination center consists of a diagnostic area, patient area, and staff area based on general examination and comprehensive examination. 2) The type of spatial composition of the 300-bed public hospital examination center is a spatial linkage type with examination rooms of the other departments where general examination and comprehensive examination are undifferentiated. 3) The examination center of public hospitals with 500 beds or more is composed of an independent space-separated type with self-installed examination rooms, and general examination and comprehensive examination are divided. 4) The examination center of public hospitals with 300 beds around, the diagnostic area occupies most of the total area, around 80%, but in public hospitals with 500 beds or more, the proportion of diagnostic area drops to 50-60%, and patient area increases to 30-40%. Implications: The examination center planning of public hospitals requires an architectural planning approach to the function and spatial composition according to the size of the hospital.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권2호
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• pp.35-46
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• 2024

Purpose: It is the responsibility of public healthcare to respond quickly to infectious disease outbreaks and disasters such as MERS, COVID-19, the Syrian earthquake, and the Miryang Sejong Hospital fire accident. It is very important to secure safe medical facilities and protect lives through emergency medical support and disaster response systems. The purpose of this study is to investigate the safety status of regional medical facilities that play a central role in the event of a disaster. Methods: The target was 41 local public hospitals, including 35 regional medical centers and 6 Red Cross hospitals nationwide. We delivered a questionnaire to 41 medical facilities and collected data from 32 regional public hospitals that received responses. Results: In order to respond to safety accidents, a survey was conducted on infections, falls, patient identification, and incorrect connections for medical accidents, and for in-hospital accidents, a survey was conducted on entrapment, collision, water leaks, falling objects, and crime prevention. For natural disasters, we investigated the response environment for typhoons, floods, and snow damage, and for social disasters, we investigated the response environment for fire, power outages, and radiation damage. Implications: We hope that it will be used as basic data for developing standards and creating hospital facilities and environments that are safe for everyone to respond to various disasters and prevent patient safety accidents in the future.

• 보건행정학회지
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• 제20권4호
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• pp.74-96
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• 2010

The purpose of this empirical study is to evaluate efficiency of the regional public hospitals, using DEA(Data Envelopment Analysis). to do this, we design a DEA-AR/AHP Hybrid model to evaluate efficiency of 34 Regional Public Hospitals. the proposed model is developed by adding Acceptance Region(AR). using analytical hierarchy process(AHP). this model is compared with those of typical DEA models. Financial data used in this study were obtained from Database of the Korea Association Regional Public Hospital and analyzed using DEA model. As a result of analysis, This study found that the DEA-AR/AHP Hybrid model was superior to those typical DEA models in determining the priority among efficient hospitals. the result of this study can provide helpful information to evaluate the efficiency of public hospitals for efficient operational management, to develop more precise measurement for the priority of the efficient hospitals.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.614-623
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• 2017

본 연구는 지방의료원의 효율성과 재무성과를 평가한 후 효율성에 영향을 미치는 영향요인에 대한 분석을 시행하고자 한다. 또한 병원의 투입 및 산출요소를 선정하여 어떠한 요소가 효율성에 영향을 미치고 있는가 뿐만 아니라 지방의료원의 시장점유율과 운영방식, 그리고 병원 규모 등 환경적 요인을 이용한 효율성 분석을 하였다는 점에서 선행연구와의 차별성이 있다고 할 수 있다. 조사대상은 2012년부터 2014년까지 3년간 31개 지방의료원의 DEA지수와 재무성과를 산출하였으며, 분석방법은 ANOVA, 위계적 회귀분석 등을 이용하였다. 연구결과를 보면, 지방의료원의 도시규모, 병상 수 등 환경적 요인과 경영실적, 생산성, 공공성에 따라서 효율성의 유의한 차이를 나타났으며, 의료수익의료이익율(p<0.05), 인건비투자효율(p<0.05), HHI(p<0.05)가 효율성에 영향을 미치는 것으로 나타났다. 앞으로 지방의료원의 비효율성 파악과 효율성을 높이기 위해서는 위한 투입되는 자원에 대한 효율성 측정과 함께 비용절감의 노력이 필요하다. 또한 지방의료원이 민간병원과의 경쟁에서 경쟁우위를 확보 할 수 있는 진료의 특성화된 기능을 갖는 등 전문화 서비스 제공의 노력이 이어진다면, 운영효율성을 높여 공공의료기관으로서의 역할을 충실히 할 것이다.

• 보건행정학회지
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• 제30권1호
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.