• Korea Journal of Hospital Management
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• v.15 no.1
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• pp.27-48
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• 2010

The purpose of this paper is to analyze the efficiency change and its determinants of the regional public hospitals. We utilize 34 regional public hospital's panel data for 6 years from 2003 to 2008. We use DEA(Data Envelopment Analysis)-CCR, BCC model, DEA/Window model, and DEA Profiling. The empirical results show the following findings. First, technical efficiency shows that approximately 3.6% of inefficiency exists on the regional public hospitals and it reveals that the cause for technical inefficiency is due to scale inefficiency. Second, DEA/Window results show that the stable dissimilarity by standard deviation, LDP of CCR. Third, the results of partial efficiency by DEA Profiling show that increase efficiency depends on the number of beds, doctors, and nurses.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.523-529
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• 2017

This study analyzed the financial information between 2011 and 2014 comparing management performance and utilization of capital and human resources between private non-profit general hospitals and regional public hospitals operated as general hospitals. The purpose of this study was to enhance the productivity for financial independence of regional public hospitals. Comparison analysis variables were value added to the total assets, value added to the productive activity tangible fixed assets, value added to personnel expenses, ratio of value added, and operating margin to revenues. According to the analysis results, regional public hospitals showed lower investment efficiency indicator and higher ratio of value added, as well as significantly lower operating margin-to-revenues compared with private non-profit general hospitals. Moreover, the effect of investment efficiency indicators on operating margin-to-revenues was value added to the productive activity of tangible fixed assets and value added to personnel expenses in regional public hospitals; the value added to personnel expenses in private non-profit general hospitals had a significant effect on the operating margin-to-revenues, the effect of value added to personnel expenses was the greatest. Therefore, it is necessary to asset utilization to the revenue and propriety of human resources to personnel expenses in regional public hospitals.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.44-52
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• 2016

Background: This study investigates the perception of the general public regarding the concentration to metropolitan, hospitals of cardiac and cerebrovascular surgeries, and the perceived public need for government policies to resolve this issue. Methods: A total of 800 participants were recruited for our telephone interview survey. Quota sampling was performed, adjusting for age and sex, to select by various geographic regions. Sampling with random digit dialing was performed; we called the randomly generated telephone numbers and made three attempts for non-responders before moving on to a different telephone number. Results: Our sample population was 818 participants, 401 men (49.0%) and 417 women (51.0%). Our data showed that 85.5% of participants thought that cardiac surgery and neurosurgery patients are concentrated in large hospitals in Seoul. The principle reason for regional patients to want to receive surgery at major hospitals in Seoul was because of poor medical standards associated with regional hospitals (87.7%). We found that a vast majority of participants (97.5%) felt that government policies are needed to even out the clustering of cardiac surgery and neurosurgery patients, and that this clustering may be alleviated if policies that can specifically enhance the quality and the capacity of regional hospitals to carry out surgeries are adopted (98.3%). Conclusion: Government policy making must reflect public desiderata, and we suggest that these public health needs may be partially resolved through government-designated cardiac and neurosurgery specialist hospitals in regional areas.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.1-20
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• 2009

The purpose of this study is to find the determinant variables to make profitability in regional public hospitals. The data come from financial statements and annual reports of 34 regional public hospitals for five years (from year 2003 to year 2007). The T or F-test and hierarchical multiple regression analysis are used. The dependant variables are the profitability indicators, ordinary income to total asset and operating margin to gross revenue, and the independent variables are general characteristics, diagnosis and treatment patterns, financial and public benefits. The findings of this study are summarized as follows. First, Variables affecting the profitability indexes revealed from DEA results is the bed occupancy rate, number of hospitalized patients to outpatients, ratio of first medical examination for outpatients, number of daily patients per medical specialist, labor cost per patient and managerial expenses per patient. Second, the ordinary income to total asset representing the asset usage performance is affected by the average hospitalized days, bed occupancy rate, labor cost per patient and ratio of patients with medical insurance coverage. Third, the operating martin to gross revenue obtained from the actual operations of hospitals has its significance with the bed occupancy rate, number of hospitalized patients to outpatients, managerial expenses per patient and public benefit indicator. This study has some restriction not to use pannel data analysis, although it used data for five years. Accordingly, various additional studies should be done to supplement such problems.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.99-119
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• 2007

In recent years, many of medical institution have reinforced educations for their employees aiming to secure competitiveness and to achieve higher performances. In an effort to actively response to the fast changing environment in the medical industry, the Ministry of Health and Welfare has implemented "Innovation and Service promotion" educations for employees of 34 regional medical institutions and 6 Red Cross hospitals. In this regards, the effect of the educations to change employees' mind for innovation and services and its results need to be evaluated. This study conducted surveys asking participants of the 2006 Education for Innovation of Regional Public Hospital Employees and Service Promotion and synthetically analyzes the effect of the education on their mind for services compare to their mind before the education. As a result, more them 92% of participants say that they are satisfied with the education, and many more participants agreed the effect of the education to change their mind for services. Under this circumstance, after the educations participants change more positively on "their mind for innovative services" and "their service skills in practice".

• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.21-29
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• 2019

Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

• Journal of Korean society of Dental Hygiene
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• v.15 no.5
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• pp.899-905
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• 2015

Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.54 no.6
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• pp.385-394
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• 2021

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

• Health Policy and Management
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• v.33 no.1
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• pp.55-64
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• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.