• 한국병원경영학회지
• /
• 제28권1호
• /
• pp.14-23
• /
• 2023

Purposes: The Specialty hospital designation policy had launched in 2011 and 110 designated specialty hospitals have been operating nationwide in 2022. This study was to estimate the market share of specialty hospitals for the specific diseases compared to other types of hospitals. Methodology: Data were derived from the National Health Insurance Claim data from 2018 to 2019. Subjects were all the inpatients with MDC(Major Disease Category) that specialty hospitals specialized in. A total of 34,231,387 claims were analyzed to estimate the market share. Findings: 90 specialty hospitals were responsible for 2.4 percent of inpatient care with specific diseases for specialty hospitals. There were regional variations in the market share of the specialty hospitals as the number of specialty hospitals in regions. Specialty hospitals' market shares were relatively high in burn(31.3%), ophthalmology(16.4%), obstetrics and gynecology(7.1%), alcohol(6.0%), joint(3.7%), spine(2.7%). After adjusting the number of inpatients per hospital, hospitals specialized in burn, alcohol, ophthalmology, breast, joint, obstetrics and gynecology, and hand replantation had treated more patients than tertiary hospitals. Practical Implications: Although specialty hospitals' market share was small, some types of specialty hospitals had an impact on the regional market as well as the national level market. To improve patients' accessibility to a specialty hospital, it is necessary to government supports non-specialized hospitals to change into specialty hospitals in certain fields and regions where the number of specialty hospitals is insufficient.

• 의학교육논단
• /
• 제14권2호
• /
• pp.69-77
• /
• 2012

The purpose of this study was to investigate the differences between medical college students and graduate school students with regard to the factors that shape career choice and specialty indecision. One hundred and thirty-three students from a medical school participated in this study. The students completed a survey, which collected information on career choice, specialty indecision, and career adaptability. Significant differences were found between high and low career adaptability groups in factors that affected specialty choice and indecision. Students with high career adaptability were significantly more affected by 'intellectual content of specialty,' 'ages and characteristics of patients,''patient contact experience during the early years of medical school,' and 'greater opportunity for research.' Among the specialty indecision factors, students with high career adaptability were affected by 'several specialties equally appealing to me' and 'many interests,' while students with low career adaptability were affected by being 'unaware of my abilities,''unaware of my interests' and having 'learned my choice was not possible for me.' The factor having the greatest influence on specialty indecision was 'need more information and support,' and there were no significant differences in these factors between the two groups. The results suggest that the development of career counseling and education programs need to be designed for medical college students and graduate students in terms of career adaptability and specialty indecision.

• 한국병원경영학회지
• /
• 제29권1호
• /
• pp.56-63
• /
• 2024

Purposes: This study aims to analyze the correlation with the current status of the medical resident application rate, physician's income, and non-benefit rates of majors in each specialty subject and to suggest implications. Methodology: First, it analyzes the correlation between the medical resident application rate by specialty subject and the income of physicians. Second, it analyzes the correlation between the income of specialists and the non-benefit rate for each specialty subject at the clinic level. Findings: First, a significant positive correlation was found between the medical resident application rate and the average physician's income for each specialty subject (r=.718, p<.01). Second, a significant positive correlation was observed between physician income at the practitioner level by medical specialty and the non-benefit rate (r=.726, p<.01). Practical Implications: In this study, the correlation between medical resident application rate by specialty subject and physician's income, non-payment and physician's income was confirmed. Choosing a department that is less risky and can earn higher income is a natural phenomenon, but it is necessary to adjust the physicians crowding phenomenon to a specific specialty subject at the government level to maintain the medical system.

• 생물정신의학
• /
• 제19권4호
• /
• pp.199-204
• /
• 2012

Objectives In the previous studies, it has been suggested that temperament and character may affect specialty choice in medical students. The aim of this study is to investigate the effects of temperament and character on specialty interests in medical students. Methods A total 132 third-year medical students initially participated in this study. Among these participants, 128 students had filled out both demographic and Temperament and Character Inventory (TCI) questionnaires. Socio-demographic data, specialty interests and Cloninger's TCI scores were obtained. The specialty interests were categorized into surgical, medical and other departments. Results Among 128 students, 88 (68.7%), 29 (22.7%) and 22 (8.6%) students chose medical, surgical and other departments, respectively. Students choosing surgery departments showed lower Harm Avoidance scores (F = 4.39, df = 1, p = 0.04) and higher Self-Directedness scores (F = 4.30, df = 1, p = 0.04) than those who chose medical departments. There was no significant differences in Novelty Seeking, Reward dependence, Persistence, Cooperativeness, Self-Transcendence scores between groups. Conclusions To the best of our knowledge, this is the first study that has demonstrated the relationship between TCI scores and specialty interests of medical students in Korea. The current study suggests that temperament and character influence specialty interests in medical students. These findings could have implications for medical education research and career counseling.

• 보건행정학회지
• /
• 제34권1호
• /
• pp.78-86
• /
• 2024

연구배경: 본 연구를 통해 전문병원과 비전문병원에서 인공관절치환술(슬관절)을 받은 입원환자를 대상으로, 전문병원 지정 여부에 따른 입원환자의 의료이용을 비교하여 전문병원제도의 효과성을 파악하고자 한다. 방법: 본 연구는 2021-2022년 건강보험심사평가원(Health Insurance Review and Assessment Service) 요양급여비용 청구자료를 활용하였다. 종속변수는 입원환자의 의료이용으로, 건당 진료비와 재원일수를 선정하였다. 독립변수는 전문병원 지정 여부이며, 통제변수는 환자 단위 변수(연령, 성별, 보험자 유형, 수술 유형 및 Charlson comorbidity index)와 의료기관 단위 변수(설립 구분, 종별 구분, 소재지, 정형외과 의사 수 및 간호사 수)를 선정하였다. 결과: 건당 진료비와 전문병원 지정 여부 간 다중회귀분석 결과, 건당 진료비와 전문병원 지정 여부 간 통계적으로 유의미한 음(-)의 관계가 있었다. 이는 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮다는 것을 의미하며, 전문병원과 비전문병원의 입원환자 간 의료이용 결과에 차이가 있음을 시사한다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, 전문병원 지정기준의 완화가 필요하다. 본 연구결과, 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮은 것으로 나타났다. 이러한 전문병원의 비용 효과성에도 불구하고 전문병원 지정에 대한 높은 진입장벽으로 인해 수도권 및 대도시 지역에 전문병원이 집중되어 있다. 전문병원의 지역불균형을 해소하기 위해 "준전문병원(가칭)"을 도입하는 등 비수도권 전문병원 지정기준을 완화한다면, 지역간 건강격차 해소 및 의료비 절감의 효과를 불러올 것으로 판단된다. 둘째, 병원 의료인력 규모의 적정성을 판단할 필요가 있다. 본 연구결과, 정형외과 의사 수 및 간호사 수에 따라 건당 진료비에 영향을 미치는 것으로 나타났다. 따라서 병원 의료인력 적정 배분을 바탕으로 의료서비스의 비용 효과성을 극대화함으로써 의료비를 절감하는 효과를 불러올 수 있을 것으로 판단된다.

• 한국병원경영학회지
• /
• 제28권2호
• /
• pp.21-31
• /
• 2023

Purposes: Patient experience is a tool to evaluate the process and results of medical services provided by medical institutions from the patient's point of view. Patient satisfaction surveys are a meaningful and essential source of information for improving quality in healthcare organizations. This study aims to provide basic data for improving the quality of medical service that patients can feel by analyzing the recommendation intention and satisfaction of inpatients in specialty hospitals. Methodology: The subjects of this study were 879 inpatients in 28 specialty hospitals in 14 designated fields. We conducted a telephone survey with a structured questionnaire on the satisfaction and recommendation intention for specialty hospitals. Findings: In inpatients, hospital satisfaction was higher in nursing care services and hospital satisfaction was low in physicians care services. The overall patient satisfaction score was 91.4(SD=11.9) out of 100, and the intention of recommendation was 92.0(SD=14.1) out of 100. The factors affecting patient experience were designated fields, sex, age, residential area, monthly household income, and perceived health status. Practical Implications: This study confirmed the high level of patient satisfaction and recommendation intention among inpatients of specialty hospitals. Patient satisfaction can be of great value to healthcare providers in recognizing and improving the quality of care, as well as predicting patients' willingness to revisit medical institutions. This study can be used to improve the quality of hospital care services in specialty hospitals rather than general and tertiary general hospitals.

• 의학교육논단
• /
• 제9권2호
• /
• pp.29-40
• /
• 2007

Purpose: This study analysed the intention of medical students career choice, educational programmes, and mentoring and counseling system for career planning at Yonsei medical school in Korea. Methods: The data were collected based on four separate graduation questionnaires at Yonsei medical school in the years of 2005, 2006, 2007, and 2008. The number of the survey was 130 in 2005, 130 in 2006, 153 in 2007, and that of the latest was 120 in 2008. We analysed the career intention on medical specialties and activities, and perceptions of important factors in choosing medical specialty. Results : The results which can be drawn from this study are these: firstly. students had more intention for choosing clinical medicine as university faculty than any other activities. While male students preferred to major in surgery, neurosurgery, orthopedic surgery, urology, otorhinolaryngology, female students in internal medicine, neurology, anesthesiology and pain medicine, diagnostic radiology, laboratory medicine. Secondly, students perceived that the most important factor which can influence on choosing a medical specialty was individual factor such as one's interests and concerns, values, and aptitudes. In stead, they relatively less perceived mentor and role model's effects on choosing a medical specialty compared to those of the United States of America. Third, the career planning at Yonsei medical school was evaluated well, especially educational programmes for career planning such as self assessment programme, elective(specialized) courses, and conversation with a senior programme. Conclusions: Unexpectedly, there are high demands for career planning by medical students. Therefore, we will reorganize systematic devices for career planning such as mentoring and counseling system at medical school.

• 한방재활의학과학회지
• /
• 제23권3호
• /
• pp.177-186
• /
• 2013

Objectives This study is to evaluate the current situation of Russian tourists for medical tourism of Spine Specialty Korean Medicine Hospital. Methods 133 Russian tourists visiting Spine Specialty Korean Medicine Hospital from January 1, 2012 to December 31, 2012, were analysed in the statistics. Their data was sourced from the computerized medical records. And 87 of them answer a questionnaire about reasons for selection of Spine Specialty Korean Medicine Hospital and satisfactory for medical service. Results A total of 133 Russian visited Spine Specialty Korean Medicine Hospital for medical service, consisting of 73 females (54.8%), the fourties to fifties 58.9% by age. They avoided visiting in the winter. The average number of visiting was 7.1 times. The average treatment period was 9.9days. Majority of the elapsed time from the onset to the arrival was more than 1 year (56.6%). Low back pain (56.4%) is the most in musculoskeletal disorders and obesity (21.7%) and gynecological diseases (30.4%) were the most in a non-musculoskeletal disorders. Medication and acupuncture was the major treatment. 89.2% of the prescribed medication was the efficacy of musculoskeletal. Russian medical tourists most visited by support of travel agent (58.6%). The main reason of their visiting was non-surgical treatment for spinal disorder (31%). 96.6% of them were satisfied because rapid pain relief and kindness. Conclusions For this study, we confirmed a possibility for the Korean medical treatment of Russian tourists for medical tourism. Still, more research and goverment support for the expansion of Korean medical tourism is needed.

• 한국병원경영학회지
• /
• 제23권4호
• /
• pp.1-14
• /
• 2018

Purpose : Customers with loyalty are very important to hospitals for sustainable growth in their medical market. Individuals with loyalty are likely to visit same hospital repeatedly when they need medical services. This study was to identify factors associated with selection of specialty hospitals among customers with loyalty. Methods : The subjects of this study were 735 inpatients in 22 specialty hospitals in 6 designated fields(joints, spine, colorectal-anal, obstetrics and gynecology, ophthalmology, otolaryngology). Customer types classified as customers with high loyalty, neutral customers, and customers with low loyalty according to net promoter score(NPS). Factor analysis was conducted to classify 22 hospital selection factors into some similar properties. Logistic regression analysis was conducted to confirm the selection factors related to loyal customers. Findings : Most of specialty hospitals received high NPS of 8 points or higher in all the designated fields. Five factors associated with selection of specialty hospital are (1) hospital facilities and convenience, (2) trust in doctor and hospital, (3) rapidness of treatment, (4) hospital awareness, and (5) accessibility. As a result of logistic regression analysis, selection factors related to loyal customers were 'hospital facilities and convenience', 'trust in doctor and hospital' and 'rapidness of treatment'. Differences in the degree of importance of three selection factors by customer types appeared for each designated field. Practical Implications : This study confirms the high level of patient experience among inpatients of specialty hospitals. Factors associated with selection of hospital among inpatients with loyalty are 'facilities and convenience of hospitals', 'trust of doctor and hospital' and 'rapidness of treatment'. This study will be meaningful as basic data to systematically enhance the roles and functions of the health care system and to provide securing competitiveness according to designated fields in the management aspect of specialty hospitals.

• 한국병원경영학회지
• /
• 제28권2호
• /
• pp.44-65
• /
• 2023

Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.