Objectives : The purpose of this study was to find factors affecting the cost-reduction practice of clinical nurses. Methods : The Data were collected from Feb. 25, to Mar. 15, 2015.the Total subjects were 201 nurses working in secondary-care hospitals located in Busan Results : The Meaningful variables that explain the cost-reduction practice in clinical nurses were psychological ownership, religion, and marital status in that order. Total explanation power was 22.1.% and psychological ownership has most explanation power. Conclusions : Psychological ownership and economic consciousness need to improve to develop cost-reduction practices. Additionally, nurses with and low concern about finances need to receive financial-related education.
Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.
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.
Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.
This study purports to learn the lessons from the managerial innovation of Japanese public hospitals. The performance of three innovation strategies of Japanese public hospitals, such as managerial efficiency, restucturing and networking, and rearrnagement of governance and ownership, were analyzed and its implications for Korea were discussed. Based upon it, several strategies for improving the performance of Korean public hospitals, were suggested.
The purpose of this study was to analyze a trend of profitability classified by characteristics of hospitals and to analyze related factors. The data for this study were derived from survey material conducted by the Korean Hospital Association on 33 hospitals in Korea between 1993 and 2002. Profitability was measured in the aspect of investment profit rate and operation profit rate with net profit to total assets, normal profit to total assets and operating margin to gross revenue as dependent variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, region), financial factors (total asset turnover, liabilities to total assets, current ratio, fixed ratio, inventories turnover, personnel costs per operation profit, material costs per operation profits), composition of manpower and facilities(personnel and area per beds), productivity index(the number of daily patients per medical doctor, the number of daily patients per nurse), the score of quality assurance activities. First, Concerning the specialists per beds or area per beds and profitability of hospitals there was not statistically significant. Second, Those hospitals having the most daily patients per nurse had significantly higher profitability than the others, but the number of daily patients per medical doctor had little effect on the profitability. Thirds, Those hospitals having a higher proportion total asset turnover tended to show significantly higher profitability compared to other hospitals, but the liabilities to total assets and liquidity ratio had a little difference to the profitability. Those hospitals having a higher proportion personnel costs per operation profit and material costs per operation profits tended to show significantly lower hospital profitability compared to other hospitals. Fourth, In regression analysis, hospital profitability had negative relationship with personnel costs per operation profit or material costs per operation profits. While it had positive relationship with total asset turnover, the number of daily patients per nurse. In conclusion, private hospitals had higher profitability than that of public hospitals. Though factors related to profitability of hospital were different according to ownership, it is important for securing appropriate profitability by operating appropriate number of nurse, raising total asset turnover, and reducing personnel costs, material costs per operation profits. This study can be used as a baseline data for planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size. However, this longitudinal observation of 33 hospitals over ten year period has significant merit alone.
The purpose of this study is to analyse statistically the relation between medical service quality and managerial performance. And then the way of analysis is the regression analysis that independent variable is service quality, dependent variable is the volume of revenue, the number of patients and the rate of beds utility, and dummy variable is the number of beds, ownership and region. The sample hospitals were the 113 hospitals on general hospitals more than 300beds which were consisted of 20 public hospitals, 41 corporate hospitals and 52 college hospitals, and also distributed 67 hospitals on big city and 46 hospitals other city. The sample hospitals were selected from the Korean Hospital Association and the data of the year 2003 and 2004. The collected data was analyzed using the SPSSWIN 10.0 version, and the study hypothesis was tested using regression analysis. The findings of this study are summarized as follows. First, as a result of analysing hypothesis 1. In the study of the relationship between the service quality and the revenue, it was verified that the more service quality in last year became the more revenue in the year. But the dummy variable, ownership and region, rarely related to hospital revenue. Therefore it means that the more service quality is connected to the more revenue on the large number of beds hospitals. Second, as a result of analysing hypothesis 2 & 3. In the study of the relationship between the service quality and the number of patients, it was verified that the more service quality in last year became the more outpatients in the year. But there was no verified to inpatients. It seems to be the reason why a hospital has operated the fixed number of beds approved by the public office. So there are no free to expand beds according to the number of inpatients as much as inpatients are increasing. Third, as a result of analysing hypothesis 4 & 5. In the study of the relationship between the service quality and the rate of beds utility, it was verified that the more service quality in last year became the shorter of average stay of length in the year. Especially it has influenced much more on a hospital which was the large number of beds, the corporate and the college, but the region. But it was denied that the more service quality became the more the beds turnover. As a result of this study, it shows that the service quality in the last year has importantly influenced on a hospital managerial performance in the year. Estimating the service quality of each hospital, most patients have selected the hospital they want. And the hospital need to keep the number of patients for the proper management. So this result of the study means that a hospital must improve the service quality for keeping efficient management.
This study focuses on the factors that make the financing decision of private hospitals in Korea. Data used in this study were collected from 98 hospitals with complete general data of current status as well as financial statements. They were chosen from the 138 hospitals that passed the accreditation process by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variables in this study consist of total liabilities to total assets, borrowings to total assets. The independent variables are ownership, hospital type, teaching status, location, bed size, period of establishment, asset structure, profitability, growth, tax shields, volatility of profit, competition(market concentration), and other factors. The major findings of this study are as follows. The factors found to have significant effect on liabilities to total assets are teaching status(-), asset structure(-), profitability(-), tax shields(+), and business risk(-). University hospitals have less liabilities than the non-university hospitals. It was also confirmed that high profitability, high fixed asset, high volatility of profit and low tax shields results in decrease in liabilities. The factors that significantly affect on borrowings to total assets are teaching status(-), period of establishment(-), volatility of profit(-) and competition(+).
This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.
Total quality management (TQM) has been adopted in the U.S. as a way of management strategies by private enterprises as well as by the public sector. The ultimate goal of all quality management techniques and strategies is to improve quality by reducing waste, improving production process, and involving all members of the company in quality management. The purposes of this study are to review the performance of TQM activities and, based on the results, practically examine whether TQM is necessary or not in enhancing the performance of medical service institutions (hospitals) by assessing the status of TQM activities of medical service institutions and comparing such activities. A questionnaire survey was conducted against employees working for general hospitals in Seoul and other provincial areas. The questionnaire contained organized questions that were answered in writing by the target employees. A total of 184 questionnaires were collected and analyzed. The results of this study are summarized as follows. First, TQM activities and performance were found to be positively correlated. Second, TQM activities and performance differed according to ownership types. Third, TQM activities and performance differed according to geographical locations. Fourth, TQM activities and performance differed according to leadership types.
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