• 한국병원경영학회지
• /
• 제7권2호
• /
• pp.24-36
• /
• 2002

The purpose of this paper is to find the factors affecting the number of patients per physician for a day at hospital and compare them with the results of previous studies. We used data of Korean national patients survey that had been carried out by central government and local health centers from October 27th to November 11th in 1999. Descriptive analyses were performed to overview the general characteristics of our study subject. Also, we tried to find the factors affecting the number of patients per physician for a day at hospital through t test and correlation analysis. Factors affecting the number of outpatients per physician for a day at hospital are location, training type, ownership, No. of physicians, No. of beds per physician, No. of physicists per physician, No. of nursing aids per physician and No. of medical technicians per physician. While factors affecting the number of inpatients per physician for a day at hospital are location, ownership, No. of physicians, No. of beds per physician, No. of pharmacists per physician, No. of nurses per physician, No. of nursing aids per physician and No. of administrative auxiliary personnels per physician. The most correlated variable with outpatients per physician for a day at hospital is No. of medical technicians per physician while the most correlated variable with inpatients per physician for a day at hospital is No. of beds per physician. A more detailed investigation is needed for verifying factors affecting the number of patients per physician for a day at hospital and other medical institutions.

• 한국병원경영학회지
• /
• 제14권3호
• /
• pp.83-103
• /
• 2009

The main objective of this study is to investigate the influence of physician's communication styles and quality, and physician-patient relationship on patient satisfaction for improving physician's communication which is one of factors determining service quality in health care services, and providing the suggestion for building the positive physician-patient relationship. Data were collected from 341 inpatients in 13 general hospitals and university hospitals located in Busan Metropolitan City and Kyeongsang-do area using structured self-administered questionnaires. Major results of the empirical analysis are as follows; First, mutual-opened-cooperative physician-patient relationship, patient's communication receptive attitude, patient-oriented physician's communication style, and quality were significantly varied by respondents' characteristics such as age, consensual, job, and income. Second, empathy, patient's communication receptive attitude, physician-patient relationship, and patient satisfaction were significantly varied by respondents' medical-related conditions. Third, there was a significant correlation between active communication receptive attitude of patient and mutual-opened-cooperative physician-patient relationship. Fourth, patient-oriented physician's communication style and physician-patient relationship were found to have positive influence on total communication quality and effectiveness and empathy facet of communication quality both. Finally, patient-oriented physician's communication style, empathy, active communication receptive attitude of patient, and mutual-opened-cooperative physician-patient relationship were found to have positive influence on patient satisfaction. This research findings suggest that putting emphasis on effective physician's communication and enhancing positive physician-patient relationship are crucial for marketing activities and customer satisfaction management in health care settings.

• 보건행정학회지
• /
• 제3권2호
• /
• pp.81-99
• /
• 1993

The purpose of this research is to assess the geographical distribution of physicians and dentists and the degree of maldistribution of the physician. Data were obtained form the Korean Medical Association's report on physicians registry and census for 1990. To assess the degree of disparity in the rural-urban distribution of physician manpower and to identify changes in the distribution pattern, the Gini index of concentration was used. Major findings are as follows; 1. Urban-rural disparity in the distribution of physician manpower exists in all categories of manpower, i.e. physician, dentist, oriental medical doctor, general practitioner, medical specialist, practitioner, public health physician and public health dentist. Urban area which had 74.4% of nation's population, accounted for over 90% of all physician manpower. 2. In terms of the ration of physician manpower per 10, 000 population, in urban area, they were 8.2 physicians, 2.7 general practitioners, 5.5 specialists, 3.0 practitioners, 1.8 dentists and 1.3 oriental medical doctors. In rural area, the ratios were 1.4 physicians, 0.6 general practitioners, 0.9 specialists, 1.0 practitioners, 0.4 dentists and 0.4 oriental medical doctors. 3. Gini indicies computed to measure inequality of physician manpower distribution were 0. 3675 for physicians, 0.3372 for general practitioners, 0.3338 for specialists, 0.2263 for practitioners, 0.3132 for dentists and 0.3293 for oriental medical doctors. 4. Inspite of increase in the number of physician manpower, urban concentration of physician manpower intensified from 1980 to 1990. However, the Gini index for all physician manpower fell by 18.3~36.7% from 1980 to 1990, indicating more even distribution. 5. In rural area, the public health physicians and dentists had increased the ratios of physicians, general practitioners, practitioners and dentists per 10, 000 population remarkebly, and had decreased the Gini indicies of physicians, general practitioners, practitioners and dentists. Thus, public health physicians and dentists contributed to improve the distribution of physician manpower in rural area. Based on the results of this study, long-term and rational manpower policies should be developed to solve the problem of geographical maldistribution of physician manpower as well as short-term policy for inducing physicians to the rural areas.

• 보건행정학회지
• /
• 제9권3호
• /
• pp.1-20
• /
• 1999

This study reviews the literature of influencing factor on hospital-employed physician's income, and it describes general distribution of hospital-employed physician's income, and analyzes influencing factor of hospital-employed physician's income. A total of 1.795 persons responded to the mail survey. through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study. and the unit of analysis is a physician. To examine the change of average income per month. multiple regression was used to test the change according to physician's characteristics. demographic characteristics. scale of hospital. average intensity of ordinary work. and specialty. The major findings of this study are as follows; 1. As for physicians working in first referral hospital. the average income of neurosurgeon per month was the largest. being 1.34 times larger than that of the family physician, and that of the emergency physician was the smallest, being 0.78 times smaller than that of the family physician, but that of the ophthalmic and Orthopaedic physician was significantly larger than that of the family physician under the control of control variables. And average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in rural area. 2. The year of physician's career, number of average out-patients per month significantly positively associated, but the number of hospital beds and average intensity of therapy significantly negatively associated with average income per month. 3. As for physicians working in second referral hospital. the average income of the psychiatric physician per month was the largest, being 1.33 times larger than that of the family physician, and that of the emergency physician was smallest, being 0.74 times smaller than that of the family physician., but no significant difference was seen under the control of control variables, and average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in large municipal area. 4. The year of physician's career and number of hospital beds significantly positively associated, but average working hours per month significantly negatively associated with average income per month. In conclusion, the year of hospital-employed physician's career is the largest influencing factor on hospital-employed physicians. But the difference of average income per month according to working regions and to number of hospital beds existed in employed physicians under the control of control variables. So this study has implementation that we must consider the influence of working regions and the number of hospital beds on the income of hospital-employed physicians in making policy for hospital. Being a cross-sectional study, this study can not suggest causal explanations. In the future, experiment or cohort study is needed for causal explanations.

• Journal of Preventive Medicine and Public Health
• /
• 제26권1호
• /
• pp.1-19
• /
• 1993

1989년 10월부터 실시되고 있는 약국의료보험과 의약분업제도에 관한 태도를 조사하기 위하여 대구시내 개원의사 및 재국약사를 계통적 표본추출법(systematic sampling)에 의한 표본을 선정하여 우편설문지법으로 1992년 4월 20일부터 5월 20일까지 조사하여 회신된 개원의사 184명, 개국약사 157명의 설문지를 분석한 결과를 요약하면 다음과 같다. 현재 시행중인 약국의료보험의 성과에 대해 개원의사는 71.2%가 '실패적'이라고 한 반면 개원약사는 13.4%가 '실패적'이라고 하였다. 개원의사의 50%는 약국의료보험을 폐지하고 의약분업을 도입해야 한다고 한 반면, 개국약사는 66.9%가 의약분업제도와는 관계없이 약국의료보험자체만으로도 성공적인 제도라고 하였다. 개국약사의 약국 1일 평균조제건수는 32.2회였으며, 약국의료보험 이용횟수는 6.2회로 조제건수의 20%에 불과했고, 의사처방전을 지참한 약국의료보험이용횟수는 조제건수의 0.7%였다. 그리고 개원의사의 원외처방전 발행경험자는 58.7%였다. 의약분업제도의 실시에 대해 개원의사는 59.2%가 찬성하였으며 27.7%가 반대하였으나 재국약사는 38.0%가 찬성, 45.5%가 반대 하였다. 그리고 약사가 의사보다 의약분업의 내용을 더 많이 안다고 하였다. 의약분업제도 실시의 찬성자중 찬성이유로 개원의사는 '의약품의 남오용 방지' (54.1%)를 많이 지적한 반면 개국약사는 '의사와 약사의 전문직능 발휘'(62.0%)를 많이 제기하였다. 그리고 분업찬성자에서 개원의사는 52.3%가 '완전강제분업'을 원한 반면, 개국약사는 81.7%가 '부분분업'을 원하였다. 의약분업제도 실시시에 처방전의 발행 방법에 대해서는 개원의사와 개국약사 모두 '일반명' 처방을 44.0%, 89.8%로 가장 많이 원하였고 개원의사에서는 '상품명' 처방도 35.3%나 차지하였다. 의약분업제도의 실시가 이루어지지 않은 이유에 대해 개원의사 및 개국약사 모두 '의사 약사단체 상호간의 업권문제'를 가장 많이 지적했으며 '국민들의 인식 및 관심 부족' '정부의 의지력 결여' 순으로 일치된 결과로 나타났다. 의약분업실시를 위한 선결조건으로는 '의료시설과 약국의 도시 농촌간의 균등분포'를 가장 많이 지적하였으며 의사는 '약사들의 수용태세 확립', 약사는 '의사의 수용태세 확립'을 그 다음으로 지적해 서로 상반된 결과가 나타났다. 이상의 결과를 종합해 보면 첫째, 조사대상 개원의사들은 현행 약국의료보험제도에 대해 부정적 견해를 보인 반면 개국약사들은 긍정적 견해를 보였으나 약국의료보험이용은 극히 저조하고 의사의 처방전 발행도 저조한 실정이다. 이에 약국의료보험제도에서 의약분업제도로의 제도적 전환이 고려되어야 할 것으로 생각된다. 둘째, 의사와 약사의 의약분업에 대한 의견이 상이한 점으로 미루어 유추할 수 있지만 의약분업제도 실시의 장애요인으로 의 약사단체 상호간의 업권문제와 의약사간의 갈등이 지적되는 바, 이들 모두를 만족 할 대안을 선택하는 것이 쉬운일 아닐 것이므로 국민의 건강보호차원에서 정부의 중립적 의지가 있어야 할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
• /
• 제24권3호
• /
• pp.400-413
• /
• 1991

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows : (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and in-patient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity (3) In case of physician's inpatient and adjusted-patient service, nurses' role is greater than nursing aides'. Therefore, more extensive utilization of nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.

• 보건행정학회지
• /
• 제7권1호
• /
• pp.125-154
• /
• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.

• 대한방사선기술학회지:방사선기술과학
• /
• 제18권2호
• /
• pp.103-117
• /
• 1995

Recently the suits for medical malpractice are gradually increasing in this country. The main purpose of this study is to excavate the most suitable theories about civil liabilities on medical malpractice by radiological technologist. To solve the above-mentioned problems in medical malpractice, I have proceeded to make a survey of traditional theories and tried to exvacate the most suitable theories for our medical circumstances among those theories. Both domestic and foreign relevant professional literatures and legal cases were investigated in this study. Several important findings of this study are as follows. First, the nature of legal interrelationship between radiological technologist and physician(or the representative of a hospital) is to define the content of employment. But in the eye of medical law, the interrelationship between radiological technologist and physician is written that radiological technologist should be directed by physician. Second, the nature of legal interrlationship between patient and physician(or the representative of a hospital) is to define the content of legal obligation of physician(or the representative of a hospital), and radiological technoligst execute his obligation as proxy for physician. Therefore, patient can not clame any legal right to radiological technologist. Third, radiological technologist has the obligation of Due Care in medical practice. Fourth, on the medical malpractice by radiological technologist the civil liability can be treated as either tortious liability or contractual liability, and physician(or the representative of hospital) take the responsibility for the damage compensation. In this case, physician has the right of indemnity to radiological technologist. But it should be dinied or extremely limited.

• 한국인구학
• /
• 제4권1호
• /
• pp.23-35
• /
• 1981

Health policy is directed to equity in the provision of primary care for rural people before the year of 2, 000. This study aimed to define and identify the need for physician's care by using empirical data, and suggested an alternative of the primary care delivery system in rural areas to the government. 1. Twenty percent of the study population wanted to obtain any form of medical care services. : 9.3 percent of the population was in need for physician's care; 15 percent of the need was met by physicians, while 85 percent remained unmet at the time of survey in 1979. 2. For meeting all the need for physician's primary care, 2.9 annual physician visits per capita are demanded. An alternative, which was devised in some favourable way at reasonable cost in rural settings, was suggested. It was to deploy the physician extender such as community health practitioner in the infrastructure of the health care delivery system, whose supervision is provided by physician, based on experience of the KHDI health demonstration project. 3. One physician, two community health practitioners and two community health aides should be assigned in distant locations for meeting all the estimated need for physician's primary care for 10, 000 rural underserved residents.

• 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.