• Health Policy and Management
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• v.9 no.3
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• pp.1-20
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• 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.

• Korea Journal of Hospital Management
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• v.29 no.1
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• pp.56-63
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• 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.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.770-785
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• 1998

This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 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 clinic, average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was mcreased \4,850,000, but the difference was \6,020,000 under the control of control variables. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.73-87
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• 1992

The level of copayment increased in order to stabilize the financial condition of the health insurance on 1986. An important question regarding the policy was whether the increase in the level of copayments reduced the utilization of medical services in the poor selectively. In spite of the importance of the research question, no study has been reported. This study was designed to find out changes in numbers of physician visits, to explain characteristics influencing the difference of utilization before and after the program. Finally the interaction effect between the program and the level of income was examined for the abover question. A total of 10,421 persons from eight institutions was selected as the study sample. Research findings are as follows. 1. The number of physician visits decreased by ten percent as a result of increasing the level of copayment. 2. The decrease was remarkable in some groups such as children, rural area and large family. 3. The most important factor which explained the difference was the number of physician visits before the introduction of the new program. The more numbers of physian visits during the last year were, the more numbers of physian visits decreased after the program. 4. The interaction term between the program and the level of income was statistically significant in the multiple regression model which explained physician visits and its coefficient was negative. It means that an increase in copayment did not reduced the number of physician visits in the poor, selectively. 5. It can be concluded that imposing adequate copayment reduces the use of medical services as well as medical costs without serious damage in access especially for the poor people.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.389-397
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• 2022

Objectives: This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups. Methods: We conducted an experimental vignette survey using a proportional quota-based sample of individuals in Korea (n=1229). In two hypothetical vignettes, participants were asked whether they would be willing to use MRI if they had uncomplicated headache and non-specific low back pain, each before and after OOP payment reduction. To account for the possible role of physician inducement, half of the participants were initially presented with vignettes that included a physician recommendation for low-value care. The predicted probability, slope index of inequality (SII), and relative index of inequality (RII) were calculated using logistic regression. Results: Before OOP payment reduction, the lowest income quintile was least likely to use low-value MRI regardless of physician inducement (36.7-49.6% for low back pain; 30.5-39.3% for headache). After OOP payment reduction, almost all individuals in each income quintile were willing to use low-value MRI (89.8-98.0% for low back pain; 78.1-90.3% for headache). Absolute and relative inequalities concerning potential low-value MRI utilization decreased after OOP payments were reduced, even without physician inducement (SII: from 8.15 to 5.37%, RII: from 1.20 to 1.06 for low back pain; SII: from 6.99 to 0.83%, RII: from 1.20 to 1.01 for headache). Conclusions: OOP payment reduction for MRI has the potential to increase low-value care utilization among all income groups while decreasing inequality in low-value care utilization.

• Health Policy and Management
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• v.9 no.2
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• pp.95-117
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• 1999

The purposes of the study was to analysis the factors on the physicians' indemnity experience and indemnity on malpractice. Data was collected from mail interview for the physicians from August, to October in 1996. Questions were asked to the physician who selected with random sample(n=8.338) about the opinion of malpractice insurance. experience that he(she) have requested the indemnity from patience. context of experienced indemnity and demographic characteristics of physician and patience. Response rate is 37.5%(n=3,124). This study was analyzed in two levels' the first. influential factors on whether physician has experience of indemnity and the second. influential factors of indemnity among physicians who had experienced the indemnity. The major findings were as follows : 1. Logistic regression on whether physicians had experience of indemnity request was conducted. And it indicated that statistically meaningful variables of model 1 (about all physicians) were department of surgery, physicians who have intention of insurance fee, physician age and income, physicians who owned the hospitals and statistically meaningful variables of model 11 (about physicians who owned the hospital) were department of surgery and internal treatment. 2. Multiple regression on the influential factors on indemnity was conducted. And it showed that statistically meaningful variables in model 1 were method of malpractice quarrel(physician association), whether physician had malpractice, whether suit succeeded, physician age, average practice time and income and whether physician owned the hospital and statistically meaningful variables of model 11 were whether physician had malpractice, number of outpatient, number of beds. As the conclusion, the thesis was examined about the variables related with experience of indemnity and cost of malpractice. But in order to prevent malpractice and promote medical quality, the reasonable system to solve a malpractice have to settle and cost estimation on malpractice is essential. Therefore an advanced research is progressed with methodology to decide the indemnity bases.

• Health Policy and Management
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• v.6 no.1
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• Korea Journal of Hospital Management
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• v.14 no.3
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• pp.83-103
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• 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.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.72-81
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• 2019

Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.419-430
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• 1988

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.