• Tuberculosis and Respiratory Diseases
• /
• 제84권1호
• /
• pp.74-83
• /
• 2021

Background: This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. Methods: Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. Results: A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m², previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. Conclusion: The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.

• 한국병원경영학회지
• /
• 제24권3호
• /
• pp.1-10
• /
• 2019

Purpose: The purpose of this study was to investigate determinants of purchasing indemnity private health insurance and its impact on the healthcare utilization among outpatients with chronic disease. Methods: The study analyzed 4,997 chronic ill patients using 2015 Korean Health Panel data. Logistic regression analysis was conducted to analyze the factors affecting the purchase of indemnity private health insurance and multiple regression analysis was conducted to analyze the effect of private health insurance on the number of outpatient visits and outpatient expenditures. Findings: The age, education level, and number of chronic diseases were significant factors affecting the purchasing of indemnity private health insurance among chronic patients. As a result of analyzing the impact of indemnity private health insurance on healthcare utilization, the number of outpatient visits for those who enrolled in the indemnity private health insurance was higher than the number of outpatient visits for those who did not. But there was no statistically significant difference in outpatient medical expenses. Practical Implications: The results of this study shows that indemnity private health insurance may cause inequality in the healthcare utilization of the socially vulnerable. It is necessary to seek ways to strengthen the health security of chronic disease patients and high-risk elderly people who need more healthcare.

• The Journal of Asian Finance, Economics and Business
• /
• 제8권1호
• /
• pp.419-430
• /
• 2021

The study aims to analyze the factors that shape patient loyalty, namely, by involving the service quality factor (SERVQUAL), hospital image, patient value, and patient satisfaction in private hospitals. This study was conducted in Makassar City, Indonesia, with a sample of 296 eligible samples from private hospitals. The sample criteria were patients with outpatient and hospitalization status. Then, this study developed 23 hypotheses to test the statistical relationship between direct, intervening and multiple-effect models. Problem-solving and research focus are carried out using a quantitative method approach with a PLS-SEM-based testing tool. The bootstrapping method is being used with the constant bootstrapping step to demonstrate the results of hypothesis testing; we find that the overall hypothesis has a positive and significant effect. The combination of testing models involving several variables shows that a patient's loyalty can be formed if a patient's satisfaction has been realized. Satisfaction can be realized if the value-customer has been felt by the patients. Therefore, the hospital image must be directly proportional to service quality. Service quality is the essence of service that directly affects customers; service quality is also the reason that shapes consumer perceptions in increasing rationalization and solid customer (patient's) decision-making.

• 한국병원경영학회지
• /
• 제6권2호
• /
• pp.3-21
• /
• 2001

Although the accounting system is a very useful information system for manager, that of the National University Hospitals is not settled until now. Specially, when it will adapt the responsibility management system itself, it will more important tools for them. The purpose of this research is to make the standard accounting system for National University Hospital. It was surveyed the 7 National University Hospital's accounting system, and compared to that of Private University Hospital. The results are fellows; First, it must be match financial report with budgeting system. By comparing to each other, it can make to evaluate the performance of hospital. Second, it must make same format and contents in financial report among 7 hospitals. Specially, the cost information is needed to be made more details. This research suggest the new direction to make the basic information form. It was confirmed with financial manager in private university hospital. We hope it will contribute to make the new accounting system for National University Hospital.

• 한국병원경영학회지
• /
• 제13권1호
• /
• pp.24-41
• /
• 2008

This research is aimed at analyzing and understanding the perception and attitudes of inpatients in a general hospital in Seoul towards the activation of private health insurance. Survey was conducted against 231 inpatients, results of which were analyzed in the methods of frequency analysis, chi square test, and logistic regression. The results are summarized as follows; First, better-educated population who finished college education at least, higher-income population, and people who had more knowledge about private health insurance showed more perception about activation of private health insurance. Second, better-educated population who finished college education at least, higher-income population, those who are insured in existing private insurance, oncological patients, and people who had more knowledge about private health insurance showed more positive attitude towards private health insurance paying for actual damages, long-term care insurance, and income security insurance. Third, age and education were the factors affecting perception about activation of private health insurance. The older the age is, perception was 1.035 times positive towards activation of private health insurance, and those who finished college education or above showed 3.148 times positive perception towards the same. Forth, surgical patients showed 1.087 times more positive attitude towards private health insurance paying for actual damages than internal medicine patients, while oncological patients showed 2.314 times more positive attitude than internal medicine patients. Further, understanding on the activation of private health insurance was 6.014 times higher in the higher understanding group than in the lower understanding group. Intention to use long-term care insurance was 2.692 times stronger in the male group than in the female group, and 3.616 times stronger in the oncological patients group than in internal medicine patients group. Further, understanding on the activation of private health insurance was 3.881 times deeper in the higher understanding group than in the lower understanding group. Intention to use income security insurance was 3.185 times stronger in those who have academic background of under the high school than those over the college, and 4.175 times higher in the group those whose monthly average income is over 4 million won than those under 4 million won. Also, intention to use income security insurance was 4.323 times higher in the group those who are insured by existing private insurances than those who are not insured by those insurances and it was 5.234 times higher in the group of oncological patients than in the group of internal medicine patients. Further, intention to use income security insurance was 3.559 times higher in the group those who thought that out-of-pocket money of the National Health Insurance is too much to bear than those it is quite endurable. Understanding on the activation of private health insurance was 4.875 times deeper in the higher understanding group than in the lower understanding group. There were some suggestions could be made based on the results of this research. First, reinforced publicity and education is needed for the low-educated or low-income group, as there are gaps in the understanding on the activation of private health insurance depending on the degree of education and income. Second, government should prepare administrative complementary measures to solve the problem of adverse selection by the consumer which is foreseen when private health insurances are activated. Third, government should suggest the desirable course of development of private health insurance items to ensure efficient use of enormous fund of private insurance market for health security of the people. Further, institutional complementary measures are needed to convert existing cancer insurances or specific disease insurances to private health insurances paying for actual damages guaranteeing against every kind of disease. Forth, it judged that, not only private health insurances paying for actual damages, but also long-term care insurances and income security insurances are prospective as fields to create fresh demand for insurance industry.

• The Korean Journal of Pain
• /
• 제31권4호
• /
• pp.305-306
• /
• 2018

• 한국응급구조학회지
• /
• 제25권1호
• /
• pp.147-158
• /
• 2021

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

• 한국병원경영학회지
• /
• 제9권1호
• /
• pp.22-45
• /
• 2004

This study was performed to identify factors affecting the profitability of private hospitals in Korea different and to make informations that could be very helpful to hospitals in improving profitability. Data used in this study were collected from 112 hospitals with complete general data of present conditions as well as financial statements(balance sheets, income statements). They were chosen from hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1998 to 2001 for the purpose of accrediting training hospitals. The dependent variables were used operating margin to total assets and operating margin to gross revenues as proxy indicators for profitability. The independent variables were ownership type, location, bed size, period of establishment, debt to total assets, current ratio, fixed ratio, total asset turnover, average length of stay, bed occupancy rate, admission ratio of outpatients, personnel costs per adjusted inpatient, and fiscal years. The factors had significantly positive effect on operating margin to total assets and operating margin to gross revenues were bed size, total asset turnover. And the factors had significantly negative effect on operating margin to total assets and operating margin to gross revenues were period of establishment, debt to total assets, average length of stay, personnel costs per adjusted inpatient. The adjusted $R^2$ of multiple regression equation was 25.2%, 21.4% respectively. It is very important for private hospitals to improve profitability by raising total asset turnover, and reducing debt to total assets, average length of stay, and personnel costs per adjusted inpatient using the rational and efficient business strategy.

• 한국병원경영학회지
• /
• 제23권2호
• /
• pp.42-53
• /
• 2018

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

• 한국병원경영학회지
• /
• 제11권3호
• /
• pp.73-93
• /
• 2006

This study aims at providing necessary informations for management decision-making to the hospital manager, such as ratios of fixed and variable cost to total operating expense, and variable cost ratio to operating revenues, and determinant factors affecting cost behavior. A study model and related hypotheses were established, data were collected from 41 private university hospitals for the 6years from 1998 to 2003, and regression analyses were performed to test the hypotheses. The results of the analyses and conclusions are as follows; First, labor cost and administration cost within the same number of beds have not only fixed quality of the cost, but variable quality of that. Also, the ratio of the variable costs to operating revenue of the metropolitan was estimated 76.9% and that of other area hospitals was 80.1%. Second, the major factors affecting the increase rate of the operating expense were the increase rates of the number of inpatients, the number of employee, and the number of hospital operating bed. This result implies that maintaining a optimal hospital bed size and efficient operation of the beds are important strategic factors of hospital management.