• Korea Journal of Hospital Management
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• 제6권1호
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• pp.1-17
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• 2001

According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

• Korea Journal of Hospital Management
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• 제12권3호
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• pp.47-67
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• 2007

This paper aims at suggesting several ways lo change financial vulnerability and to improve managerial capability of local public hospitals (LPHs) in Korea through the identification of factors affecting profitability. Several findings of the research are as follows: To begin with, LPHs exhibited a statistically significant difference in their profitability from one another, according to tile analyses of their profitable margins from tile general characteristics. It depends on the number of hospitals in the area, the population of the hospital-built area, the number of competing hospitals, the number of staff per 100 beds, the opening of special clinic, the educational function, and the capacity of rooms. However, there was no variable in the managerial characteristics, presenting a significant difference, in contrast with hospitals which have been managed by private companies and made a great amount of profits. Second, according to the analyses of profit differences in behavioral effort-characteristics, a statistically significant difference was revealed upon the basis of the efforts to improve the clinic service, invite special patients, and shorten the period of being hospitalized. Third, the result of analyses about the difference of profitability from medical care and finance is statistically significant in the rate of labor cost, the rate of management cost, bed-occupancy rate, and the period of being hospitalized. Fourth, according to the analyses of the factors influencing the net profit ratio of the entire capital, Adjusted explanatory power(Adjusted $R^2$) was shown up to 65.2%, which is high. To compare the adjusted explanatory power stage by stage, the first stage model applying only two variables such as structural and strategic characteristics exhibited 23.8%, and the second stage model adding financial characteristics showed 51.5%. The explanatory power was much improved up to 65.2% when the third stage model incorporated the outcome of medical care performance. When the return on investment(ROI) was examined by using the multi-variate linear regression analysis at the final model of third stage, it was found that ROI had a positive relationship with the increase rate of patients, labor costs per doctor, and medical care rate of socially protected inpatients. However, it revealed that ROI had a negative relationship with the ratio of labor costs, the number of patients per managerial staff, and occupancy rate of rooms, respectively. The research suggests that in order for LPHs to increase profitability, LPH, should make efforts not only to attract patients to the hospitals without any discrimination of the patients depending on their financial status, but also to develop efficient management methods to reduce labor costs.

• Knowledge Management Research
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• 제16권1호
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• pp.209-224
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• 2015

Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.

• Health Policy and Management
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• 제18권4호
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• pp.185-206
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• 2008

The National Health Insurance (NHI) has been the main body of health care system in Korea for the last 30 years since the NHI was founded. However, the inefficient management and strong regulations of the NHI have hindered the development of health care industry. The establishment of the MB government, whose interest lies on economic growth rather than equity, is expected to help the health care services gain a momentum. The essential measures that can step up public health care services overall are the following: the introduction of competition within NHI, the activation of private health care insurance, and the allowance of for-profit hospital. The private-public mix with market mechanism would level up the health care service for the public.

• Health Policy and Management
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• 제11권1호
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• pp.107-130
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• 2001

During the last year, we had a very severe situation with the strike of physicians working in medical facilities. From that time, many politicians and scholars insisted on the expansion of public hospitals to enhance the public role in the medical care sector. They think that private medical facilities work for profit motivation and that the high proportion of private to whole facilities is an obstacle to the public function of medical care under social insurance system. They found that one of the reasons for failing to prevent the physicians' strike was the high proportion of private facilities. Others insisted that the strike was not a good reason for the expansion of public hospitals. The physicians' strike was a very rare case, and it is not a good basis for generalization of the discussion of public hospitals. Last year almost all apprentice physicians in public facilities took part in the strike, and consequently the public hospitals also lost the role of public function. They view this increasing involvement of government in the medical sector as improper and the cause of inefficiencies. In this paper we review the debate over the expansion of public facilities. To clarify the debate, we review traditional criteria for the role of government in a market system and to apply these criteria to medical care. There are two traditional areas where government Is acknowledged to have a role in a market system: market imperfections and market failure. Where market imperfections and market failure exist, there may be a role for government. The justifications for government intervention are consumer protection and the existence of externalities. One of externalities is to provide medical care for the poor. The appropriate measures to provide medical owe to the poor can be sought in both demand and supply side subsidies. National health insurance is a method of demand subsidies and establishment of public hospitals is a method of supply side subsidies. Under the National Health Insurance System, the expansion of public hospitals is not an appropriate subsidy policy.

• Korea Journal of Hospital Management
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• 제20권3호
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• pp.13-23
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• 2015

This research is intended to inquire any discrepancy depending on the variables such as types, geography and size of hospitals of Korea in order to develop differentiated marketing strategy and to investigate how the aforementioned variables affect the management performance such as the increase in the number of foreign patients, their willingness to re-visit, the increase in profit and etc. The survey for this research was conducted for five weeks from July 10th 2014 to August 30th 2014 with 251 participants in charge of foreign patient attraction for 161 domestic hospitals. As the method of the research, a hypothesis was first established based on previous studies, followed by the incorporation of self-administered questionnaire to confirm the formulated hypothesis. Frequency analysis and ANOVA analysis were used to analyze the result of the survey. The outcome of the research and the implications are as follows. First, according to the demography of the persons-in-charge of foreign patient attraction, the proportion of female was superbly high by 76.5%. As for the age, those in their 30s were highest in proportion. Finally, for the education level, college graduates took up the largest portion by 46.5%. Second, in respect to the hypothesis assuming the difference in performance depending on the types of hospitals, national university-affiliated hospitals showed the highest level of the increase in foreign patients by the average of 3.25. Third, in respect to the hypothesis assuming the difference in performance based on geographical position, it was confirmed that hospitals in Ulsan City experienced the largest growth in the number in foreign patients. Fourth, in respect to the sizes of hospitals, those with 201 to 300 sickbeds showed the highest increase by the average of 3.45. The implication of the above research outcome indicates that while the number of foreign patients visiting Korea for medical purposes is on the rise, the number of professionals in place with necessary knowledge and capacity is insufficient and requires improvement.

• Health Policy and Management
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• 제24권1호
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• pp.4-12
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• 2014

Background: The purpose of this study is to investigate current status and investigation of government agencies, communities, corporates, hospitals, non-governmental organization, non-profit organization, and so on which performed Corporate Social Responsibility to global health issues. Methods: This paper focuses on analyzing definition and principle of public-private partnership (PPP), types of PPP, challenge of PPP through delphi survey and interview which need to be discussed by professional groups such as private groups, universities and researches, government decision makers, corporates, and hospitals for successful PPP. Results: Based on this analysis on global health issues of 237 groups, the results were shown that main global health issues of many hospitals were aids of the developing countries (48%). Main program was activities of overseas volunteers (30%) and most 152 groups (42%) supported Asia. Also, this paper gives a definition of PPP that is the growth together in PPPs as a way of fulfilling public tasks in partnership between the state administration and private enterprises to apply both strengths behind transparency, accountability. Conclusion: In conclusion, from the results of analysis, we suggest as prior setting of global issues for both demand and supply side and are served as the effective way by PPP on global health issues. Moreover, this study will be expanded on the sections of findings, multiple researches, discussion, and policy recommendations.

• Journal of The Korea Institute of Healthcare Architecture
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• 제13권2호
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• pp.53-60
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• 2007

Various changes in medical environments including growing elderly population, chronic diseases, deepening competition among hospitals since opening to foreign medical service, economic strategy for improvement of profit system have caused hospitals to be specialized. In this backgrounds, the purpose of this study is to receive basic data for architectural planning on the spatial organization of outpatient department in general hospital. The results of this study were as follows; First, major changes of outpatient department in general hospital are composed of 'co-work in medical examination and treatment', 'decentralization of diagnosis and treatment(D/T)' and 'patient-oriented medical service'. Changes by co-work system include appearance of medical offices for co-work, activation of specialized clinics, grouping of E/T section for outpatient and various types of specialized centers. Second, the grouping of E/T sections means the modification of E/T system and organization in general hospitals, and a new spatial organization will be needed. Third, the types of specialized centers are getting varied. they are classified into several types including disease-resource, social stratum-resource, human organ-resource, health-resource, rehabilitation-resource, alternative medical center and so on.

• Korea Journal of Hospital Management
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• 제4권2호
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• pp.162-191
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• 1999

This study was conducted to establish finance performance evaluation model for physicians in each clinical department, by using factors which determines financial outcome(performance) in each clinical department The ultimate aim of study is to develop effective performance-based pay system for physicians. The system, by motivating physicians, should increase their productivity. To do so, it is critical to establish finance performance evaluation model to achieve final goal of this study. 232 private hospitals were chosen from 693 hospitals which were subject to hospital survey by the Korea Institute of Health Services Management and their revenue and expense-related data during 1997 were collected. By adopting multiple regression method, the study shows that the evaluation model for each clinical department was statistically significant. The study suggest the effective performance-based pay system based on financial performance of each clinical department. The pay system includes the level of compensation, the way of how to allocate profits to each department, and criteria whether the compensation should provide or not. In conclusion, the study has following implications. First, the study suggest finance performance evaluation model for each clinical department Second, the study suggest guidelines and plans to establish qualitative measure of financial performance in each clinical department. Third, the study suggest that adopting performance-based pay for physicians could be impetus to achieve organizational goal by motivating them with fair compensation.

• Korea Journal of Hospital Management
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• 제3권1호
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• pp.62-82
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• 1998

The purpose of this study is to assess the cause and level of conflict arising within and between departments among administration office workers who work in a recently established tertiary hospitals of a major cooperation or related non-profit cooperation: The study also aimed to find methods for resolution of such conflicts by comparing with other existing university hospitals. The subject population included 299 business administration office workers randomly selected from two cooperate related tertiary hospitals of less than 3 years in its existence and two university hospitals over 700 beds in Seoul and Kyong In area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors within and between the departments. The results are as follows: 1. Those in the 30-39 rears of age group demonstrated significantly higher level of conflict between departments. Those working in the new hospitals, who were older and had long-term tenure, and those with short-term job experience at current working hospital had higher level of conflict between the departments with statistical significance. 2. Concerning the involvement of conflicting factors and the level of conflict in the administration there was statistically significant positive correlation between reliability and job-related intra- and interdepartmental level of conflict in existing hospitals. There was a significant positive correlation between intradepartmental conflicting factors of mutual dependence, difference in goal/orientation and intra- and interdepartmental level of conflict. 3. In multivariate regression analysis, women more than men, and those who had worked for many years in hospitals had statistically significant influence on factors involved in interdepartmental level of conflict, explaining 51.0% of the model. 4. In existing hospitals, gender was a significant factor with women showing a higher level of interdepartmental conflict compared to men. Among the interdepartmental factors, mutual dependence had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in managerial or general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospital setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in Purchasing, Material and Computer Department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess and make improved efforts for rapid stabilization of the premature hospital system from its inception, In the existing hospitals a lack of conflict within and between departments may give rise to stagnation or inefficiency of the organization. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.