• Korea Journal of Hospital Management
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• v.9 no.4
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• pp.45-69
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• 2004

The purpose of this study is to identify the nature of the inpatient service quality of national university hospital, and based on that, to examine the relationship of hospital inpatient's perceived quality, overall satisfaction, customer loyalty(intention of revisiting, intention of oral transmitting). To carry out these objectives, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality, overall patient satisfaction and customer loyalty. Data were collected by self-administered questionnaires at a 809 bed national university hospital. These questionnaires measuring the service quality were distributed to 400 inpatients. The data samples are 347 cases in final. The response rate was 86.8%. Firstly, to categorize inpatient service quality in hospital, the factor analysis was performed on 48 items. The reliability and validity of these items was evaluated. Finally to explore the relationship of service quality, overall satisfaction, and customer loyalty, the multiple regression and logistic regression analysis are used. This study shows firstly, the dimension of inpatient service quality was categorized into 7 dimensions, that is, kindness, medical service, nurse caring, environment, facilities, appropriateness and access. Secondly, the reliability and validity of inpatient service quality items was satisfied. Thirdly, as a result of multiple regression analysis, the effect of inpatient's perceived service quality, especially, nurse caring(P<0.01), environment (P<0.01), facilities, appropriateness and access variables(P<0.05), on overall satisfaction was statistically significant. Lastly, in case of the effect on customer loyalty as a intension of oral transmitting, medical service(P<0.05), environment(P<0.01) and overall satisfaction(P<0.01) are statistically significant. Also, in case of intension of revisiting, medical service, environment, access, and overall satisfaction variables are significant factors. In conclusion, to maintain the satisfaction and customer loyalty on national university hospitals, the efforts to improve the inpatient service quality, especially, environment, medical service, and access factors might be needed.

• Health Policy and Management
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• v.26 no.2
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• pp.107-114
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• 2016

Background: Over the last few decades, because hospitals in South Korea also have undergone dramatic changes, Korean hospitals traditionally have provided specialized health care services in the health care market. Inner Herfindahl-Hirschman Index (IHI) measures hospital caseloads based on patient proportions, independent of patient volumes. However, IHI that rely solely on patient proportions might be problematic for larger hospitals that provide a high number of diagnosis categories, as the patient proportions in each category are naturally relatively smaller in such hospitals. Therefore, recently developed novel measure, category medical specialization (CMS) is based on patient volumes as well as patient proportions. Methods: We examine the distribution of hospital specialization score by hospital size and investigate association between each hospital specialization and length of stay per case and hospital cost per case using Korean National Health Insurance Service-cohort sample data from 2002 to 2013. Results: Our results show that IHI show a decreasing trend according to the number of beds and hospital type but CMS show an increasing trend according to the number of beds and hospital type. Further, inpatients admitted at hospitals with higher IHI and CMS had a shorter length of stay per case (IHI: B=-0.104, p<0.0001; CMS: B=-0.044, p=0.001) and inpatients admitted at hospitals with higher IHI and CMS had a shorter hospital cost per case (IHI: B=-0.110, p=0.002; CMS: B=-0.118, p=<0.0001). Conclusion: This study may help hospital policymakers and hospital administrators to understand the effects of hospital specialization strategy on hospital performance under recent changes in the Korean health care environment.

• Journal of Information Technology Applications and Management
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• v.21 no.2
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• pp.31-48
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• 2014

The concept of Health Related Quality of Life and its determinants have evolved since the 1980s. Although many researchers have published articles of technology usage in hospitals and the installation of technology based healthcare system, the research about applying the information technology to improve the patients' perceived quality of healthcare services is still limited. In general, services are deeds, processes and performances that are essentially concerns of the consumer. The healthcare service quality depends on tangible factors, such as equipments, facilities, and the quality of hospital staff and also the intangible ones. The main purpose of this work is to establish new model and find out the contribution of information technology to enhance the patients' perceived quality of healthcare service. We attempted to examine the main information technology related factors in 3 aspects, namely quality of information, the technology accessibility and the community that can improve patients' perceived quality of healthcare services. Offline and online questionnaires were used to measure the patients' perceived quality and were distributed to 384 people in 2 countries, Laos and South Korea. A principle component analysis and multiple regressions were used to verify our model. Results show that the use of information technology has partial positive effect on patient-physician interaction in both countries. However, patient knowledge and patient autonomy which are the 2 dimensions of patient-physician interaction has significant positive effect on patients' perceived quality of healthcare service.

• Korea Journal of Hospital Management
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• v.20 no.4
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• pp.1-13
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• 2015

This study attempts to investigate how healthcare service quality impacts upon hospital reputation, service value, and customer satisfaction. Additionally, the association of customer satisfaction with hospital loyalty and the mediation role of service value and reputation are examined. Analysis results can be summarized as followings: First, the procedural convenience and efficiency have significant impact upon customer satisfaction but personnel service and service scape do not significantly affect customer satisfaction. Second, the personnel service and service scape have significant impacts upon both the service value and hospitals' reputation. Third, service value and hospital reputation contribute significantly to the customer satisfaction. Fourth, customer satisfaction enhances significantly customer's satisfaction and intention to recommend. We conclude that a regional medical center should be able to offer high quality medical services to its customers to satisfy or delight them. Only the satisfied customers will have intention to revisit the medical center or to recommend it to their friends.

• Research in Community and Public Health Nursing
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• v.20 no.2
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• pp.243-250
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• 2009

Purpose: This is a qualitative study to identify dimensions of long-term care hospital care quality that provide high-level medical services for long-term care patients in Korea. Methods: Service consumers and providers were interviewed, and collected data were analyzed into thesis, type and dimension. The focus group method was applied to two provider groups and individual interview was applied to two persons who had experienced a long-term care hospital. Results: The results of analyzing the consumers and providers was integrated into 8 dimensions: physical environment, staff, clinical care and nursing, multiplicity of activity program, atmosphere, interaction with family, nutrition, and quality improvement system. Conclusion: The dimensions of long-term care hospital care quality from this study can be used as a basis of quality indicators. Quantitative studies to test these dimensions are required for establishing quality management systems.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.151-159
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• 2009

Objectives : This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. Methods : Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. Results : The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. Conclusions : The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.

• Korea Journal of Hospital Management
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• v.3 no.1
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• pp.165-191
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• 1998

The objectives of this research are 1) to identify different motivation of choice for each National University hospitals 2) to examine the factors influencing the patients' satisfaction, 3) and to investigate that the patients' satisfaction effects the hospital re-choice and recommendation on seven National University's hospitals. The data for this analysis were collected by questionnaire survey. Totally 852 interviews were conducted. The major statistical methods used for the analysis are paired t-test, factor analysis, x2-test, and multiple regression. We find that satisfaction level is a function of not only the quality of medical service but also non-medical service. The main results of research are follows: 1) The most important factor of hospital choices is 'the trust and fame as National University hospitals'; 2) Overall satisfaction of inpatients is turned to be influenced by the doctor's services, nurse's services, environment, and convenience. And overall satisfaction of outpatients is also found to be influenced by the waiting time for lab test; 3) Highly satisfied patients preferred to revisit and to recommend to others.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.88-104
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• 2017

The purpose of this study explains how service characteristics such as service competence, service customization, interpersonal communication and image affect service trust and affective commitments and how service trust, affective commitment play a role in affecting risk-taking and service loyalty in specialty hospital. and then confirm the mediating role of relationship quality components such as service trust and affective commitment in the above path relation. For this purpose, the research hypothesis was verified by structural equation model analysis(SEM) using SPSS 21.0 and AMOS 20.0 statistical package. The results of the study are as follows. First, interpersonal communication influenced service trust, image influenced affective commitment, service ability influenced service trust and emotional commitment, while service customization did not affect any factor. Second, service trust and affective commitment did not effect each other. Third, service trust and affective commitment were more powerful in risk-taking than the influence on service loyalty. Fourth, Risk takings affected service loyalty. Therefore, marketers of special hospitals not only medical services by providing medical service with superior service ability, but also by always strengthening interpersonal communication at the time of providing services. This will enable consumers to overcome the avoidance in the service decision process and implement a specific service marketing strategy that can continuously use the hospital service.

• Journal of Korean Academy of Nursing
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• v.34 no.2
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• pp.225-234
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• 2004

Purpose: The purpose of this study was to develop a tool that measures the quality of nursing service, to measure the quality of nursing service perceived by consumers, and to identify the gaps between ideal and actual nursing services. Method: A questionnaire was developed and distributed to 300 people who had been hospitalized in one of six general hospitals with quality of nursing services in five provincial cities in Korea. For data analysis, the SPSS/WIN(ver 10.0) program was used. Result: The 20 attributes included in the instrument of quality of nursing service is abstracted into 2 factors: tangibility and intangibility. In quality analysis, 15 of 20 attributes are minus scores, meaning that those nursing services are perceived as generally low. However among the minus scores' attributes, only two attributes are significant statistically. Gaps between importance and performance of the nursing service exists in 19 among 20 attributes. Conclusion: Nursing service quality (performance-expectation) needs to be improved, and Gaps (importance-performance) reduced. In addition, a tool measuring nursing service quality has to be developed so nurses can deal successfully with the quality and gaps of nursing service perceived by consumers.