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The determinants of the Profitability of University Hospitals in Korea (대학병원 수익성에 영향을 미치는 요인 분석)

  • Yang, Jong-Hyun;Chang, Dong-Min;Suh, Chang-Jin
    • Korea Journal of Hospital Management
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    • v.15 no.4
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    • pp.43-62
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    • 2010
  • This study provides an evidence on the determinants of the profitability of university hospital by analyzing university hospital-level data set of hospital performance during the year 2007 (32 university hospitals in total). For the study, a multiple regression model is employed in which profitability index obtained from the DEA computations, operating margin to total asset and gross revenue are used as the dependent variables, and a number of hospital operating characteristics are chosen as the independent variables such as ownership type, location, bed size, period of establishment, bed occupancy rate, admission ratio of outpatients, patients per medical specialist, personnel cost per patient, liabilities to total assets, current ratio, fixed ratio, total asset turnover, medical assistance rate and public indicator. First, the results indicate that the bed occupancy rate and liabilities to total assets are positively and significantly associated with operating margin to total asset. Second, number of beds, the bed occupancy rate and number of patients per medical specialist are positively and significantly associated with operating margin to gross revenue. Third, the bed occupancy rate, number of patients per medical specialist, liabilities to total assets, total asset turnover are positively and significantly associated with profitability index revealed from DEA.

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Study of Management and Environmental Factors Affecting Medical Expense Reduction (의료기관 운영요인과 환경요인이 진료비 삭감율에 미치는 영향에 관한 연구)

  • Yang, Yu-Jeong
    • Journal of Digital Convergence
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    • v.10 no.11
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    • pp.493-502
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    • 2012
  • This study aimed to determine the management and environmental factors affecting medical expense reduction. For analysis, medical expenses were divided into hospitalization expenses and outpatient treatment expenses, and the rate of medical expense reduction was classified into initial and final reduction rates. Data were collected through a direct survey among 205 directors of independent health insurance review departments of hospital-level medical institutions in Korea. The results of the study are discussed below: In the analysis, differences in the initial and final reduction rates of hospitalization expenses and outpatient treatment expenses were compared. The results showed that, in hospitalization expenses, the initial and final reduction rates were both significantly affected by the following management factors: number of beds, number of departments, number of personnel reviewing health insurance cases, and total number of employees. Further, in outpatient treatment expenses, the initial and final reduction rates were both affected significantly by the following management factors: management of medical records, number of beds, number of departments, number of personnel reviewing health insurance, and total number of employees. The management factors significantly affecting both the initial and final reduction rates were higher number of beds for hospitalization expenses and electronic medical record management for outpatient treatment expenses. The environmental factors significantly affecting both the initial and final reduction rates of hospitalization expenses were a highly cooperative work environment, better implementation of indicator management systems, and overtime pay. Better implementation of indicator management system and a committee for handling medical expenses had significant effects on the initial reduction rate for outpatient treatment expenses. A highly cooperative work environment, better implementation of indicator management system, and overtime pay had significant effects on the final reduction rate for outpatient treatment expenses.

Hospital Nutrition Services I : Organization, Personnel and Productivity of Nutrition Department (의료기관 영양서비스 현황 I : 영양부서 조직.인력체계 및 작업생산성)

  • 김동연;이윤태;김정원;장영애;서희재;김영찬;윤성원
    • Journal of Nutrition and Health
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    • v.34 no.4
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    • pp.458-471
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    • 2001
  • To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)

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Species Composition of Fish from Sea Grass Bed in Chuuk Lagoon, Micronesia (마이크로네시아 축 환초내 잘피밭의 어류 종조성)

  • Choi, Young-Ung;Yoon, Kon-Tak;Lee, Dae-Won;Kim, Taihun;Kim, Yoonchil;Park, Heung-Sik
    • Ocean and Polar Research
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    • v.35 no.4
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    • pp.441-452
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    • 2013
  • The fish species composition of seagrass bed in Chuuk Lagoon, Micronesia, was investigated every month from August 2009 to July 2011, using a seine net for fish caught. A total of 32 fish species belonging to 18 families under 6 orders were identified during the study period. Of these fish, Atherinomrus lacunosus, and Strongylura incise were the major dominant species representing 85.0% in total number of individuals. The number of species and individuals were high from August to December 2009, 2010. The biomass was highest in September 2010 and the diversity index was higher in September 2009, April, August 2010 and July 2011. The 14 dominant species could be divided into 2 groups of 3 individuals based on appearance patterns; (1) resident species and temporal species (9 species, e.g. Atherinomrus lacunosus), juvenile and adults living in seagrass beds and juveniles living only in seagrass beds; (2) temporal species (2 species, e.g. Hemiramphus lutkei), juveniles living only in seagrass beds; (3) temporal species (3 individuals, e.g. Caranx sexfasiatus). For some species, the appearance patterns were affected by water temperature. However, the relationships between sea currents, salinity, tide, and structure of fish assemblage remain unclear. Further studies that regularly monitor sea grass habitats are necessary to clearly understand the correlation between environmental factors and sea grass habitat use patterns in fish assemblages.

The Effects of Hospital Resources on the Service Uses: Hospital Service Area Approach (병원서비스지역 내 병원자원과 의료서비스 이용 간의 관련성 분석)

  • Kwak, Jin-Mi;Kim, Da-Yang;Seo, Eun-Won;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.25 no.3
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    • pp.221-228
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    • 2015
  • Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

The Effects of Insurance Types on the Medical Service Uses for Heart Failure Inpatients: Using Propensity Score Matching Analysis (의료보장유형이 심부전 입원 환자의 의료서비스 이용에 미친 영향분석: Propensity Score Matching 방법을 사용하여)

  • Choi, Soyoung;Kwak, Jin-Mi;Kang, Hee-Chung;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.26 no.4
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    • pp.343-351
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    • 2016
  • Background: This study aims to analyze the effects of insurance types on the medical service uses for heart failure inpatients using propensity score matching (PSM). Methods: 2014 National inpatient sample based on health insurance claims data was used in the analysis. PSM was applied to control factors influencing the service uses except insurance types. Negative binomial regression was used after PSM to analyze factors that had influences on the service uses among inpatients. Subjects were divided by health insurance type, national health insurance (NHI) and medical aid (MA). Total charges and length of stay were used to represent the medical service uses. Covariance variables in PSM consist of sociodemographic characteristics (gender, age, Elixhauser comorbidity index) and hospital characteristics (hospital types, number of beds, location, number of doctors per 50 beds). These variables were also used as independent variables in negative binomial regression. Results: After the PSM, length of stay showed statistically significant difference on medical uses between insurance types. Negative binomial regression provided that insurance types, Elixhauser comorbidity index, and number of doctors per 50 beds were significant on the length of stay. Conclusion: This study provided that the service uses, especially length of stay, were differed by insurance types. Health policy makers will be required to prepare interventions to narrow the gap of the service uses between NHI and MA.

Species Composition and Seasonal Variation of Fish Assemblages in Sargassum Beds in Gamak Bay, Korea (가막만 모자반 군락지 어류군집의 종조성 및 계절변동)

  • Yoon, Ho-Seop;An, Yun-Keun;Choi, Sang-Duk
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.17 no.1
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    • pp.15-21
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    • 2011
  • Species composition and seasonal variation of fish assemblages in Sargassum beds in Gamak Bay was determined using fish samples collected monthly by a surrounding net from October 2008 to September 2009. A total of 21 species, 582 individuals and 5,345.1 g of fishes were collected during the study period and Perciformes accounted for 47.6 % of the total number of species. Takifugu niphobles, Engraulis japonicus and Lateolabrax japonicus predominated in number, accounting for 55 % of the total number of individuals. Higher number of species and individuals occurred in June and in September-October. Species were grouped into three by cluster analysis: A) dominant species such as Leiognathus nuchalis and Takifugu niphobles, B) fish collected mainly in spring such as Sebastes inermis, Chaenogobius heptacanthus, Pterogobius zonoleucus, Pholis nebulosa, and Trachyrhamphus serratus, and C) fish collected mainly in autumn such as Engraulis japonicus, Lateolabrax japonicus, and Hyporhamphus sajori.

Variation in Species Composition of Fishes in the Eelgrass Beds of Minyang in Tongyeong, Korea (경남 통영 민양마을 잘피밭 어류의 종조성 변동)

  • Gwang-Hyeon Jo;Woo-Seok Gwak
    • Korean Journal of Ichthyology
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    • v.36 no.1
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    • pp.58-67
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    • 2024
  • The purpose of this study was to find out the fish species that appeared monthly through the fish stock survey of Minyang eelgrass beds in Tongyeong and compare them with the results of previous studies in the same area. This survey confirmed the species compositional characteristics of fish using surf net from March 2021 to February 2022. During the survey period, a total of 24 species, 8,679 individuals, and 3,714.42 g of the total fish were collected. The dominant species were Gymnogobius castaneus, G. heptacanthus, Chaenogobius gulosus, Pholis nebulosa, Rudarius ercodes which accounted for 95.9% of a total number of individuals collected. Similar to previous studies, most of the fish species that appeared were gobiidae, and in this study. Leiognathus nuchalis, which was selected as pollution indicator species, appeared for the first time.

Analysis of Clinical Nutrition Management Performance and Importance of Clinical Nutritionists According to the Accreditation of Mental Medical Institutions (정신의료기관 인증여부에 따른 임상영양사의 임상영양 관리업무 수행도와 중요도 분석)

  • Kim, Song-Hee;Jeong, Yong-Ju
    • Quality Improvement in Health Care
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    • v.25 no.2
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    • pp.56-72
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    • 2019
  • Purpose: The purpose of this study was to determine the factors that influence the performance and importance of clinical nutritionists. Methods: Ninety-nine nutritionists working in mental health institutions were assessed. Results: Factors affecting the performance of clinical nutritionists in certified hospitals were shown to have a significant positive effect on the description of treatment diet, status of clinical nutrition management, and presence of a nutrition counselor. The factors affecting importance were the number of permission beds and total work experience. Conclusions: In order to improve the accreditation system of mental hospitals, it is necessary to expand the scope of this study to include hospitals with fewer beds, and clinical nutrition management should be mandatory.

Analysis of influencing factors on hospital-employed physician's income (병원근무 전문의 소득에 영향을 미치는 요인분석)

  • 박웅섭;김한중;손명세;박은철
    • 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.

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