• 한국환경보건학회지
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• 제43권3호
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• pp.214-222
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• 2017

Objectives: A hospital is a complex building that serves many different purposes. The indoor environment in a hospital plays a major role in patient well-being and the work efficiency of the hospital staff. This study was conducted to evaluate overall comfort in two major hospitals over the course of one year. Methods: Various indoor environmental conditions were measured in two general hospitals for one year (April 2014 to April 2015). Monitoring alternated between the hospitals at one month per respective monitoring session. The indoor air temperature, relative humidity (RH), mean radiant temperature and air velocity were measured in order to calculate the predicted mean vote (PMV). Carbon dioxide concentration, noise level and illumination level were concurrently measured and applied to the overall IEQ acceptance model for the hospitals (IEQh). Results: The IEQh at the two general hospitals was different at five spaces within a building. The IEQh for summer and winter were significantly different. Real-time IEQh demonstrated that indoor comfort was affected by the hospital's operating hours due to operation of the HVAC system. The percentage of indoor comfort in the hospitals was higher using PMV than IEQh. Conclusion: IEQh in the hospitals was different at locations with different purposes. Indoor comfort assessment using IEQh was stricter than with PMV. Additional research is needed in order to optimize the IEQh model.

• 한국병원경영학회지
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• 제28권3호
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• pp.58-67
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• 2023

Purpose: The purpose of this study was to analyze the factors associated with long-term hospitalized patients in long-term care hospitals using the quality assessment data for long-term care hospitals by the Health Insurance Review. Methods: Among 1,376 long-term care hospitals, frequency analysis and descriptive statistics were used to analyze the characteristics of these hospitals. Multiple linear regression was conducted to examine the associations between infrastructure characteristics, medical personnel characteristics, health outcomes and the proportion of long-term hospitalized patients. Results: The research findings indicate that the number of patients per doctor, the number of patients per nurse, and the number of patients per nursing staff were positively associated with the proportion of long-term hospitalized patients. Among health outcomes, a higher proportion of patients with more than a 5% weight loss compared to the previous month and the proportion of patients showing improvement in ADL, were more likely to have a lower proportion of long-term hospitalized patients. However the proportion of diabetic patients with HbA1c test results within the appropriate range was positively associated with the proportion of long-term hospitalized patients. Conclusion: The present study results provide fundamental data for the establishment of policies for long-term care hospitals. Based on this study, it is important to suggest screening methods for unnecessary long-term hospitalizations, such as sufficient medical personnel to improve the quality of care in long-term care hospitals. It is also necessary to clearly separate the roles of medical institutions and long-term care facilities and implement policies to support patients' social reintegration.

• 보건의료산업학회지
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• 제9권1호
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• pp.1-16
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• 2015

This study intended to measures for high performance and for identifying competitive advantages by examining the relation between the competence and performance of the first special hospitals for which the law has now been in effect for 3 years. Furthermore, the members of special hospitals were also surveyed on measures to improve the special hospital system in order to activate it. A total of 80 special hospitals participated in this study, and 171 people responded to a survey on the special hospital system. According to the results of the multiple regression analysis the relation between the competence and performance after establishing a hypothesis that special hospital competence would have an effect on organizational performance, member competence and hospital business management competence significantly had a positive (+) effect on internal performance, and marketing management competence significantly had a positive (+) effect on external performance, which partially supported this research hypothesis. Moreover, according to the results of survey on the special hospital system, the policy thought to be the most important by special hospitals was reasonable fee system reform, followed by granting incentives.

• 대한간호학회지
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• 제41권5호
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• pp.593-602
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• 2011

Purpose: In this study analysis was done of utilization of rooming-in care in South Korean hospitals in order to examine the factors related to mothers and hospitals that affect rooming-in care. Methods: With the involvement of 254,414 mothers who gave birth across 953 hospitals, the analysis used the health insurance qualification data of the National Health Insurance Corporations and Health Insurance Review and Assessment Service (2006). Factors associated with rooming-in care were analyzed using a GEE logistic regression analysis to consider factors related to both mothers and hospitals. Results: Only 45.1% of the mothers used rooming-in care. The results of the regression analysis revealed that individual factors of the mothers were not associated with rooming-in care, whereas group factors of the hospitals were. Rooming-in care use was primarily related to small hospital, location of hospital, and higher nurse staffing level. Conclusion: The findings of this study indicate that the utilization of rooming-in care is not associated with factors an individual mother, but rather with the group factors of the hospitals. Thus, a policy-based approach considering both of these types of factors is required to enhance the utilization of rooming-in care.

• 보건행정학회지
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• 제20권3호
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• pp.21-35
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• 2010

This study examined the changes in the service mix of Korean hospitals in 6 metropolitan cities between 2003 and 2005, and assessed whether the sample hospitals exhibit consistent trend or chance variation in multiple years. Three measures of hospital service mix, focusing on the specialization of services, were applied: information theory index, internal Herfindahl index, and number of distinct diagnosis-related groups (DRGs) treated. National Health Insurance claims were used to calculate the indexes. Specialization indexes were calculated in each year, and then examined to identify the pattern over time. Kappa analysis was applied to assess the agreements of specialization score between two years after hospitals were categorized into 4 groups with quartiles. Kappa score showed that the service mix of hospitals were changed during the study years. Specialization scores were increased given the market structure for three years. Hospitals which showed higher or lower specialization scores than the average of the scores consistently classified into the same group. Specialization indexes showed relatively consistent pattern over 3 years, and such consistencies were evident for hospitals regardless of the specialization status. Policy makers can identify the degree of specialization with the indexes, and it could provide a picture of how hospital services were mixed and changed over time.

• 보건행정학회지
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• 제25권2호
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• pp.118-128
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• 2015

Background: We measured productivity changes of regional public hospitals using both global Malmquist productivity index-based on global production possibility set over all the periods-and the traditional Malmquist productivity index and analyzed the factors of productivity change. Methods: The data used in this study is two annual inputs and two annual outputs of 32 regional public hospitals in Korea from 2005 to 2009 and the results such as distances and Malmquist productivity index and global Malmquist productivity index are obtained by an R program written for this study. Results: The results can be summarized as follows. Firstly, technical efficiencies of regional public hospitals are affected largely by scale efficiency than pure technical efficiency. Second, productivity progressed and technological change has more significant influence on productivity advance over the period between 2005 and 2009. Third, the circularity problem of the traditional Malmquist index is confirmed, and so the global Malmquist index without this problem are valid for the analysis. Conclusion: Though this study also has some limitations with the data of regional public hospitals with a short time span, it is the first study of hospitals using global Malmquist productivity index and later it can be expanded to private hospitals and longer time periods.

• 보건행정학회지
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• 제18권2호
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• pp.67-85
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• 2008

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

• 임상간호연구
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• 제23권1호
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• 보건행정학회지
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• 제6권1호
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• pp.144-162
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• 1996

This study was conducted to identify the problems related to operation of the committee system in university hospitals and to propose the direction for reforming it. Data were collected by surveying 138 working-level administration managers of committees from 12 university hospitals in Seoul in October, 1995. The results were as follows: 1. The purposes of the committee were to promote the reasonable dicision making in the hospitals, to satisfy the requirement of Hospital Accreditation Program and, to execute the administrational instructions in due order. The sort of job which was charged of chairmen and the majority of committee member was doctor. 2. The committees which were to be held the meeting frequently in a year were general management committees(8.25 times/year). But in case of operation rate, medical care-related committees showed the most frequent meeting(90.15%). Most of committees made the regulations and reported the results of their meeting to the CEO of their hospitals by written documents. 3. Most doctors thought the medical care-related committees useful. Medical technicians regarded education and research-related committees as useful, while administrators favored the general management committees. 4. The factors related to the perceived performance of the committee were the kind of job, the class of job and the kind of committee. Also, the perceived performance of the committee was positively related to the usefulness in efficient management of work, and negatively to uncertainties in responsibility and a nominal role of the committee. 5. Most of the respondnts thought that the concern of the top manager about the committee was the most important factor for the improvement of committee system at hospitals. They also regarded that formalization of the objectives and regulation rule and composition of committees with members which work in various fields as essential. Further studies on the organizational and operational cjharacteristics which include general hospitals in various areas are required.

• 간호행정학회지
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• 제4권2호
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• pp.363-385
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• 1998

The purpose of this study is to investigate the relationship between organizational culture types and organizational effectiveness in the hospitals and to identify the cultural and organizational characteristics of the hospitals with high organizational effectiveness. Data were collected from May 12 to June 14. 1997 through questionnaire taken by 1.118 nurses working in 10 hospitals with more than 800 beds and from annual reports published by the hospitals. The instruments were used for collecting the data: Organizational Culture Questionnatire and Organizational Characteristics Questionnatire developed by the researcher. Mowday's Organizational Commitment Questionnaire. Taylor & Bovver's General Satisfaction Scale. The Results were as follows: 1. The meta culture of the hospital organizations was the conservative culture. 2. There were significant differences of the four organizational cultural types - affiliative culture. innovative culture. conservative culture. task culture among the hospitals(p=.00). 3. The hospital organizations were classified in to three cultural patterns. each of which had similar cultural composition. on the basis of the scores indicating the similarity and difference of the foul' organizational cultural types among the hospitals. The organization of each group represents conservative- dominant culture. innovative-dominant culture and competitive culture. 4. Nurses' organizational commitment and job satisfaction were significantly different among the cultural patterns(p=.00). In other words. the hospitals with innovative-dominant culture showed higher organizational commitment and job satisfaction than ones with conservative-dominant culture and competitive culture. And also. the growth rate of outpatients and inpatients were significantly different among the cultural patterns(p<.05). The hospitals with innovative -dominant culture showed higher growth rate of outpatients and inpatients than ones with conservative-dominant culture and competitive culture. 5. The hospitals with conservative-dominant culture and competitive culture showed higher level of centralization than ones with innovative -dominant culture(p=.00) And the hospitals with competitive and innovative-dominant culture showed higher level of communication than those with conservative-dominant culture(p=.00) Finally. the hospitals with innovative-dominant culture showed higher level of managerial strategy than those with conservative-dominant and competitive culture. among which the latter showed higher level of managerial strategy than the former(p=.00).