• Korea Journal of Hospital Management
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• v.9 no.2
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• International Journal of Advanced Culture Technology
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• v.9 no.1
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• pp.16-21
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• 2021

As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.83-107
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• 1996

This study discusses how to rationalize or innovate the managerial practice of the profitability-deteriorated hospitals in Korea, and attempts to suggest proper planning models and strategies to reorient them. For these purposes, the hospitals' financial indicators were analysed, the process of profit planning were reviewed, and strategic assessment were made, using relevant data. The analysis shows that failures both in proper capital investment to fixed assests and in effective containment of operating costs have been causing the worsening of profitability. For the improvement of the profitability management, seven procedural and behavioral strategies were suggested from the innovative and rationalizing perspectives, together with necessary prerequisite conditions to be equipped with for their implementation. This study concludes that the top management should attempt the changs on their own initiative.

• Management & Information Systems Review
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• v.17
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• pp.107-133
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• 2005

The purpose of this study was to analyze a trend of profitability classified by characteristics of hospitals and to analyze related factors. The data for this study were derived from survey material conducted by the Korean Hospital Association on 33 hospitals in Korea between 1993 and 2002. Profitability was measured in the aspect of investment profit rate and operation profit rate with net profit to total assets, normal profit to total assets and operating margin to gross revenue as dependent variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, region), financial factors (total asset turnover, liabilities to total assets, current ratio, fixed ratio, inventories turnover, personnel costs per operation profit, material costs per operation profits), composition of manpower and facilities(personnel and area per beds), productivity index(the number of daily patients per medical doctor, the number of daily patients per nurse), the score of quality assurance activities. First, Concerning the specialists per beds or area per beds and profitability of hospitals there was not statistically significant. Second, Those hospitals having the most daily patients per nurse had significantly higher profitability than the others, but the number of daily patients per medical doctor had little effect on the profitability. Thirds, Those hospitals having a higher proportion total asset turnover tended to show significantly higher profitability compared to other hospitals, but the liabilities to total assets and liquidity ratio had a little difference to the profitability. Those hospitals having a higher proportion personnel costs per operation profit and material costs per operation profits tended to show significantly lower hospital profitability compared to other hospitals. Fourth, In regression analysis, hospital profitability had negative relationship with personnel costs per operation profit or material costs per operation profits. While it had positive relationship with total asset turnover, the number of daily patients per nurse. In conclusion, private hospitals had higher profitability than that of public hospitals. Though factors related to profitability of hospital were different according to ownership, it is important for securing appropriate profitability by operating appropriate number of nurse, raising total asset turnover, and reducing personnel costs, material costs per operation profits. This study can be used as a baseline data for planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size. However, this longitudinal observation of 33 hospitals over ten year period has significant merit alone.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.1-21
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• 1997

In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

• The Journal of the Korea Contents Association
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• v.12 no.8
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• pp.207-214
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• 2012

The purpose of this study was to review the agreement and disagreement logics on privatization of health care to bring quality enhancement of medical service and alienated area without medical services at the same time, to identify the core keywords through language network analysis a kind of contents analysis on the editorials dealing with privatization of health care and hospitals for profit published on the major daily newspapers for the recent three years, and to find out what is the core of the controversy through the connection centrality analysis of core keywords. Conclusively, it was found from the centrality analysis that "medical service," "hospital," "privatization," "privatization of health care," "hospital for profit" and "Government" were situated in the center of the controversy. It is natural that keywords such as "medical service," "hospital," "privatization," "privatization of health care"and "hospital for profit" were located in the center because this study reviewed the editorials published on major newspapers for the recent three years regarding the privatization of health care or hospital for profit. Next important keywords (words) were "people," "health"and "health insurance." It shows that privatization of health care was not simply seen as the opening of medical service market but as an important issue related to health of people and health Insurance. Next words with high centrality were "objection" and "allowance." Through the contents analysis of editorials for the last three years, it was found that the opinions for and against the privatization were equally matched according to the centrality analysis result. On the other hand, there is one noticeable result in centrality analysis, which is the keywords such as "US," "Korea US" and "FTA" showed centrality to some extent. It shows privatization is handled relating US and Korea US FTA by editorials.

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.25-43
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• 2002

This study focuses on the factors that make the financing decision of private hospitals in Korea. Data used in this study were collected from 98 hospitals with complete general data of current status as well as financial statements. They were chosen from the 138 hospitals that passed the accreditation process by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variables in this study consist of total liabilities to total assets, borrowings to total assets. The independent variables are ownership, hospital type, teaching status, location, bed size, period of establishment, asset structure, profitability, growth, tax shields, volatility of profit, competition(market concentration), and other factors. The major findings of this study are as follows. The factors found to have significant effect on liabilities to total assets are teaching status(-), asset structure(-), profitability(-), tax shields(+), and business risk(-). University hospitals have less liabilities than the non-university hospitals. It was also confirmed that high profitability, high fixed asset, high volatility of profit and low tax shields results in decrease in liabilities. The factors that significantly affect on borrowings to total assets are teaching status(-), period of establishment(-), volatility of profit(-) and competition(+).

• Korea Journal of Hospital Management
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• v.10 no.3
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• pp.45-66
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• 2005

The purpose of this study was to analyze related factors affecting profitability on general hospitals(300-499 beds). The data were derived from survey by the Korean Hospital Association on 33 hospitals during 10 years (from 1993 to 2002). Profitability was measured by 3 ratios - net profit to total assets, normal profit to total assets and operating margin to gross revenue - as dependent variables. Independent variables were classified by general factors (ownership, number of bed, period of establishment, region), financial factors (total asset turnover, current ratio, liabilities to total assets, personnel costs per operation profit, material costs per operation profits), productivity index(number of daily patient per nurse), the score of quality assurance activity and the time lag score. Multiple regression model was used in this study. First, Number of bed, region was not statistically significant for profitability. But ownership was affect positively to normal profit to total assets and operating margin to gross revenue. Private hospitals had higher profitability than that of public hospitals Second, the score of quality assurance activity was not statistically significant to profitability. Third, Those hospitals having more daily patient per nurse had significantly higher profitability than the others. Fourth, Those hospitals having higher proportion in total asset turnover had significantly higher profitability than other hospitals. But liabilities to total assets and liquidity ratio had no difference to the profitability. Those hospitals having higher proportion in personnel costs and material costs per operation profits had significantly lower hospital profitability than others.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.4
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• pp.273-285
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• 2022

Using data from a departmental profit and loss management questionnaire survey conducted for a group of hospitals consisting of various establishment entities, this study evaluates the effectiveness of departmental profit and loss management practices, such as break-even analysis, based on objective performance data. The study also examines whether the implementation of departmental profit and loss accounting is still effective in improving profitability in the financial year 2021 and whether the effectiveness of the implementation of departmental profit and loss accounting is robust. This study reconfirmed that the implementation of departmental profit-and-loss accounting has a positive effect on objective financial performance in hospitals and that the effect of improving profitability can be enhanced by implementing it monthly with high frequency and regularity and by using the accounting results more actively. It was also found that the department's implementation of break-even analysis had a positive impact on financial performance, which was enhanced by more active use of the data. Given the current economic climate, a hospital organization's active participation in income statement management, not only for the hospital as a whole but also for each department, would be an effective management activity.

• Health Policy and Management
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• v.33 no.1
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• pp.55-64
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• 2023

Background: Despite the various activities of the regional public hospitals, discussions are being made as to whether or not to continue due to the issue of financial deficit. Therefore, the main factors affecting the fiscal deficit were analyzed with 10-year data. Methods: This study is a panel analysis that analyzed the characteristics of 34 regional public hospitals and influencing factors on medical benefits for 10 years from 2010 to 2019. First, we analyze the determinants of medically vulnerable areas set by the government, analyze the trend of medical profit per 100 beds and medical profit rate from 2010 to 2019, and identify the factors that affect them. Results: Differences in medical profit per 100 beds and medical profit-to-medical profit rate were caused by market share representing regional characteristics, and both indicators improved as the number of outpatients increased. The important influencing variables are the number of doctors and nurses, and both indicators improve when there are specialists, but medical benefits decrease as the number of doctors increases when judged by the number of people per 100 beds. In addition, the number of nurses per 100 beds does not contribute to medical profit and has a negative effect on the medical profit ratio. Conclusion: As only regional characteristics were taken into account for medically vulnerable areas, operational characteristics need to be considered. The greatest impact on the finances of local medical centers is the proper staffing of doctors and nurses, and their efficient arrangement is the most important factor in financial stability.