• Korea Journal of Hospital Management
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• v.16 no.3
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• pp.92-114
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• 2011

The study has its purpose on providing basic resource to enforce the capability of the middle managers by examining the level of performance and the level of awareness about the capabilities of the managers and by understanding the significance of the difference and the reasons for the differences. The source of the study was 195 survey questionnaires that were carried out to the managers of the 9 general hospitals and the method of the analysis was the frequency analysis, analysis of the credibility, matching to sample T-test, independent sample T-test, dispersion analysis, correlation analysis, and multiple linear regression analysis using accumulated variables. The followings are the main result of the study. First, the difference between the level of awareness about the capabilities and the level of performance of the mediator managers in general hospitals had high capability in change management. The following orders were: competence in achievement and behavior, competence in management, competence in recognition, competence in influence, competence in individual effectiveness, and competence in personal relationship service. Second, as the result of the relation analysis in order to understand the correlation between awareness and performance of the mediator managers, everything had significant positive correlation. In the study about the level of importance, the cognitive capability and the management capability had the highest correlation with the correlation number of 0.88. In the study about the level of performance, the cognitive capability, individual capability, and the management capability had the highest correlation with the correlation variable number of 0.79. Third, as the result of studying the reason for the difference between the level of the awareness capability and the level of the performance, lack of the support recognition compensation in the organization level, inappropriate work environment, limit in the regulation were found as the highest reason in the order. As the result of the study, it was concluded that the creation of the efficient capability estimation model and the securement of the system that estimate the capability of the managers should be carried out in order to enforce the capability of the mediator managers in general hospitals.

• Health Policy and Management
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• v.16 no.4
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• pp.48-67
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• 2006

The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low ($2.36{\pm}0.36$, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest $(2.93{\pm}0.36)$, followed by drug availability $(2.51{\pm}0.07)$ and general cleanliness $(1.66{\pm}0.55)$. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.

• Health Policy and Management
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• v.29 no.4
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• pp.482-495
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• 2019

Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.11
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• pp.3444-3450
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• 2009

Our study was carried out to suggest the way of improving the accessibility of medical service through identifying the factors that make patients be hospitalized in non-residential area not in their residential area. The subjects were 523,782 inpatients of the 2005 Patient Survey data. The 2004 Hospital Evaluation data, the 2005 census data which were obtained from the Korean National Statistics Office, and the 2006 Survey on National Healthcare Resources data were used. The data were analyzed using descriptive statistics, chi-square test and logistic regression in a SAS program. The most important factor was quality level of care of local hospitals. In the possibility of being hospitalized in non-residential areas, the region with the score of more than 9.5 per 100,000 people in the hospital evaluation was 8.3 times more than the region with the score of less than 9.5. However patients is hospitalized in the area with the hospitals with above 910 beds per 100,000 people more than in the area with the hospitals with less than 910 beds by 2.0 times. For the accessibility of medical services, government policy should focus on improving the quality of care in local hospitals not on increasing and distributing health care resources.

• Journal of Digital Convergence
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• v.13 no.7
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• pp.259-268
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• 2015

This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

• Journal of Digital Convergence
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• v.17 no.2
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• pp.217-230
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• 2019

This study was conducted to develop a customized severity-adjustment method and to evaluate their validity for acute myocardial infarction(AMI) patients to complement the limitations of the existing severity-adjustment method for comorbidities. For this purpose, the subjects of KCD-7 code I20.0 ~ I20.9, which is the main diagnosis of acute myocardial infarction were extracted using the Korean National Hospital Discharge In-depth Injury survey data from 2006 to 2015. Three tools were used for severity-adjustment method of comorbidities : CCI (charlson comorbidity index), ECI (Elixhauser comorbidity index) and the newly proposed CCS (Clinical Classification Software). The results showed that CCS was the best tool for the severity correction, and that support vector machine model was the most predictable. Therefore, we propose the use of the customized method of severity correction and machine learning techniques from this study for the future research on severity adjustment such as assessment of results of medical service.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.126-136
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• 2018

The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

• The Journal of the Korea Contents Association
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• v.20 no.12
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• pp.332-345
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• 2020

This study sought to explore the demand in the social service sector and present policy implications, focusing on the vulnerable in rural villages exposed to worse conditions amid the Covid-19 crisis. To this end, the social service needs of vulnerable groups by household type were analyzed by utilizing the raw data of the 2018 Survey on Rural Well-Being. Analysis showed that the greatest demand social services for all rural villages, the elderly, the disabled, one-person, one elderly and low-income households were income support services, while in household that included children the demand was for childcare and education-related services. The second-highest social services in terms of demand were cultural leisure vacation support services for all rural villages, healthcare-related services for the elderly, the disabled, one elderly and low-income households, cultural leisure vacation support services for households including children and daily life support services for single-person households. Based on these results, a measure was proposed to support social services, tailored to vulnerable groups in rural villages. In addition, the government's lack of a consultation system between urban and rural welfare policies, such as a basic plan for health and welfare in rural villages, led this paper to discuss the need for a feedback function and dedicated formulation of mid- to long-term policies in rural villages. It also proposed the establishment of conditions for providing customized social services for rural villages.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.151-161
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• 2021

The purpose of this study was to identify citizens' needs and what they perceive the health-related problems are so public opinion can be reflected in the Daegu Community Health Plan. A citizen participation group was organized, and two roundtable discussions were held in June and July 2018. The number of participants in the first and second round was 40 and 44, respectively. Customer itinerary guidance, DVDM (Definition, Value, Difficulty, and Method) Map, and Persona-based scenario method were used for the roundtable discussions. The measures to improve the health status proposed by the citizens included expanding access to health services, establishing health services centered on small-living areas, expanding mental health services, creating health-friendly environments, resolving environmental problems, and improving social health. In addition, enhancing communication and creating harmonized environments, improving access to healthcare, generating pleasant physical environments, and assigning socials roles for vulnerable individuals were brought up as the means to resolve health disparities. The strength of the present study lies in the fact that, unlike survey methods, the citizens' exact needs were identified by sharing their thoughts. Moreover, it was proven that practical measures would be needed to implement citizen participation in planning health-related projects.

• Journal of Industrial Convergence
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• v.21 no.5
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• pp.109-122
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• 2023

The purpose of this study is to look into how elderly people's health promoting behaviors influence their successful aging, to realize how their perception of successful aging and their life satisfaction have the mediating effect on the path from health promotion behaviors to successful aging, and to find the significant influence of successful aging perception and life satisfaction on successful aging. This researcher conducted a questionnaire survey with elderly people using a senior welfare center in Gyeonggio-do, and analyzed 250 copies that. For data analysis, SPSS Win 25 was applied to conduct frequency analysis, descriptive statistics, t-test, one-way ANOVA, and correlation analysis. Mediating effect analysis was made to verify the causal relations between health promoting behaviors and successful aging, and to validate the mediating effect of successful aging perception and life satisfaction on the causal relations. As a result, elderly people's health promoting behaviors influenced their perception of successful aging, their life satisfaction, and their successful aging. Their perception of successful aging had the mediating effect on health promotional behaviors and successful aging, but life satisfaction did not so. This study has the following implications: it is necessary to train persons specializing in support for health promoting, to develop an efficient health promotional model and program, and to provide an opportunity of education. It is necessary to come up with a support policy in consideration of tangible or intangible factors. It is necessary to establish a policy in line with economic levels and health conditions of elderly people.