• 간호행정학회지
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• 제7권1호
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• pp.5-14
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• 2001

To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

• 대한간호학회지
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• 제20권1호
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• pp.16-37
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• 1990

A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.150-160
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• 1999

Background : Because hospitals had to faced with financial hardship, we have to have more effective hospital management. In this study, we tried to improve job performance and to reduce cost maintaining safety in fields of patients care. Methods : Central Supply Room(CSR) staffs taught strategy of material cost reduction to middle level managers and staffs 14 times. All staffs and voluntary service workers, working in 33 nursing units, participated in this activity. We developed questionnaire to check the degree of participate in cost reduction activity and job performance in CSR, and quality improvement in the wards. Two hundred questionnaires were distributed and 197 returned. Results : Because CSR staffs developed new items and every item was managed at each department, stocks of each department were reduced. Overall, by comparing before and after cost reduction activity, almost 1.2 billion won reduced for one year. Staffs' loyalty and spirits of cost reduction were improved by changing clothes and duty environment. Furthermore, these activity improved patients' satisfaction. Conclusion : We suggest that CSR activity in a university hospital contributes to improve job performance and to reduce cost without any problem in patient care.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.696-706
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• 2013

본 연구는 DEA모형에 바탕을 둔 표준원가에 기초한 원가차이 분석의 개념을 구현할 수 있는 모형을 설계하고 69개 종합병원의 투입 산출물을 이용해 효율성 분석과 원가관리 방안을 살펴보았다. 이를 위해 DEA모형을 통해 달성가능한 목표원가를 구하고 이를 실제원가와 비교하여 차이분석모형의 틀을 구축하였다. 또한 이 모형을 바탕으로 의사 간호사 인건비 정보를 구해 2008년도 결산기준 69개 종합병원의 표준원가차이를 구하고 이를 기술적 비효율성으로 인한 원가차이, 가격 비효율성에 기인한 원가차이, 표준예산원가 원가차이로 분리하여 원가관리의 새로운 방식을 제시할 수 있었다. 또한 실증분석을 통해 69개 종합병원은 병상수와 같은 규모를 늘리는 것이 효율성 개선에 기여하지 않으며 오히려 예산목표원가 관리 측면에서는 비효율적인 것으로 나타나 규모 확장 일변도의 전략을 수정할 필요가 있는 것으로 나타났다.

• 임상간호연구
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• 제18권2호
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• pp.183-195
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• 2012

Purpose: This study was performed to identify the variations of nursing care cost depending on nursing care requirement and calculate nursing care cost per one day and one care requirement point. Methods: Nursing care requirement was measured by classifying 3,855 patients according to KPCS-1(Korean Patient Classification System for nurses-1). Nursing care cost was calculated from personnel expenses and nursing care requirement. Nursing cost factors were identified by multiple regression analysis. Results: Average nursing cost per patient per day was 33,588 won, Average nursing care cost per 1 patient classification score was 3,558 won. The nursing cost per 1 patient classification score was different depending on the types and levels of the hospitals. The 4th patient classification group revealed the highest nursing care cost. Nursing cost factors included the number of beds in the hospitals, seniority, number of nurses and first grade in nurse personnel accreditation ($adj-R^2$ 74.0%. p<.05). Conclusion: Nursing care requirements expressed by patient classification scores don't directly correlate with nursing care cost. Further research is needed to evaluate validity and reliability for refining KPCS-1 and to apply variable criteria to nurse personnel accreditation.

• 한국병원경영학회지
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• 제26권2호
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• pp.17-26
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• 2021

Purposes: This study aims to identify factors affecting dental university hospitals' profitability and understand recent their business condition. Methodology: Data from 2016 to 2019 was collected from financial statement, public open data in 8 dental university hospitals. For the study, multiple regression test with stepwise selection was applied. Findings: First of all, 9 out of 19 independent variables were selected by stepwise selection. As a result of multiple regression test with selected independent variables and the dependent variable(operating profit margin ratio), the factors affecting hospitals' profitability were the number of dental unit chair, hospital location, debt ratio, total capital turnover ratio, employment cost rate, material cost rate, management expense rate, the number of patient per a dentist. Practical Implication: To improve dental university hospitals' profitability, hospitals specifically analysis and manage their cost such as employment, material and management cost and seek effectiveness by managing the proper number of patient per a dentist.

• 한국병원경영학회지
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• 제1권1호
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• pp.154-169
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• 1996

Some of the large sized companies have taken parts in a hospital business with a view or justification to improve medical care regadless of the disadvantageous fee-for-service medical insurance reimbursement system controlled by authorities related. This gradually brought about the financial difficulties to university hospitals as well as general hospitals that were less competitive. In this circumstance the hospital administrators are called for preparing and implementing proper financial strategies by analyzing external circumstances and internal abilities of their hospitals. In this aspect, an effective cost-analysis system in the hospital has been needed for years. K-University hospital developed the practical cost-analysis system and applied it to the hospital management. The effects of cost analysis system are as belows: first, the trend of the monthly revenue per medical specialist from March to July in 1996 showed increasing pattern which is different from that in past years. second, it turned out that the department of functional laboratory in relation to medical treatment enlarged the medical revenue very sharply. third, the intensive care units were being operated at the state of deficit, while other general wards were lucrative.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8339-8343
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• 2016

Background: To determine the outcome and cost saving by placing ultrasound guided surgical clips for tumor localization in patients undergoing neo-adjuvant chemotherapy for breast cancer. Materials and Methods: This retrospective cross sectional analytical study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital, Karachi, Pakistan from January to December 2014. A sample of 25 women fulfilling our selection criteria was taken. All patients came to our department for ultrasound guided core biopsy of suspicious breast lesions and clip placement in the index lesion prior to neo-adjuvant chemotherapy. All the selected patients had biopsy proven breast cancer. Results: The mean age was $45{\pm}11.6years$. There were no complications seen after clip placement in terms of clip migration or hemorrhage. The cost of commercially available markers was approximately PKR 9,000 (US$ 90) and that of the surgical clip was PKR 900 (US$ 9). The cost of surgical clips in 25 patients was PKR 22,500 (US$ 225), when compared to the commercially available markers which may have incurred a cost of PKR 225,000 (US$ 2,250). The total cost saving for 25 patients was PKR 202,500 (US$ 2, 025), making it PKR 8100 (US$ 81) per patient. Conclusions: The results of our study show that ultrasound guided surgical clip placement in index lesions prior to neo-adjuvant therapy is a safe and cost effective method to identify tumor bed and response to treatment for further management.

• 한국병원경영학회지
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• 제13권2호
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• pp.1-19
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• 2008

BSC(balanced scorecard) is expected of the effective integrated tool of the management problem such as links of the management vision, the strategy, and the business scheme. This study discusses the recent development and problems of hospital BSC practices in in several countries. First, the article discuss the recent development and problems of hospital BSC implementation. Second, we review the links of strategic alignment with hospital's strategy and BSC on weight design, organizational culture and hospital performance. Finally, we explore hospital BSC framework that clarified easy to understand integrative approach to hospital BSC research using contingency theory model.

• Journal of Acupuncture Research
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• 제33권2호
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• pp.61-76
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• 2016

Objectives : This study was designed to clarify population-social characteristics that influence the utilization patterns of hospitalized patients in a traditional korean hospital, thereby providing clinical data which would help further improvements of traditional korean medical service in particular the Acupuncture and Moxibustion. Methods : We investigated population-social characteristics and annual utilization patterns of all patients who were hospitalized for more than 24 hours in a Korean Medical Hospital from January 2005 to December 2014. The obtained data were recorded in the EMR chart and statistical analysis was performed using SPSS 21.0. Additionally, data from the patients admitted to the department of Acupuncture and Moxibustion were analyzed separately. Results : 1. All inpatients had a significant annual difference in age, gender, hospitalized department, and disease code annually but not in re-hospitalization number. Inpatients of the department of Acupuncture and Moxibustion also varied in their age, gender, and disease code annually, but not in re-hospitalization number. 2. Pearson correlation analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except medical care insurance. Total cost, cost per day per person and recuperation cost had a positive correlation with all variables except medical care insurance. There was no meaningful relationship between nonrecuperation cost and the variables. 3. Stepwise multiple regression analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except automobile insurance. The total hospitalization costs had a positive correlation with both general insurance and medical care insurance. Cost per day per person and recuperation cost had a positive correlation with the females. There was no meaningful relationship between non-recuperation cost and the variables. 4. Pearson correlation analysis on inpatients of the department of Acupuncture and Moxibustion inpatients showed that the mean days of hospital treatments had a positive correlation with all variables except general insurance and automobile insurance. Total cost and recuperation cost had a positive correlation with all variables except medical care insurance, and cost per day per person had a positive correlation with females and general insurance. There was no meaningful relationship between non-recuperation cost and the variables. 5. Stepwise multiple regression analysis on inpatients of the department of Acupuncture and Moxibustion inpatients, the mean days of hospital treatments, total cost, cost per day per person and recuperation cost had a positive correlation with general insurance. There was no meaningful relationship between non-recuperation cost and the variables. Conclusion : Population-social characteristics of inpatients annually varies, and the change influences the utilization pattern.