• 한국병원경영학회지
• /
• 제22권2호
• /
• pp.44-57
• /
• 2017

The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.

• 한국병원경영학회지
• /
• 제8권3호
• /
• pp.118-142
• /
• 2003

This study is aimed at evaluating the financial structure of hospitals before and after the separation of prescription and drug dispensing policy started to be implemented in July 2000 and at making a suitable hospital managerial strategy through the verification of the factors which have effect on their profitability. This study investigated the hospitals which have passed the accredition review to be designated as a accredited training hospital each year for three years from 1999 to 2001. Those hospitals were selected from members of the Korea Hospital Association. 106 hospitals were targeted for analysis except for the hospitals whose financial statements and managerial performance were not reported faithfully. The financial indicators used in this study were stability indicators(liability to total assets, ratio of debt to fund balance, fixed ratio), liquidity indicators(current ratio, quick ratio), activity indicators(total assets turnover, fixed assets turnover), profitability indicators(net profit to total assets, net profit to net worth, operating margin), and operating expenses to patient revenues indicators(drug and supplies costs/payroll/overhead expenses). The result of this study are as follows: First, the analysis of the increase of loss-making hospitals before and after. The separation of prescription and drug dispensing policy shows that the number of loss-making hospitals increase after the separation(22.6% before the separation; 31.1% after the separation). However, there was no significant statistical difference. Second, the analysis of operating expenses to patient revenues indicators showed that the ratio of drug and supplies cost became lower in all hospitals but the ratio of payroll/overhead expenses became higher. Additionally, the factor which have the greatest effect on profitability was operating expenses to patient revenues indicators (drug and supplies costs/payroll/overhead expenses). Third, the analysis of managerial performance by four types of loss-loss, loss-profit, profit-loss and profit-profit compared the results before the separation with those after the separation revealed as follows : Reliance on liability to total assets became higher in the profit-loss type($56.2%{\rightarrow}66.4%$), lower in the loss-profit type($82.7%{\rightarrow}74.5%$). Total assets turnover became higher in the profit-profit type($1.3{\rightarrow}1.5$), but lower in the loss-profit type($0.8{\rightarrow}0.7$). Operating margin decreased to minus 5.9% from 4.3% in the profit-loss type, but increased to 7.2% from minus 7.8% in the loss-profit type. Forth, operating expenses to revenues indicators showed that the increase of payroll was the biggest in the profit-loss type($39.2%{\rightarrow}49.9%$) and that overhead cost decreased in the loss-profit type but that rather increased in other types.

• 한국임상보건과학회지
• /
• 제2권1호
• /
• pp.1-16
• /
• 2014

Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

• 대한한의학회지
• /
• 제41권1호
• /
• pp.1-10
• /
• 2020

Objectives: This study investigated the financial performance of Korean Medicine hospitals in Korea in order to understand the current status of hospital management and improve its efficiency. Methods: Financial statements of 24 medical corporations, 19 juridical foundations and 18 school hospitals from 2016 to 2018 were obtained from the secondary data published by the Health Insurance Review and Assessment Service, the National Tax Service and the Korea Advancing Schools Foundation. Financial performance was measured on 6 dimensions: liquidity, profitability, activity, growth, cost and productivity (investment efficiency) by analyzing 8 financial indicators: Liability to Total Assets, Net Profit to Patient Service Revenues, Total Assets Turnover, Growth Rate of Patient Service Revenues, Operating Expenses to Patient Service Revenues, Value Added to Patient Service Revenues, Value Added to Total Assets, and Value Added to Personnel Expenses. Results: Korean Medicine hospitals showed lower Liability to Total Assets, Liquidity and Value Added to Total Assets than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than Western Medicine hospitals did. They also showed higher Value Added to Patient Service Revenues and Value Added to Personnel Expenses than those of Western Medicine hospitals do. The net profit decreased significantly (-50.8%) in 2018 whereas Patient Service Revenues increased (6.9%) for the same period due to Operating Expenses increase and Non-Operating loss. Conclusions: These findings suggest that the Korean Medicine hospital sector in Korea needs to improve liquidity and financial structure and to enhance profitability by reducing Personnel Expenses and generating Non-operating revenues in order to improve its investment efficiency and competitiveness.

• 한국병원경영학회지
• /
• 제23권4호
• /
• pp.53-64
• /
• 2018

Purposes: The hospitals needs to generate a minimum profit, in order to perform its own role such as providing high-quality medical services. The demand for hospital management is increasing, as the social demands are diversified and the financial transparency is emphasized. The purpose of this study is to compare hospitals management based on Dupont Identity, by various hospital classification. Methodology: This study is based on '2016 Statistics for Hospital Management' provided by the Korea Health Industry Development Institute. The hospitals were classified according to the scope of care, the type of establishment, the location, and the number of beds. We analyzed the general and financial characteristics of over 337 hospitals using the method of Dupont Identity. Findings: Net profit margin (PM) has the biggest impact on return of equity (ROE). By the number of beds, general hospital with 160-299 beds have the highest return on equity (ROE). By location, hospitals in local municipalities have higher return on equity than hospitals in urban municipalities. According to the type of establishment, public hospitals have lower business performance, and although they invest more than private hospitals. Practical Implications: This study can inspire interest and provide understanding in hospital management and financial structure, by analyzing through an intuitive indicator named Dupont identity. It is possible to provide basic data for hospital management methods for each financial elements, in order to increase the profitability of hospitals.

• 한국병원경영학회지
• /
• 제6권2호
• /
• pp.138-155
• /
• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

• 보건행정학회지
• /
• 제17권2호
• /
• pp.68-90
• /
• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• 한국병원경영학회지
• /
• 제7권3호
• /
• pp.25-43
• /
• 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(+).

• 한국시스템다이내믹스연구
• /
• 제11권4호
• /
• pp.5-23
• /
• 2010

The competition between hospitals has become an issue for many hospitals because of the sudden increased number of health providers. As the marketing or customer management have become important factors as means of competition, a number of hospital have been considered or already adopted the coordination system. A system dynamics model is developed to see the effect of the hospital coordination system. This paper after briefly explaining the structure of the system dynamics model, discusses the roles of the hospital coordination system with examples. The system dynamics model quantifies through simulations the process of effects of coordination system on the number of customers, productivities of employees (nurses and doctors), and finally the financial status. As a conclusions of the simulations and their analysis, it is concluded that coordination system could be more effective than the investment to the facilities. Since the study is based on only one hospital case, it is limited. However, it explains the mechanism of the coordination system quantitatively as well as qualitatively.

• Journal of Trauma and Injury
• /
• 제24권2호
• /
• pp.95-97
• /
• 2011

Purpose: We analyzed the medical costs for severely traumatized patients according to the severity and medical performance so that we could improve the financial balance of the trauma center. Methods: Retrospective analysis was performed on patients visiting SNUH Trauma Center from May 2011 to August 2011. Among a total of 55 severely traumatized patients, 31 patients whose medical bills were available and categorized were included in this study. The injury severity score (ISS) was calculated from the abbreviated injury score (AIS), which was updated in 2008,for each patient to assess the severity of injury. Major trauma was defined as an ISS above 15. Results:The 31 patients in this study included 20 males and 11 females. The average ISS was $33.23{\pm}16.65$ points. We categorize the patients into three groups according to ISS, 16-24: group 1, 25-40: group 2, and above 41: group 3. Total incomes, admission fees, surgery fees, and imaging test fees are shown in table 1. The costs seem to be higher costs in group 2, but this result has no statistical significance. Statistical significantly data are as follows: high radiologic test fees in group 1, short hospital stay in groups 1 and 2, and short ICU stay in group 1. The average hospital stay was 17 days, and the average emergency intensive care unit (EICU) stay was 7.5 days. Although the EICU stay was only 44% of the total hospital stay, the income from the EICU covers 79.4% of the total hospital income. Conclusion: From this study, we found several items that show relatively high medical income from severely traumatized patients visiting the SNUH Trauma Center. Most of the medical fees arise in the early phase of acute medicine usually in the ICU. Efforts to identify the items with high income and to minimize expenses will improve the financial structure of the Trauma Center,which is facing a budget crisis.