Objectives : This study aimed to analyze the management efficiency of Korean Medicine hospitals for recent 10 years(2001~2010) using the Data Envelop Analysis(DEA) model. Methods : We collected the management data of 23 Korean Medicine hospitals for DEA model from the Korean Oriental Medicine Hospitals' Association (KOMHA). Input variables of DEA model are numbers of beds, numbers of doctors, numbers of nurses and numbers of other staffs of each Korean Medicine hospitals. Output variables are numbers of inpatients and numbers of outpatients of each Korean Medicine hospitals. Based on the DEA model, we calculated the efficiency score of each Korean Medicine hospital and compared it by hospital's ownership, location, and size. Results : Average DEA efficiency scores of Korean Medicine hospitals by year ranged from 0.86 to 0.92. Private owned hospitals showed higher efficiency scores than the university affiliated hospitals with statistical significance (p=0.001). And Korean Medicine hospitals located in capital region of Korea(Seoul City, Incheon City, Gyeonggi-do) and the rest Korean Medicine hospitals did not show statistical difference (p=0.516). Lastly, Korean Medicine hospitals with different size did not show statistical difference in management efficiency (p=0.499). Conclusion : We have found that Korean Medicine hospitals management efficiency have not changed throughout 10 years, and that different ownership forms of Korean Medicine hospital show statistical difference in management efficiency while location, and size do not.
The purposes of this research were to identify nursing interventions performed by Korean nurses and to compare the interventions performed by nurses working in the oriental medicine hospitals and with those performed by nurses working in the general hospitals. The samples consisted of 144 Korean nurses working in three hospitals, 70 nurses working in the oriental medicine hospitals and 74 nurses working in the general hospitals. The Nursing Interventions Classification (NIC) Use Questionnaire developed by the Iowa Intervention Project team was translated to Korean and verified using the method of back-translation. The questionnaire consists of 433 intervention labels and definition. Thirteen interventions were used at least daily by nurses working in the oriental medicine hospitals, while twenty-one interventions were used at least daily by nurses working in the general hospitals. The most frequently used interventions by nurses working in the oriental medicine hospitals were Documentation, Shift Report Vital Signs Monitoring, Pressure Ulcer Prevention, Positioning, Fall Prevention, Exercise Promotion, Intravenous (IV) Therapy, Pressure Ulcer care, and Bed Rest Care in that crder. For nurses working in the general hospitals the most frequent intervention was Analgesic Administration, followed by the interventions of Medication Administration : Parenteral and Intravenous Therapy (IV) Therapy, Documentation, Intravenous(IV) Insertion, Shift Report, Fall Prevention, Vital Signs Monitoring, Medication Adnninistraction : and, Fluid Monitoring, and Medication Maragement in that order. The interventions performed least often by nurses working in the oriental medicine hospitals were Hemodialysis Therapy and Bleeding Reduction : Antepartum Uterus, while the interventions performed least often by nurses working in the general hospitals were Rape Trauma Treatment and Contact Lens Care. The nurses working in the oriental medicine hospitals performed the interventions in the Physiological : Complex domain significantly more often than the nurses working in the general hospitals, while the nurses working in the general hospitals performed the intervention in the Behavior domain significantly more often than the nurses working in the oriental medicine hospitals. This study suggests that further study will be needed to developed and validate more interventions sensitive to Korean culture.
This study was conducted to analyze if there is a difference between the head hospital and branch hospital by comparing the profitability and operating expenses to patient revenue of oriental medicine hospitals affiliated with universities in order to find whether opening branch hospitals is an appropriate method to increase profitability. Profit indices used for the comparison of head hospital and branch hospital include ratio of operating profit on medical revenue, net-income on medical revenue, net profit to total assets, and operating profit to total assets; and cost indices included ratio of labor costs, material costs and administrative costs. In comparison of profit indices of head hospitals and branch hospitals, head hospitals displayed negative(-) in all four profit index averages while branch hospitals displayed positive(+), showing that branch hospitals have higher profitability. In particular, in the case of head hospitals, ratio of net profit to total assets was -13.6%, while that of branch hospitals was 12.9%, which was higher than 3.1%, the average of Korean oriental medicine hospitals in 2011. As a result of difference analysis between groups of head hospitals and branch hospitals, profit indices of ratio of operating profit on medical revenue, net-income on medical revenue, and ratio of net profit to total assets were found to vary by hospitals, but there was no statistically significant difference between head hospitals and branch hospitals(p<0.1). Only the ratio of operating profit to total assets of head hospitals and branch hospitals indicated significant difference between the two groups, showing that ratio of operating profit to total assets of branch hospitals is larger than that of head hospitals. Meanwhile, the cost indices of ratio of labor costs, material costs and administrative costs in the difference test results did not show significant difference between the head hospital and branch hospital(p<0.1). Thus, it cannot be said that a certain oriental medicine hospital's profitability is high or low depending on whether it is head hospital or a branch as profitability varies depending on the management environment of the hospital. Therefore, oriental medicine hospitals affiliated with universities would need to make efforts to increase their profitability as an individual hospital rather than focusing on whether they are head hospital or a branch.
Park, Minjung;Lim, Buoungmook;Cha, Wungseok;You, Myoungsoon
The Journal of Korean Medicine
/
v.35
no.1
/
pp.145-156
/
2014
Objectives: Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector. Methods: On the basis of Scott and his colleagues' identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed. Results: First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status(1971~1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987~2001), and the reinforcement of specialization and competition(2002~present). Conclusions: Results suggested that: (1) changes in institutional environments hada heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases(e.g. cerebrovascular disease). Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.
Purpose: The purpose of this study was to compare compliance with standard precautions of infection prevention between nurses at accredited Korean medicine hospitals and non-accredited Korean medicine hospitals. Methods: Data were collected from a total of 138 participants (69 nurses from 3 accredited hospitals and 69 nurses from 3 non-accredited hospitals) in January of 2021 using structured questionnaires. Descriptive statistics, t-test, one-way ANOVA, and multiple regression analyses were carried using the SPSS Statistics 24.0 Program. Results: Results showed that the scores of nurses' compliance with standard precautions of infection prevention at accredited Korean medicine hospital (40.54±2.74) were significantly higher (p=.002) than the scores of nurses at the non-accredited Korean medicine hospitals (38.94±3.28). After controlling for covariates, the results were same. In addition, we found that scores of compliance with standard precaution for infection prevention in nurses at hospitals belong to university were significantly high compared to those of nurses at private hospitals. We also found that the scores of compliance with standard precaution for infection prevention in nurses with more than 5 years of experience were significantly higher than those of nurses with less than 3 years of experience (p=.039). Conclusion: Nurses working at the accredited Korean medicine hospitals showed higher scores of compliance with standard precaution for infection prevention. Therefore, it is suggested that the participation in the hospital accreditation program should be encouraged for the Korean medicine hospitals.
Objectives: The aim of this study was to investigate cancer patients' utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.
Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.
Lee, Sun Hee;Chae, Yoo Mi;Jee, Young Keon;Choi, Kui-Son
Quality Improvement in Health Care
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v.8
no.2
/
pp.172-185
/
2001
Background : This study was carried out to assess the quality improvement(QI)activities in Korean hospitals. Methods : A mailed questionnaire survey was conducted between September 15 and October 30, 2000. The staffs being charge of QI each of the hospitals with 400 beds or more responded to the questionnaire. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Results : Based on these survey, 87.3 percent of the responding hospitals were performing QI projects and 54 percent of the hospitals had a separate department for QI activity. About 62 percent of hospitals performing QI activity (QI hospitals) had a QI manager and 58 percent had a separate budget for QI activities. Among the QI hospitals, 85 percent had cross-functional or cross-departmental teams as the major mechanisms for doing QI projects, 94 percent had one or more educational programs on QI. The level of physician's participation level for QI projects was lower than other staff(CEO, nurses and other administrators). Conclusion : The majority of the hospitals have undertaken activities in QI. For the successful implemented QI, the involvement of and education for employees(including physicians and other health professionals)are needed as well as management strategy and leadership. Understanding of other hospitals experience would be helpful for health care managers to plan and initiate QI activities.
Kim, Dongsu;Ryu, Jiseon;Lee, Byungwook;Lim, Byungmook
The Journal of Korean Medicine
/
v.37
no.3
/
pp.112-122
/
2016
Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.
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