• Title/Summary/Keyword: inpatient services

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The Economies of Scale and Scope in the Medical Service Industry of Korea and Its Policy Implications (한국 의료서비스산업의 규모 및 범위의 경제와 그 정책적 시사점)

  • Kim, Seon Jae;Lee, Younghwa
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.176-186
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    • 2013
  • The purpose of this study is to investigate the economies of scale and scope in the medical service industry of Korea using the multiple output translog cost function. The results show that the single-product scale economy (SSE) estimated is highly significant and less than one, implying that Korean medical service institutes are on average enjoying the product-specific scale economy in providing their services. In addition, the ray scale economies (RSE) reflects the overall economy of the scale in individual firm, showing less than one. Thus, the medical service industry in Korea is generally operating in the region of increasing returns to scale. The findings provide evidence of the economy of scope, in particular, with the joint production of inpatient and outpatient services as well as inpatient and administrative services.

Reclassification of healthcare utilization of inpatients to estimate the demand for long-term care services (현 입원의료이용량의 급성기진료 및 장기요양 서비스 재분류)

  • 장혜정;김창엽;윤석준
    • Health Policy and Management
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    • v.11 no.3
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    • pp.31-45
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    • 2001
  • With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.

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Effects of Visiting Nursing Services in Long-term Care Insurance on Utilization of Health Care (노인장기요양보험의 방문간호 서비스가 의료이용에 미치는 효과)

  • Lee, Sangjin;Kwak, Chanyeong
    • Research in Community and Public Health Nursing
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    • v.27 no.3
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    • pp.272-283
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    • 2016
  • Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

Factors Affecting the Satisfaction of the Hospital Services among Injured Workers (산재근로자의 의료기관 서비스 만족에 영향을 미치는 요인)

  • Lee, Hyun-Joo
    • Korean Journal of Occupational Health Nursing
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    • v.19 no.1
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    • pp.97-104
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    • 2010
  • Purpose: The purpose of this study was to determine factors that affect satisfaction of the hospital services among injured workers. Methods: The subjects of this study were 532 injured workers. The questionnaires were selected as literature suggested for explaining satisfaction of the hospital services, general characteristics of injured workers, characteristics of the hospital services. The data were analyzed with descriptive statistics, t-test, ANOVA, multiple regression analysis by SPSS 19.0. Results: There were significant differences in satisfaction scores, depending on the types of disease, health status and possibility to return to work among the injured workers. Also, there were significant differences in satisfaction scores, in terms of medical facilities, food service, specialization of doctors and nurses, cleanliness of hospital, convenience of hospital teaching and counselling of doctors and nurses, supporting workers' compensation process, counselling of workers' compensation and unfair treatment. In the results of the standard multiple regression analysis, food service, medical facilities, specialization of doctors and nurses, health status and hospital cleanliness were significant factors for satisfaction scores of the hospital services. Conclusion: It is necessary to promote food service, medical facilities, specialization of doctors and nurses, hospital cleanliness, health status of injured workers for developing hospital services.

The Analysis on the Regional Comparison and Affecting Factors of Customer Satisfaction (고객만족도에 대한 지역간 차이 비교 및 영향요인분석)

  • Park, Jae-San
    • Korea Journal of Hospital Management
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    • v.10 no.4
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    • pp.23-50
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    • 2005
  • The main objectives of this study are to compare the regional differences and to analyse the affecting factors of customer satisfaction. The subjects are 9 hospitals(5 Daegu region, 4 Seoul region) patient satisfaction index that were surveyed the 2004 Hospital Accreditation Program performed by KHIDI(Korea Health Industry Development Institute) and MOHW(Ministry of Health and Welfare). The sample used in this study consisted of 450 inpatients and 454 outpatients. The survey instrument is composed of physical environment items, physician factors, nursing staff factors, ancillary staff factors, administrative procedure items, and quality of hospital stay items. And overall satisfaction, intent to revisit, and intent to recommend as dependent variables are measured. Basically, the reliability and validity of survey items was evaluated. And the T-test was performed to compare regional differences of customer satisfaction. Finally to analyse the affecting factors on overall satisfaction, and customer loyalty(intent to revisit and intent to recommend), the multiple regression analysis was used. This study shows firstly, the Daegu region's patient satisfaction level of inpatients and outpatients is lower than Seoul region. Especially, nursing staff factors and quality of hospital stay items are very low on inpatient's satisfaction. Also all independent variables except the sufficiency of goods in hospital stand are very low on outpatient's satisfaction. Secondly, as a result of multiple regression analysis, ancillary staff factors(Beta=0.281) have a significant effect on overall satisfaction of inpatient cases in Daegu region. In regard to intent to revisit and intent to recommend, physical environment factors have a significant effect. Thirdly, in Seoul region, physical environment factors(Beta=0.430) have a significant effect on overall satisfaction of inpatient cases. In regard to intent to revisit and intent to recommend, administrative procedure items and nursing staff factors have a significant effect, respectively. In conclusion, these results indicate that hospitals in Daegu region make an effort to improve the customer satisfaction level, especially, of physical environment factors on inpatients and administrative procedure factors on outpatients

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A study on utilization behavior for hospital injury inpatient in Gyeongsangnam-do (경남지역 입원손상환자의 의료이용에 관한 연구)

  • Nam, Mun-Hee;Kun, Yeong-Chae
    • Journal of Digital Convergence
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    • v.10 no.5
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    • pp.289-299
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    • 2012
  • The study was carried out to provide basic data of improving the accessibility of medical service through identifying the factors that make hospital injury inpatient in non-residential area not in their residential area in Gyeongsangnam-do. This study analyzed not only 8,225 cases of discharged patients with damages from 2008, provided by the Korea Centers for Disease Control and Prevention, but also using a census and a research data on the actual condition from health care system. This study conducted a frequency test, a chi-square test and a logistic regression In result, first, the centralization of medical utilization of patients with damages is apparent centrally the city area. Second, medical utilization of injury patients in non-residential areas were significantly higher local area compared to City area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments, for the accessibility of medical services, government is demanded policy for patients with damages in local area.

An Analysis of the Change in Job Contents and Personnel Structure of Hospital Pharmacy Services after the Implementation of the Separation of Prescription and Drug Dispensing Policy (의약분업 이후 병원 약제부서의 업무내용 및 인력구조 변화 분석)

  • Youn, Kyung-Il;Ryu, See-Won
    • Korea Journal of Hospital Management
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    • v.7 no.2
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    • pp.37-51
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    • 2002
  • It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

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Determinants of Hospital Inpatient Costs in the Iranian Elderly: A Micro-costing Analysis

  • Hazrati, Ebrahim;Meshkani, Zahra;Barghazan, Saeed Husseini;Jame, Sanaz Zargar Balaye;Markazi-Moghaddam, Nader
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.3
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    • pp.205-210
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    • 2020
  • Objectives: Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider's perspective. Methods: The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used. Results: Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery. Conclusions: Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.

Relationship between Hospital Use Satisfaction and Medical Service Provision Process (입원환자들의 병원이용 만족도와 의료서비스 제공과정 간의 관계)

  • Ha, Au-Hyun;Park, Ki-Hyeok
    • Journal of Convergence for Information Technology
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    • v.10 no.1
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    • pp.235-242
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    • 2020
  • This study aims to provide direction for improvement of the hospital's management environment for customer satisfaction management, which is ultimately consumer-oriented in practice. this study was analyzed the relationship between hospital use satisfaction relative to expected level and medical service provision process for inpatients. The study method collected data from September 10 to September 30, 2018 for patients with inpatient care at hospitals and general hospitals under 300 beds, and conducted a t-test, ANOVA, and logistic regression. According to the analysis, hospital brands were the most frequently chosen reason for hospitalization, followed by doctor brands. The satisfaction level of the inpatient medical service provision process showed no statistical differences depending on the general characteristics. It has been confirmed that the hospital's satisfaction level relative to the expected level of inpatients has a causal relationship that significantly affects the hospitalized procedure the course of the provision of medical services.

The effect of social capital, health risk behavior and health status on medical care utilization by the elderly (노인의 사회자본과 건강위해 행위 및 건강수준이 의료서비스 이용에 미치는 영향)

  • Woo, Kyung-Sook;Seo, Jae-Hee;Kim, Gye-Soo;Shin, Young-Jeon
    • Health Policy and Management
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    • v.22 no.4
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    • pp.497-521
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    • 2012
  • Objectives This study aimed to investigate the effect of social capital, health risk behavior and health status on medical care utilization by the elderly. The data and Research method Data were obtained from the 4th wave survey of the Korea Welfare Panel Study. 4,087 household members aged 65 years and over were subject to analysis. Descriptive statistics are used to describe the basic features of the data in a study. we performed a structural equation modeling(SEM) analysis to evaluate the effect of social capital and mediating effect of health risk behavior and health status. Results Results showed that factors related to medical care utilization of the elderly were different depending on types of service (inpatient and outpatient service) except health status. Age, higher social capital, more health-risk behavior and poorer health status were associated with increased use of inpatient service. Social capital was found to have a positive direct effect on it. Also, social capital had an indirect effect on reducing use of inpatient services by improving health status. On the other hand, lower age and higher household income tended to increase use of outpatient service, while higher social capital and higher health status were inversely related. Social capital had a direct effect and an indirect effect on reducing use of outpatient service and, at that time, health status played a mediating role. Conclusions Social capital may contribute to improve health status and indirectly reduce medical care utilization of the elderly by enhancing their health status. These results provide evidence that more policy and strategy considerations should be needed for the elderly to strengthen their social capital in order to enhance their levels of health and more efficient utilization of medical care.