• Korea Journal of Hospital Management
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• 제9권3호
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• pp.49-70
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• 2004

This study analyzes the effect of separation of dispensary from medical practice on hospital management performance. The results are as follow. The earning ratios of large size hospitals become deteriorated significantly after the separation of dispensary. The growth ratios of revenues from inpatient were unchanged, but the growth ratios of revenues from outpatient of large and middle size hospitals were decreased significantly. Hospitals can't sell the medicines to the outpatient after the separation of dispensary, but they can do to the outpatient. The labor cost ratios of small and large size hospitals are increased significantly after the separation of dispensary. There are two reasons for increase of labor cost ratios. One is the decrease of material cost ratio. The other is the increase of doctor's salary. The material cost ratios of every size hospital are decreased significantly after the separation of dispensary. Because medicines costs of outpatients are decreased. The labor cost and doctors' salary per patient of middle and large size hospitals are increased significantly after the separation of dispensary. And average treatment fees per day of inpatients of middle and large size hospitals are increased significantly after the separation of dispensary. But those of outpatients are decreased significantly. Average numbers of outpatients per bed of small and large hospitals are decreased significantly after the separation of dispensary. And average numbers of inpatients per bed of large hospitals are decreased significantly. In summary, as a consequence of separation of dispensary from medical practice, management performances of large size hospitals become deteriorated significantly.

• Korea Journal of Hospital Management
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• 제11권1호
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• pp.110-126
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• 2006

The purpose of the study is to find the factors influencing small or middle size clinics and hospitals CEOs' expectation level on the affiliation with the large size teaching hospitals. Data for analysis was collected to use self-administrative structured questionnaire on 164 CEOs of small or middle sized clinics and hospitals affiliated with large sized teaching hospital located in Kyung Ki Province. For the study, the researchers develop the constructs for questions on the expectation on the affiliation, the attitude such as confidence, knowledge on the affiliation, previous relationship of the affiliation, and selection guideline of the affiliation with exploratory factor analysis and reliability test. Through the confirmative factor analysis using AMOS 4, the researchers develop constructs based on exact relationship between constructs and questions. CEOs' expectation level on the affiliation is influenced on attitude or confidence, gender, types of clinics and hospitals, distance to the affiliated large hospital, types of recommender, and number of affiliated hospitals. Large sized hospitals that want to affiliation with other clinics and hospitals can promote the affiliation to consider these factors from the results.

• The Journal of Industrial Distribution & Business
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• 제10권4호
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• pp.67-76
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• 2019

Purpose - This study attempted to construct and validate a structural model of the relationship between the quality of medical services, perceived risk, reputation and customer satisfaction, which is the main concept of the relationship between large hospitals as well as small and medium hospitals and medical consumers. Through this verification, the small and medium hospitals are to find the way for wise coping in competitive situation with large hospitals. Research design, data, and methodology - This research developed a hypothesis by constructing a structural equation that reaches the satisfaction and the relationship between reputation of perceived risk and perceived risk of service quality perceptions of customers of small and medium hospitals. Research data were collected through a questionnaire survey of respondents who had medical service experience from small and medium hospital. A total data of 252 respondents were used as the sample for the final analysis and analyzed using SPSS 23.0 and AMOS 23. Results - As a result, the relationship of quality of medical service, reputation, and customer satisfaction among small and medium hospitals was consistent with the results of precedent studies, and the perceived risk has a significant impact on reputation, so the greater the perceived risk, the higher the preference for reputable medical institutions as large hospitals. In addition, it was found that the direct route from perceived risk to customer satisfaction was not significant, and reputation was found to have a full mediating effect on perceived risk and customer satisfaction. Customers who use small and medium hospitals prefer to use reputable medical institutions if their perceived risk is high, which is different from risk perception when specific targets are specified. Conclusions - In terms of the effect from customer satisfaction, not only the path of perceived risk → reputation → customer satisfaction, but also the quality of service quality → reputation → customer satisfaction. These findings suggest that small and medium hospitals are appropriately responding to competition with large hospitals, rather than focusing on the perceived risks and reputation of customers in establishing and utilizing competitive strategies to create new customers and preserve existing customers.

• Health Policy and Management
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• 제26권3호
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• Korea Journal of Hospital Management
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• 제5권1호
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• pp.62-83
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• 2000

Client satisfaction(CS) has played an important role in the assessment of health service quality. Thus client satisfaction management(CSM) has been highlighted as one of strategic management. Specifically, the client satisfaction approach by moment of truth(MOT) makes significant contributions to the settlement of bottlenecks on client satisfaction. This research deals with the two issues of client satisfaction in large, small and medium sized hospitals. With regard to CS, one issue is to examine the difference of patient satisfaction through MOT between them and the other derives a strategy for improving client satisfaction from the viewpoint of small and medium sized hospitals. We use the survey data for 4 large and 14 small and medium sized hospitals in 1998. Major findings of this research can be summarized as follows: first, in case of outpatients, small and medium sized hospitals have a comparative advantage on contact-points of preparation and accounts over large ones. Second, while inpatients in small and medium sized hospitals are very satisfied with the contact-point of accounts, they are dissatisfied with the contact-points of facilities and hospital rooms. Under the given budget and time constraints, the settlement of these bottlenecks could be effective strategies for improving their patients' satisfaction.

• Journal of the Korean Dietetic Association
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• 제19권4호
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• pp.317-342
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• 2013

The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

• Quality Improvement in Health Care
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• 제22권2호
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• Journal of Korean Society for Quality Management
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• 제37권4호
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• pp.71-86
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• 2009

The healthcare environment today is changing rapidly with factors of healthcare consumers in selecting medical institutions also altering at a fast pace under the circumstances. In this study, the theory of consumption values established by Sheth in 1991 is adopted in order to examine particular value affecting consumer selection of healthcare institutions. For the purpose of this study, healthcare consumers were surveyed using questionnaires developed based on the five values of Sheth supplemented by value of effort to acquire hospital information and value in health. Consequently, 24 consumption values affecting selection process were confirmed through discriminant analysis. As a result of regression analysis on factors affecting consumer selection of healthcare institution, effort to acquire hospital information and age among demographic characteristics of respondents are determined important predictors for consumer selection of general hospitals over clinics or small-sized hospitals. Further, service, reputation scale of healthcare institution among functional values and importance of health and effort to acquire hospital information among value in health are identified as significant predictors for consumer selection of large-sized general hospitals over clinic or small-sized hospitals. This study suggests not only vital implications for marketing strategy of healthcare institutions, but also methods to promote positive image for healthcare providers. In addition, this study closely examines the cause of the leaning phenomenon of healthcare comsumers toward large-sized general hospitals.

• Journal of The Korea Institute of Healthcare Architecture
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• 제8권1호
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• pp.13-20
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• 2002

Large hospital designs try to accommodate functional needs and spatial organization. The purpose of this study is to propose an effective compositional method by horizontal interconnection of public circulation spaces with 'hospital street'. 'Hospital street' and network of public circulation spaces are major elements of consideration for the design of large hospitals, which not only connect functional components but also provide satisfying environment, amenity and patients' life.

• Journal of Nutrition and Health
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• 제34권4호
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)