• Title/Summary/Keyword: organization of health administration

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An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.2 no.1
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    • pp.1-16
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    • 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.

Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan (보건소 중심 호스피스 운영모델 개발 - 부산지역 일개 보건소 시범사업을 중심으로 -)

  • Kim, Sook-Nam;Choi, Soon-Ock;Kim, Young-Jae;Lee, So-Ra
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.109-119
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    • 2010
  • Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

The Electroconvulsive Therapy in the Prevention of Suicide Risks and Attempts (자살 위험성 및 자살 시도 방지에 대한 전기경련치료의 역할)

  • Kim, Hee Cheol;Jeong, Seong Hoon;Ahn, Yong Min;Park, Seung Hyun;Kim, Yong Sik;Chung, In Won
    • Korean Journal of Biological Psychiatry
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    • v.27 no.2
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    • pp.64-73
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    • 2020
  • Suicidality is the most serious complication of mood disorders and psychosis; effective treatment should reduce suicide rates. The Organization for Economic Cooperation and Development age-standardized suicide rate in Korea was 22.6 in 2018, much higher compared to other countries worldwide. As mental and psychiatric problems are the main reasons for suicide attempts, accounting for 31.6% in 2018, targeting such problems should be the focus of efforts to reduce suicide rates. However, the ability of current pharmacotherapeutic and psychotherapeutic interventions to reduce suicide rates is limited due to their delayed effects. Therefore, electroconvulsive therapy (ECT) has been proposed as an alternative treatment. This approach is effective for treating most mental disorders associated with high suicide rates, including severe depression, bipolar disorder, and intractable psychotic disorders; ECT is also effective for Parkinson's disease, which has the highest suicide rate among all disorders in Korea. The acute, long-term, and prophylactic effects of ECT on suicidality have been reported in the literature, and treatment guidelines outside of Korea recommend that ECT be used at an early stage for rapid reduction of suicide rates, as opposed to being applied as a treatment of last resort. However, only ~0.092 of every 10000 members of the Korean general population received ECT in 2018; this is much lower than the average rate worldwide, of 2.2 per 10000. Elimination of obstacles to the use of ECT, early crisis intervention involving administration of ECT for rapid stabilization, and maintenance ECT to prevent recurrence should reduce suicide rates.

Determinants Influencing Labor Union Commitment of Hospital Employees (병원직원의 노동조합몰입에 영향을 미치는 결정요인분석)

  • Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.12 no.1
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    • pp.75-99
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    • 2007
  • The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of general hospital organization management. The subjects of this study were 428 employees in 8 Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from November 10 to November 30, 2006 through survey questionnaires. The main results of this study were as follows: 1. The commitment level of the subjects according to their characteristics was higher in older employees than the younger ones, large family to support than small family to support and those who had higher positions in labor union. 2. The commitment level of the subjects according to the Job and role related variables were higher those who had higher satisfaction level to their job, role conflict in all hospitals. 3. The commitment level of the subjects according to union related variables, variables jointly controlled by union and employer was statistically significant positive correlation. 4. The results of multiple regression analysis shows that formal and informal socialization, satisfaction with the labor union's were all found as important antecedents of labor union commitment. 5. The results of AMOS shows that structure characteristics of hospital, Job and manager satisfaction, socialization were statistically significant labor union satisfaction. The satisfaction level of labor union was statistically significant labor union commitment To summarize study results, the level of commitment in labor union depends on job satisfaction, managers' attitudes, union satisfaction factors, their colleagues attitudes toward union. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as formal and informal socialization is important determinant in union commitment, hospital managers should have countermeasures to enhance the colleague attitude and job satisfaction level of hospital employees. Moreover, as managerial factors of the principal of hospital influence union commitment directly, the attitudes of hospital managers toward union and transparency of hospital management should be improved.

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The Degree of Market Orientation by Type and Size of Hospital, and Moderating Effect of Environments on Performance (병원의 특성에 따른 시장지향성 분석과 성과에 있어서 환경의 조절 역할)

  • Kim, Pyung-Wung;Yoo, Kyu-Soo;Lee, Yong-Gi
    • Korea Journal of Hospital Management
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    • v.5 no.2
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    • pp.1-21
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    • 2000
  • This study was to examine the degree of market orientated effort by hospital type and size,. and analyzed the moderating effect of environments between market orientation and it's performance. First, there was no significant differences by hospital type, such public hospital, university hospital, and private hospital. However, the orders of market orientation implementation was university hospital. private hospital, and public hospital This finding suggest that university hospital and public hospital, should be market-oriented, or customer-oriented more now, relatively. Second, there were no significant differences in marketing as management policy by hospital types, i.e. public, university or private sector hospitals. However, as to the intensity of the implementation of the market-oriented approach, private hospitals came first, followed by the university hospitals, then the public ones. This finding suggests that university and public hospitals should be more market or customer oriented to compete in the market. Third, only the competitive environment does active moderating roll on hospital performance. The competitive environmental factor forces the organization to be more market oriented. This means the more you are positively situated in the competitive environment, the more you are looking for a market oriented approach. You become more aware of the value of customers and you become more focused on the customer satisfaction and thus become more patient oriented in every facet of decision making. And market oriented hospitals recognize the importance of utilization of high tech medical treatment skills and equipment in patient care. Fourth, according the analysis, market oriented effort gives more influence on hospital performance than the environmental factors. This means that the market oriented effort should become a culture of the hospital which seeks to out distance themselves from its competitors.

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Case Report : The Hypoglycemic Effect of Gamiyookmigihwang-tang on A Mild Diabetes Mellitus patient with Impaired Glucose Tolerance & Impaired Fasting Glucose (가미육미지황탕(加味六味地黃湯)이 공복혈당장애와 내당능장애를 가진 경증 당뇨병환자의 혈당조절에 미치는 영향 1례)

  • Kim, In Soo;Kim, Myeong Sin;Lee, Young Su
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.677-682
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    • 2013
  • Impaired glucose tolerance(IGT) & Impaired fasting glucose(IFG) were standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes. The main clinical significance of IGT & IFG shows some risk factors on type 2 diabetes, cardiovascular disease and component of the metabolic syndrome. In 1997, the American Diabetes Association(ADA) proposed the new classification and diagnostic criteria for diabetes, which wss striction on the diagnostic baseline of Diabetes from 140 mg/dl to 126 mg/dl. This is because that the early diagnosis and treatments can prevent chronic complications. In the oriental medicine, Gamiyookmigihwang-tang has been using for the treatments of Diabetes including IGT & IFG; however, there have not been enough studies about the effect of the glycemic control objectively. So clinical studies have been performed on a mild DM(Diabetes Mellitus) patient with IGT and IFG in order to investigate whether there is hypoglycemic effect of Gamiyookmigihwang-tang. Prior to the study, for two weeks fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. in addition ECG, T-cholesterol, TG, HbA1c levels were measured; then, Gamiyookmigihwang-tang has administrated for 4 weeks. and FBS, PP2hrs, T-cholesterol, TG, HbA1c were measured again after the herb medicine treatment. FBS, PP2hrs glucose levels and other measuring levels (T-cholesterol, TG, HbA1c) were decreased by the administration of Gamiyookmigihwang-tang. Gamiyookmigihwang-tang has hypoglycemic effects on a mild DM patient with IGT and IFG.

Factors affecting the Intention of transfering of Radiology Technologists to Different Institutions (방사선사의 전직의사와 관련된 요인분석)

  • Kim, Chang-Ho;Yu, Seung-Hum;Lee, Sun-Hee;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.1 no.1
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    • pp.37-55
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    • 1996
  • This study attempts to analyze the factors affecting the intention of transferring to another hospitals among radiology technologists. 344 cases were reviewed in 5 university hospitals and 1 general hospital. Self-administered questionaire were given to study the socioeconomic characteristics, working conditions, job satisfaction level, and the reasons for transfer among the technologists. The major findings were as follows : 1. Job position and hospital characteristics had a statistically significant relationship with the intention of transferring to another hospital. 2. Those who were not satisfied with their salaries and promotional opportunity showed a higher tendency towards to transfer. 3. Those who were less satisfied with the opportunity for developing the personal ability and had the negative attitude on their job showed a higher tendency to transfer. 4. Those who did not sustain good relationship with their superiors and co-workers scored high on the tendency to transfer. 5. In the result of mutiple regression, recognition of radiation hazard, job satisfaction, satisfaction with salary levels, job attitude were significantly related to transfer. The above indicate that besides economic incentives, job satisfaction and organizational culture to promote their ability and form a good relationship with organization members were very important to decrease the intention of transfer. Since these results represent only 6 hospitals from a limited area, more hospitals nationwide, especially small and medium-sized institutions where there is a high turnover rate of employment, need to be examined in order to investigate the various factors that affect the intention of transferring.

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A Study on Positive Effect affecting Medical Development with Integration of Oriental-western Medicine in China (최근 중국의 중.서의 결합에 관한 연구 -- 의학발전에 미치는 긍정적인 영향을 중심으로 --)

  • Lee, Jun-Mu;Lee, Seon-Dong
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.17-33
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    • 1996
  • Chinese medical science with long history has experience and theory of cure and prevention as well as the perfect different system with western medicine. Western medical science also was introduced in recent times and has been used in fast development in China extensively. Therefore only China that coexist oriental and western medicine is used the term, the integration of oriental and western medicine. Its object is to make better treatment and prevention value with utilizing their strong point and weak point. That is, its great principle is to develop through interchange together without interference in the other science. For mutual growth of both medical science, national concern and support, medical staffs, administrative system and a lot of fruits, etc should be arranged simultaneously. This paper was obtained the as follows. 1. The system of public health administration is composed a sanitary department for a western medicine and a managing agency for a chinese one in the center. There are each local organization under the control both agency in the locality 2. The importance of the integration of chinese and western medicine is to get the merit of special chinese system through the interchange of both medicine and union with modem science and chinese pharmacy. 3. It is the long term and great project. So its important study field is illness treatment and cure, oriental medical remedy and theory, acupuncture and moxibution etc. 4. It makes steady progress in all the healthy medical field. It has studied its foundation, the education of medical staffs, scientific study and strengthening of skill management considerably. 5. The products are the development of new chinese medicines and many researches about traditional chinese medical science. In brief, the integration of chinese and western medical science is the historical stream. Besides it will contribute toward the cure and prevention of human illness for future 21 century.

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Marketing Activities and Financial Performance of Korean Hospitals (우리나라 병원의 마케팅 활동수준과 재무성과)

  • Han, Chang-Hoon;Kim, Won-Joong
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.106-130
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    • 1999
  • The main objective of this paper is to perform an empirical analysis on the relationship between various marketing activities and financial performance of Korean hospitals. A survey was conducted through structured questionnaire for 495 hospitals, and data from 218 hospitals were utilized in the final anaylsis.(response rate: 44%) Survey items include general characteristics of the hospitals(size, type, location), degree of competition, financial performance. marketing organization! budget, and level of various marketing activities in service development, access improvement, promotion, and pricing. We examine descriptive statistics of the response scores on marketing activities to evaluate the current status of marketing management of Korean hospitals, compare the results across hospital size, type and location, and perform regression analysis to investigate the relaionship between marketing and financial performance. Major findings are as follows: 1) About 46% of the responding hospitals have marketing departments although they are named as 'planning' or 'PR' departments, and the marketing budget on average represents 1.74% of the total expenditures. 2) Average level of marketing activities is calculated to be about 3.32 on 5-point scale, meaning that Korean hospitals implement their marketing programs 'somewhat actively'; however, the scores on the areas of marketing plannning and strategy are relatively low. 3) Large hospitals tend to be more active in marketing than small hospitals, and public hospitals' activities in marketing are not lower compared to private hospitals. 4) Level of overall marketing activities is positively related with financial performance measured by various finacial indicators except for profitability, implying that marketing is successful in revenue generation but needs to be more cost-effective. Also, when the marketing variables are separately included in the regression, no significant relationship is found, which means that various marketing activities are more effective when they are collectively implemented.

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Human-Technology Integration for Implementing Electronic Approval System in a Hospital (의료기관 전자결제시스템 도입을 위한 Human-Technology Integration에 관한 연구)

  • Park, Jae-Sung;Park, Ki-Soo
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.102-120
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    • 2002
  • The purpose of study is to understand human-technology integration mechanism by using the study model that takes the core concept and motivation assumptions of technology acceptance model(TAM) into account. This study identifies three motivation mechanisms in adopting or using computer mediated communication(CMC) tool for work. The mechanism comprises with extrinsic, extrinsic motivation, and subjective norm pressure. One hospital with 430 beds and 367 human power was identified and we administered the questionnaire during their work hours. There is 32.4% response rate. The fitting index of the study model surpass the acceptable level, GFI = .980 for none-users, GFI =.986 for users, NNFI = .973 for none-users, and NNFI = .989 for users. In the case of none-users, perceived ease of use determines perceived usefulness that explains behavioral intention to use. As a result, adotpers' usage motivation is based on extrinsic motivation that does not consider their affective factor, attitude, in use of CMC. Users considers their attitudes as the mediating factor of all behavioral beliefs for using CMC continually. Thus, users are likely to depend their adoption behaviors on their affective factor. Moreover, users' behavioral intention is subject to pressures of use from other persons who are important to them, such as supervisor, director, or boss. Achieving human-technology integration in a hospital may cause cost saving and work efficiency. However, the success of information system should base on a profound understanding of employees' adoption behaviors in rejecting, adopting, using, continually using of IT, and organization culture in using IT.

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