• Journal of The Korea Institute of Healthcare Architecture
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• v.7 no.1
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• pp.23-31
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• 2001

In order to improve their hospital services in unlimited competitive situations, the general hospitals, particularly, have since the 1990s been concentrating more on hospital information processing systems and the automation of the patients' convenience. They also give priority to the advance of integrated hospital information systems centred around the patients. Introducing more progressive information technology to already established hospitals, the OPD has been most affected by HIS because there are a lot of patients and doctors. On this background, this study analyse the change of OPD and some related departments around the 1990s with the general hospitals as it's object. It investigates the way of building hospitals and presents some information about the planning of building hospitals.

• Quality Improvement in Health Care
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• v.3 no.1
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Quality Improvement in Health Care
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• v.1 no.2
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• pp.60-72
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• 1994

Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

• The Korean Journal of Health Service Management
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• v.5 no.4
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• pp.177-192
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• 2011

The arguments exist that private health insurance(PHI) policy holders tend to use the health care services more than non-policy holders due to their little out-of-pocket spending, resulting in the adverse effects on the finances of National Health Insurance. This study aims to increase the objective understanding of the issue and to draw a direction of further research, by reviewing the articles, reports and statistics which examined the effects of purchasing PHI policies on health care utilization. Significant differences in healthcare utilization, except for the very partial increase of utilization in outpatient settings, have been not found. The similar trends of the results have existed in a few previous studies which tried to control the endogeneity of medical use and health insurance with latent variables which affect the decision on medical use and health insurance. However, we can not exclude the potential change of healthcare utilization patterns because the portion of the insured of indemnity PHI is becoming rapidly larger in the market. For further research, we should try to obtain the objective information of subjects' past medical history, health status, health related behavior, and income affecting purchase of PHI and utilization of healthcare services. And the efforts of controlling the endogeneity of medical use and health insurance with latent variables which affect the decision on medical use and health insurance, are very considerable.

• 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.

• Health Policy and Management
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• v.18 no.3
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• pp.41-57
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• 2008

To examine the gap between physician's perceived importance and performance of care and to identify factors associated with the gap. A self-administered questionnaire survey was conducted with 91 physicians working in a University hospital in Seoul. The respondents were asked about their perceived importance and actual performance of interpersonal care on a 5-point Likert-type scale, indicating a higher score as higher importance and performance. Interpersonal care was measured by questions modified from the Korean Standard Service Quality Index, which are grouped into 6 categories: basic services, extra services, reliability, courtesy, convenience, and tangibles. Multiple regression analysis was conducted to find out physician characteristics associated with the gap. All of the 6 interpersonal care categories showed lower performance than perceived importance. The respondents tended to have a worse performance than perceived importance as the number of patients per outpatient care session ($\beta$=-0.0204, p<0.05) and the need for customer satisfaction education increase ($\beta$=-0.2226, p<0.05). Female physicians ($\beta$=0.2336, p<0.05) and those with higher job satisfaction($\beta$=0.0096, p<0.05) showed a better performance than perception. Overall, it appears that lower quality of interpersonal care was delivered to patients than the desired level considered by the responding physicians. Based on the regression analysis results, it is suggested that reducing patient volume per session, fulfilling education need for customer satisfaction, and improving job satisfaction may contribute to reduce the gap between physician's perceived importance and performance of interpersonal care.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.379-388
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• 2022

Objectives: Throughout history, societies have been impacted by inequality. Many studies have been conducted on the topic more broadly, but only a few have investigated inequalities in out-of-pocket health payments (OHP). This study measures OHP inequality trends among the Iranian households. Methods: This study used data from the Iranian Statistics Center on Iranian household income and expenditures. The analysis included a total of 995 300 households during the 36 years from 1984 to 2019. The Gini coefficient, Atkinson index, and Theil index were calculated for Iranian OHP. Results: Average Iranian household OHP increased from 33 US dollar (USD) in 1984 to 47 USD in 2019. During this 36-year span, the average±standard deviation Gini coefficient for OHP was 0.73±0.04, and the Atkinson and Theil indexes were 0.68±0.05 and 1.14±0.29, respectively. The Gini coefficients for the subcategories of OHP of outpatient diagnostic services, medical assistant accessories, hospital inpatient services, and addiction cessation were 0.70, 0.61, 0.84, and 0.64, respectively. Conclusions: In this study, we scrutinized trends of inequality in the OHP of Iranian households. Inequality in OHP decreased slightly over the past four decades. An analysis of trends among different subgroups revealed that affluent households, such as households with insurance coverage and households in higher income deciles, experienced higher inequality. Therefore, lower inequality in health care expenditures may be related to restricted access to health care services in Iran.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.349-358
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• 2023

Objectives: We used the 2019 Korea Health Panel Annual Data to analyze factors related to visits to Korean medicine (KM) outpatient clinics among patients with mood disorders in Korea. Methods: Individuals aged 19 years or older, with depressive or bipolar disorders, and with a record of using Western medicine (WM) and/or the KM medical service were included. The 266 subjects were classified into the WM group or the integrative medicine (IM) group. The Andersen healthcare utilization model was used to analyze factors that potentially influenced the subjects' healthcare utilization. Binomial logistic regression analysis was used to analyze factors influencing the use of IM medical services. Results: Among the subjects, 75.56% (n=201) were in the WM group, and 24.44% (n=65) were in the IM group. Statistically significant differences were observed in residential areas, total annual income, the presence of disability, and the level of pain/discomfort between the two groups. Regression analysis found that residential areas and pain/discomfort were factors related to the use of IM services. Specifically, reporting "a lot" of pain/discomfort compared to "no" pain/discomfort showed a significant positive relationship with the use of IM (odds ratio=4.57, 95% confidence interval=1.79 to 11.70). Conclusions: This study was the first to analyze the status of KM medical service use and related factors among patients with mood disorders in Korea. The finding that the presence of pain/discomfort was positively correlated with the use of KM services is potentially related to medically unexplained physical symptoms or somatization phenomena.

• Korea Journal of Hospital Management
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• v.28 no.4
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• pp.73-89
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• 2023

Purposes: The purpose of this study was to empirically analyze the effect of the attitude of medical staff providing medical services on the treatment satisfaction of the patients who experienced outpatient care at the hospitals and clinics. In particular, it was verified whether the courtesy of the medical staff to the outpatients has moderated the effect of the medical staff's explanation on the treatment satisfaction. Methodology: After controlling the socio-demographic factors of the outpatients with their treatment and waiting time, multiple regression analyses were conducted to figure out the effect of the attitude of the medical staff on the treatment satisfaction. And the covariance analyses were adopted to verify the moderating effect of the variables of the medical staff. Findings: At both hospitals and clinics, all attitudes of medical staff such as the way they explain to and communicate with the patients, and their courtesy showed positive effects on treatment satisfaction. Among them, the courtesy of the medical staff was the most influential variable on the satisfaction of the treatment, and it only had the control power over the effect of the way they explain on the treatment satisfaction. Practical Implication: Among the medical staff's attitudes toward patients at hospital or clinic level, the courtesy of doctors and nurses is an important factor in improving treatment satisfaction. In particular, if the level of their courtesy is low among the medical services rendered at the clinics, the satisfaction level will decrease even if the level of explanation of the medical staff is high. Therefore, in terms of hospital management, treatment satisfaction can be improved when doctors and nurses provide medical services to visitors with polite, humble and friendly manner in explaining to and communicating with the patients.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.2
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• pp.31-45
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• 2014

Objective : This study was intended to provide information pertaining to reasonable consumption of medical services based on comparative analysis of the characteristics of musculoskeletal diseases(MSDs) among outpatients of Korean medical institutes, and furthermore help lay groundwork for mapping out effective Korean medical policies. Method : Based on the data of 3,889 outpatients of Korean medical institutions which were obtained from the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine, the analysis was carried out by using the SAS 9.2. Results : 68.2% of subjects were found to use Korean medicine(KM) for the treatment of MSDs. Patients with MSDs were older than those with nonmusculoskeletal diseases(NMSDs). And married state, education, employed state and incomes are effected on MSDs and NMSDs. Subjective health status, number of outpatient treatments, medical cost, medical treatment satisfaction, and habitue status are depend on MSDs or NMSDs. Acupuncture and physical therapy is Major treatments of subjects investigated to have the highest treatment effect. It was found that they had high degree of satisfaction with Korean medicinal outpatient treatments, and those with MSDs were found to have significantly greater satisfaction than those with NMSDs. Conclusion : Although aforesaid results suggest significant satisfaction with KM and high treatment effects for MSDs. Accordingly it is considered necessary to develop various services related to KM for treatment of MSDs and to plan for cost down of KM. Moreover, in-depth research into NMSDs is required for utilization growth of KM.