• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.786-800
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• 1998

This study has attempted to show general characteristics of health centre directors who have served the post of directorship during the last 40 years. Of 3,000 such health centre directors, information on about 2,500 directors was collected. While average length of service for health center directors has increased, that of vacancy period has decreased. Rural areas have a shorter average length of service than the urban area. Rural areas have twice longer length of vacancy period per health center. Kangwon-do has the longest average length of vacancy period since 1980(2.79 months/year), and Daejeon has the shortest length of vacancy period(0.21 months/year). Chung-buk has no physician directors. The civil servant's rank for the directorship has promoted from the fifth level to the fourth level since 1990. A comparison between the physician director & non-physician director was made as follows : first, the proportion of physician directors had maintained rather high before 1980 s; 62.5% in 1963, 78.3% in 1970, 70.4% in 1980. It decreased to 44.1% in 1990 and 47.6% in 1997. Instead, non-physician directors has abruptly increased since 1980s (12.4% in 1980, 55.4% in 1990 and 50.8% in 1997). Second, physician directors mainly locate in the urban area(58.0% in 1997), but non-physician directors mainly in the rural area(67.2% in 1997). Third, since 1980, the average length of service for physician directors and for non-physician directors has become similar. Fourth, the mean age of physician directors is 45.1 years, and that of non-physician directors 55.7 years. The latter is 10 years older than the former.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.770-785
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• 1998

This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic, average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was mcreased \4,850,000, but the difference was \6,020,000 under the control of control variables. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.

• 보건행정학회지
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• 제9권2호
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• pp.95-117
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• 1999

The purposes of the study was to analysis the factors on the physicians' indemnity experience and indemnity on malpractice. Data was collected from mail interview for the physicians from August, to October in 1996. Questions were asked to the physician who selected with random sample(n=8.338) about the opinion of malpractice insurance. experience that he(she) have requested the indemnity from patience. context of experienced indemnity and demographic characteristics of physician and patience. Response rate is 37.5%(n=3,124). This study was analyzed in two levels' the first. influential factors on whether physician has experience of indemnity and the second. influential factors of indemnity among physicians who had experienced the indemnity. The major findings were as follows : 1. Logistic regression on whether physicians had experience of indemnity request was conducted. And it indicated that statistically meaningful variables of model 1 (about all physicians) were department of surgery, physicians who have intention of insurance fee, physician age and income, physicians who owned the hospitals and statistically meaningful variables of model 11 (about physicians who owned the hospital) were department of surgery and internal treatment. 2. Multiple regression on the influential factors on indemnity was conducted. And it showed that statistically meaningful variables in model 1 were method of malpractice quarrel(physician association), whether physician had malpractice, whether suit succeeded, physician age, average practice time and income and whether physician owned the hospital and statistically meaningful variables of model 11 were whether physician had malpractice, number of outpatient, number of beds. As the conclusion, the thesis was examined about the variables related with experience of indemnity and cost of malpractice. But in order to prevent malpractice and promote medical quality, the reasonable system to solve a malpractice have to settle and cost estimation on malpractice is essential. Therefore an advanced research is progressed with methodology to decide the indemnity bases.

• 한국의료질향상학회지
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• 제5권1호
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• pp.16-26
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• 1998

Background : As many previous studies proved, the quality of medical record is thought to reflect the quality of care. In this study, we analyzed the relationship between the quality of record and some factors influencing the quality of record, especially the commitment of the attending physician. Method : We developed checklist for evaluation of medical record with 36 criteria. 300 inpatient records of 10 attending physicians' patients were evaluated and the quality' of records were scored. The attending physician's commitment to medical records were scored by 34 residents. The relationship of the quality of records with physician's commitment to records, and some other factors were analyzed. Results : More than 75% of the immediate postoperative notes on the progress note were missed. More than 69% of the contents of explanation about the procedures on the consent form or on the other forms were also missed. The physician whose quality score of records was the highest(78.9) got the highest commitment score. The score of attending physician's commitment to the record, and his seniority were positively related with the quality score of his medical records when number of patients and department were adjusted. Conclusion : The quality of the 5 forms of the record reviewed were evaluated as moderate or excellent except 2 or 3 items. The quality of record was positively related with the attending physician's commitment to the record, and the seniority of the physician.

• 보건행정학회지
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• 제27권1호
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• pp.18-29
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• 2017

Background: In Korea, the problem of physician workforce imbalances has been a debated issue for a long time. This study aimed to draw key lessons and policy implications to Korea by analyzing projection models of physician demand/supply among five countries. Methods: We adopted theoretical framework and analyzed detail indicators used in projection models of demand/supply comparatively among countries. A systematic literature search was conducted using PubMed and Google Scholar with key search terms and it was complimented with hand searching of grey literature in Korean or English. Results: As a results, Korea has been used a supply-based traditional approach without taking various variables or environmental factors influencing on demand/supply into consideration. The projection models of USA and Netherlands which considered the diversity of variables and political issues is the most closest integrated approach. Based on the consensus of stakeholder, the evolved integrated forecasting approach which best suits our nation is needed to minimize a wasteful debate related to physician demand/supply. Also it is necessary to establish the national level statistics indices and database about physician workforce. In addition, physician workforce planning will be discussed periodically. Conclusion: We expect that this study will pave the way to seek reasonable and developmental strategies of physician workforce planning.

• 대한예방한의학회지
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• 제13권1호
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• pp.105-115
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• 2009

Background: The resource-based relative value scale has been applied to Korean medicine services as part of the National Health Insurance, yet the proper scoring method for physician's work needs to be developed. Objectives: To measure physician's work for Korean medicine services using Analytical Hierarchy Process(AHP) and to compare results abstracted by AHP with those by Magnitude Estimation method. Methods: We developed the AHP questionnaires for Korean Medicine services and administered it to 12 Korean medicine insurance experts. Weighted scores were calculated and were converted into physician's work scores. Results: In AHP measurement, the physician's work scores for acupuncture activities, especially special acupunctures, far increased, while those for diagnosis and basic consultations decreased. Variations in the scores enlarged. Conclusions: As an alternative, AHP method can be considered for measuring the physician's work for Korean medicine services with careful management of scoring variation.

• 동서간호학연구지
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• 제21권2호
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• pp.156-164
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• 2015

Purpose: This study was conducted to identify the relationship of assertiveness and attitudes toward nurse-physician collaboration in general hospital nurses. Methods: The subjects were 196 clinical nurses from two general hospitals in P city. Data were collected from August 1 to 30, 2014 and analyzed by SPSS 18.0 program using descriptive statistics, t-test, ANOVA, $Sheff{\acute{e}}^{\prime}s$ test, and Pearson's correlation coefficients. Results: The mean scores of assertiveness and attitudes toward nurse-physician collaboration were $3.20{\pm}.42$ and $3.20{\pm}.30$, respectively. Assertiveness and attitudes toward nurse-physician collaboration according to the general characteristics showed significant differences on the numbers of advisors and job satisfaction. There was a significant positive correlation between assertiveness and attitudes toward nurse-physician collaboration. Conclusion: Based on results of this study, additional variables related to attitudes toward nurse-physician collaboration need to be identified. Educational programs to improve the attitudes toward nurse-physician collaboration should be developed.

• 한국직업건강간호학회지
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• 제31권3호
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• pp.105-113
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• 2022

Purpose: This study aimed to identify the effects of emotional intelligence and self-leadership on job satisfaction among physician assistant nurses. Methods: The participants were 146 physician assistant nurses working at two university hospitals. Data were collected from August 1-September 31, 2020 and analyzed through t-test, ANOVA, Scheffé test, Pearson correlation, and hierarchical regression analysis using SPSS/WIN version 26.0. Results: Factors affecting job satisfaction were self-leadership (β=.30, p=.003), "less than 1 year of experience as a physician assistant nurse" (β=.27, p=.025), and emotional intelligence (β=.25, p=.007), and the explanatory power was 34.4% (F=6.03, p<.001). Conclusion: Our study shows that self-leadership and emotional intelligence play a significant role in the job satisfaction of physician assistant nurses; thus, strengthening these two factors is crucial to improve the nurses' job satisfaction. The results of this study may serve as basic data for the development of strategies to enhance job satisfaction among physician assistant nurses.

• 보건교육건강증진학회지
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• 제2권1호
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• pp.56-80
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• 1984

The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.