Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km2 area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.
In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.
Needs for public healthcare have recently increased. This paper proposes education topics for competency development in public healthcare in line with the needs of the times. In Korea, various lifelong education providers have already provided public health-related education. For example, the Research Institute for Health Policy (RIHP) under the Korean Medical Association provided an "executive course for physicians' public health care competencies" in 2019 and 2020. At the end of the course, the RIHP published a comprehensive report, entitled "Curricular development and evaluation for doctors' public healthcare competencies." This article is based on a summary of that report. To develop a curriculum for public healthcare, the RIHP adopted the following methodologies for a needs analysis; reviewing already-existing education subjects, evaluating end-of-course reports, and conducting in-depth focused group interviews and questionnaire surveys with doctors at public healthcare-related institutions. The results from the needs analysis can be categorized into two domains of education topics for public healthcare. The first domain includes education subjects related to the theory and practice of public healthcare, as follows: a general overview, community or population health, organizational administration, planning and evaluation, budget and finance, responses to disasters such as infectious diseases, health policy, and the legal system. The second domain contained education topics related to general professional competencies: leadership, communication, cooperation, teamwork, and professionalism. In conclusion, the curricular content for public healthcare will be an appropriate combination of competencies specific to public healthcare and core competencies for health professionals.
Objectives : This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. Methods : Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. Results : The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. Conclusions : The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.
This study analyzes Korea health panel data (2008) (beta version 1.2) of Korea Institute for Health and Social Affairs, and National Health Insurance Corporation to figure out determinants of healthcare expenditure. In result of Multiple Logistic Analysis, in-patents felt burden on the medical expenditure were 70.0%. As to the patients' payment of medical expenditure, patients over 65 years old had 4.765 times higher than those under 14 years, disabled patients 2.778 than non-disabled patients, chronic patients 1.632 times than non-chronic patients, patients belonging to 12 million won ~ 46 million won and under 12 million won in family income had 1.680 times and 2.168 times respectively than patients with over 46 million won, patients in professional recuperation facility 1.546 times than patients in hospital, patients in private medical institutions 1.700 times than patients in national and public medical institutions, patients using upper grade rooms 1.701 times than patients in non-upper grade rooms. As a health care safety net mechanism to protect people from medical expenditure burden, there is the patients' payment ceiling in the National Health Insurance System. Thus, in order to facilitate the patient's payment ceiling, it is required that the level of ceiling is to be specified according to the income level, and self-payment items is to be included.
This study aims to analyze the characteristics of the management situation of the Korea Railroad Corporation(KORAIL) through the management innovation process of the KORAIL and to suggest its implications for military application. Despite stable demand, the railway passenger industry had the limitation of not being able to abolish deficit routes due to public service obligations. In addition, the launch of the Suseo High-Speed Line has introduced a competitive system, posing a threat to corporate management. KORAIL wanted to overcome this crisis by innovating its management through the utilization of big data, improvement of the freight business, decentralization of demand, the introduction of tourism railroads, and development of station influence areas. By utilizing big data, KORAIL was able to optimize the railway fare system while reducing fixed costs spent on railway maintenance. It also drastically reduced the station of cargo and created a base station to pursue economies of scale. On the other hand, the existing exclusive station system was abolished to solve the chronic saturation of the downtown area, and the railway demand was moved to Gwangmyeong Station and Suwon Station to optimize the passenger supply. In particular, it developed a new business model called the tourism railway by developing the mountain Byeokjin Line, which was a chronic deficit line, and sought to improve liquidity through the development of the station influence area. Such a process of innovation at KORAIL suggests an appropriate direction in seeking ways to innovate the military medical institutions. First of all, the necessity of improving organizational immersion through the development of a personnel structure suitable for the compulsory organization, while expanding the facilities of the division and corps, and reducing the time required for medical treatment and waiting through the establishment of a data-based medical system was suggested. Next, it was also discussed to integrate the National Health Medical College, which received accreditation as a medical facility through the designation of advanced general hospitals and is ultimately under discussion with the Medical Institution. Through this, we hope that the military medical institutions, which are facing various challenges, will overcome existing limitations and be re-lighted as innovative institution that provides comprehensive public health services.
The purpose of this study is to analyze the management performance of hospitals by analyzing the ratio of stability, profitability ratio, and growth rate through the financial ratios of medical institutions using accounting information disclosure data of medical institutions, financial status table and profit and loss statement. The main goal is to analyze and analyze financial statements of medical institutions' accounting information in 2016 and 2017, analyze the difference and analyze the general characteristics and financial ratios by type, type and size of medical institutions, The financial characteristics of medical institutions were identified. The ratio of stability, profitability, and growth rate through financial ratios were compared and analyzed. In addition, we analyzed the correlation between the medical profit margin, the total asset profit margin, the medical profit margin rate, and the net profit margin of the medical institutions through the financial ratios of accounting information disclosure data of medical institutions. The main results are as follows: First, the size of the hospital and the size of the debt through the change of assets, liabilities and capital of the financial statement are increasing, the size of own capital is relatively decreased, and the management performance is getting worse It is showing. Second, the increase in average medical revenues in the income statement is small, and the average increase in net profit is small. Thus, medical institutions were able to confirm the difficulty in creating profits through medical activities. In addition, there was a large difference in the debt ratio, the stability ratio, and the profitability ratio of the general hospitals and the general hospitals according to the types of medical institutions, and the difference in the average financial ratios of national and public hospitals, school corporation hospitals, I could confirm. The correlation between independent variables in the correlation was -0.904 between the capital ratio and the total assets turnover ratio, -0.800 between the labor cost ratio and the hospital income ratio, and -0.631 between the labor cost ratio and the foreign profit ratio. In order to improve the management deterioration of hospitals by using accounting information disclosure data of medical institutions, it is necessary to have a large effect on the net profit margin of the medical care and the net profit margin of the total assets.
Seo, Young-Joon;Kang, Shin-Hee;Kim, Yeon-Hee;Choi, Dae-Bong;Shin, Hyun-Kyu
The Journal of Korean Medicine
/
v.31
no.1
/
pp.69-80
/
2010
Objectives: This study aimed to find determinants of customers' use of and satisfaction with oriental medical services in Korea. Methods: A total of 33 articles which consist of 9 articles published in academic journals, 20 master's theses, and 4 doctoral dissertations were included in the systematic review. Among the articles used in the study, 29 used primary survey data, while 4 used secondary data produced by the Korean National Health and Nutrition Evaluation Survey. Results: First, it was found that people who prefer to use oriental medical services usually have one or more of the following diseases: musculoskeletal disorders, paralysis, or diseases or injuries without clear diagnosis. Other variables of gender, age, expectation of treatment outcome, and kindness of doctor and other staff were found to be significant determinants of using the oriental medical services. Second, the determinants of customers' satisfaction with oriental medical services were found to be age, gender, level of education, chronic disease with long length of stay, kindness of staff, medical cost, clinical environment, doctor's reputation, and public image of the institutions. Conclusion: The results of this study can be used to develop marketing strategies for oriental medical institutions in Korea.
Total quality management (TQM) has been adopted in the U.S. as a way of management strategies by private enterprises as well as by the public sector. The ultimate goal of all quality management techniques and strategies is to improve quality by reducing waste, improving production process, and involving all members of the company in quality management. The purposes of this study are to review the performance of TQM activities and, based on the results, practically examine whether TQM is necessary or not in enhancing the performance of medical service institutions (hospitals) by assessing the status of TQM activities of medical service institutions and comparing such activities. A questionnaire survey was conducted against employees working for general hospitals in Seoul and other provincial areas. The questionnaire contained organized questions that were answered in writing by the target employees. A total of 184 questionnaires were collected and analyzed. The results of this study are summarized as follows. First, TQM activities and performance were found to be positively correlated. Second, TQM activities and performance differed according to ownership types. Third, TQM activities and performance differed according to geographical locations. Fourth, TQM activities and performance differed according to leadership types.
Purpose: To identify the importance and performance levels of health management duties, work-related and general attributes of health managers in medical institutions and analyze their impact on the performance of managing health-care related tasks. Methods: This research identified the performance levels of 150 health managers who have been executing industrial health-related duties for more than six months as nurses in medical institutions with more than 30 hospital beds. The variables which affect their performances were then analyzed. Results: The average importance of health care duties was 8.1 out of 10 and 5.5 for performance levels. Multi-regression analysis on the variables affecting performance levels of health managers in medical institutions showed that health managers exhibit higher numbers under the following conditions: over 300 full-time employees, more than 1 year but less than 3 years of experience, positions above section chief level, affiliation to the safety and health department, and high perception of duty importance. Conclusion: Improved cognizance of health manager importance should occur initially; then, health-care center setup, assigning of exclusive occupational health managers, and organizational efforts to improve the working environment in tandem with the provision of educational training programs to improve work quality are necessary.
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