• Korea Journal of Hospital Management
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• v.18 no.1
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• pp.70-87
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• 2013

This study investigated contents of mission statements for Strategic Management of hospitals in Korea and Japan. For the study, 44 tertiary care hospitals in korea, which were accredited by the Ministry of Health and Welfare, were selected. And 83 special functioning hospitals in Japan, which were approved by the Minister of Health, Labour and Welfare, were included. Both quantitative and qualitative analyses were conducted by classifying 5 components of the mission statement; market, service, philosophy, image, contribution. Findings from this study are as follow. First, hospitals in Korea emphasized image(93.2%) and philosophy(81.8%) components in their mission statements, whereas hospitals in Japan highlighted components of service(89.2%) and market(72.3%). In detail, mission statements of Korean tertiary care hospitals describe the components of hospital's image (93.2%), philosophy(81.8%), contribution(56.8%), market(22.7%) and service (18.2%) in order. On the other hand, mission statements of Japanese special functioning hospitals describe hospital's service(89.2%), market(72.3%), contribution(61.4%), image (49.4%) and philosophy(34.9%), respectively. Second, as results of Content analysis, there were some differences in mission statements of hospitals between two countries, and it is mainly from the divergences of standards for recognition of medical institutions, environmental factors, and different ways of mission statement description. For strategic hospital management, carrying out innovative restructuring organization or promoting of research and training for medical development is considered as a desirable approach. However, clear description of mission statement is more important and it is required for effective control and managing organization. And then the mission should be communicated within an organization so all internal members understand it and put their efforts to achieve the mission of organization. In conclusion, it is recommended that a leader and senior managers should re-evaluate its mission statement whether it reflects characteristics of an organization. In addition, a mission statement should be created or improved based on critical decision, as well as it should be clearly shared within an organization in order to become a future oriented organizations.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.183-202
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• 1997

Health care organizations have been faced with financial difficulties under turbulent health care environment. This situation led hospitals to concentrate their efforts to improve their managerial efficiency in various ways. This study aims to evaluate technical efficiency of 31 tertiary hospitals in Korea and find determinants which are closely related with hospital efficiency. Data envelopment analysis(DEA) and Tobit Model were adopted for study. For the analysis, human resource factors such as number of physicians, nurses, and administrative staffs are used as input variables and the number of inpatients and outpatients) are used as output variables. Among 31 hospitals, in CCR model, 8 hositals showed efficiency score 1 which means they have been operated in very efficient ways and BCC model showed 13 of 31 hospitals as efficient organizations. Next, we analyzed determinants which are closely related with hospital efficiency. By using Tobit model, the study showed hospital size, Quality of care, value added per capita, and revenue per patient were closely related with hospital efficiency, However, it appeared that financial status of hospitals(i.e : making profit or not) was not related with hospital efficiency.

• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.66-72
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• 2014

Although stress has been implicated to be a risk factor that can threaten physical and mental health, there have been no sufficient studies that analyze the different levels of stress among employees working in the different levels of the hospitals. We aim to identify the general characteristics of hospitals at different levels, to compare the stress levels among customer service representatives working in the tertiary care hospitals as well as acute general hospitals. In addition, we also wanted to analyze the relationship between the types of hospitals and the stress level. The work stress was measured using the Korean Occupational Stress scale. Study subjects' demographic characteristics and lifestyle factors were analyzed using analysis of frequency and multiple regression analysis. Our study revealed that the levels of medical facility were significantly associated with the levels of job stress(P=0.043), and the stress levels of employees working in the acute general hospital's medical facilities were higher than those who were working in tertiary care facilities. We also found that those with higher depression level tended to have higher job stress (P<0.001). Therefore, it is urgent to implement some kind of job stress interventions, especially in the acute general hospital's medical facilities. Moreover, further studies including social and policy research are necessary in order to analyze the overall impact of stress on physical and mental health and to reduce health inequalities among healthcare workers.

• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.1-11
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• 2021

Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.

• Korea Journal of Hospital Management
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• v.27 no.1
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• pp.20-30
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• 2022

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.35-44
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• 2021

Purpose: The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals' nurses. Methods: The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors. Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses' individual innovative behaviors in tertiary care hospitals.

• Korean Journal of Health Education and Promotion
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• v.7 no.1
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• pp.27-32
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• 1990

Since the medical insurance covered the total population in Korea in July, 1989, the number of patient's visitation to the tertiary care hospital had changed because of referral regulation. In the referred patients through the secondary care hospitals such as out-patients of departments of internal medicine, general surgery, obstetrics and gynecology, pediatrics had decreased as well in-patients in these departments. However, departments of urology, dermatology, dentistry, ophthalmology and ear-nose-throat had more or less similar number of patients after medical insurance implemented for the total population. Contrarily, the number of patients visited emergency clinics and department of family medicine had increased very many. Thus, expansion of emergency clinic department, new special clinic set-ups, establishment of family medicine department in each hospital etc are strongly recommend.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.32-43
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• 2023

Purposes: This research is conducted to identify main features and trends of mission, vision and core values in Korean tertiary general hospitals by using text-mining. Methodology: For the study, 45 mission, 112 vision and 190 core values are collected from 45 tertiary general hospitals' homepages in 2022 and use word frequency analysis and Leyword co-occurrence analysis. Findings: In the tertiary general hospitals' mission, there are high frequency words such as 'health', 'humanity', 'medical treatment', 'education', 'research', 'happiness', 'love', 'best', 'spirit', and mission mainly includes the content of contributing humanity's health and happiness with these words. In case of vision, high frequency words are 'hospital', 'medical treatment', 'research', 'lead', 'trust', 'centered', 'patient', 'best', 'future'. By using these words in vision, it represents the definition and characteristics of vision such as ideal organizations in the future, goals and targets. As a result of the Leyword co-occurrence analysis, vision includes the content of 'high-tech medical treatment', 'special care for patients', 'leading education and research', 'the highest trust with customer', 'creative talents training'. -astly, the high frequency word-pairs in core values are 'social distribution', 'innovation pursuit', 'cooperation and harmony', and it defines standards of behavior for organizations. Practical Implication: To correct the problems of vision, mission and core values from findings, firstly, it needs for Korean tertiary general hospitals to use the words that can explain organization's identity and differentiate others in their mission. Secondly, considering strengthening the role of hospitals in their community and the importance of members in organizations, it is necessary to establish vision with considering community and members to activate vision effectively. Thirdly, because there are no specific guidelines of establishing mission, vision and core values for healthcare organizations, this research concepts and results could be utilized when other organizations establish mission, vision and core values.

• Health Policy and Management
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• v.20 no.4
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5049-5054
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• 2013

Background: To assess the treatment pattern and expenditure incurred by cancer patients undergoing treatment at government tertiary hospitals in India. Materials and Methods: A cross-sectional study of 508 cancer patients randomly selected from tertiary cancer hospitals funded by central/state governments located in major cities of five states in India, namely Kerala, Maharashtra, Rajasthan, West Bengal and Mizoram, during March - May 2011 was conducted. Information related to direct costs, indirect costs and opportunity costs incurred on investigations and treatment, major source of payment and difficulties faced by patients during the course of treatment was collected. Results: About 45% of the patients used private health facilities as the first point of contact for cancer related diseases as against 32% in public hospitals. About 47% sought private health facilities for cancer investigations, 21% at district/sub-district hospitals, and about 4% contacted primary health care facilities. A majority of the patients (76%) faced financial problems while undergoing treatment. Conclusions: The results highlight the importance of involving the primary health care system in the cancer prevention activities.