Since the late 1980s, there have been radical changes in the managerial environment of Y University Medical Center(YUMC). Externally, the competition among hospitals has intensified due to the establishment of universal health insurance in 1939 and the entrance of large enterprises into the health care industry in the early 1990s. In addition, government regulation of medical institution is becoming stricter. Also, consumer groups have continued to demand the respect for patient rights and improvement of the quality of medical services. Internally, the financial condition of YUMC has worsened, not only because weak control and poor mediation in its large-scale structure have made its operation inefficient, but also because the rates of increase in the prices of goods and labor have grown faster than any increases in revenues. This study on materials management at YUMC presents a way for YUMC to reduce costs and increase its productivity, thereby overcoming its financial difficulties and dealing with external pressures. This study utilized the case studies of the materials purchasing and medical supply management in the United States and the comparative analysis of management to suggest short-term and long-term alternatives for innovation in YUMC. The goals of the short-term alternatives for innovation are to centralize the purchasing and supply departments and to simplify the decision-making processes. Through these attempts, it is estimated that YUMC's costs could be reduced by $600,000 per year. In the long-term, it is necessary to consider introducing a Supply Processing Distribution(SPD) system and setting up a centralized electronic system for supply and inventory management, although it is difficult to estimate the effect of cost-cutting because of the lack of analysis data. Thus, YUMC should thoroughly analyze initial investment costs and economical efficiency generated from long-term alternatives.

This study attempts to analyze the relationship between various job-related factors and the intent to turnover of employees working at different types of hospitals/clinics in urban and rural areas. The data was compiled from 1,506 employees in 21 hospitals and 10 clinics located in Kyung-gi Do. Korea, using a self-administered questionnaire. Major findings are as follows: 1) The intent to turnover was higher for the employees of small hospitals located in rural areas. It was also higher when the employees were less than 30 in age, female, single, had not received college education, and had worked for 2-5 years in their hospitals. 2) An important factor affecting the intent to turnover was job satisfaction, which in turn had a strong correlation with the job itself(opportunity of utilizing abilities and skills, subjective value attached to the current job, sense of accomplishment) and had a rather weak correlation with salary, supervision, promotion and co-worker relationship. 3) In the analysis by job category, it was found that, besides job satisfaction, the intent to turnover was significantly affected by the job itself in case of administrative personnel and by the level of salary in case of nurses. 4) For a successful management of turnover, hospitals need to develop (a) programs for improving adaptive abilities of 'new' employees(who have worked for less than 2 years), and (b) for the other employees(who have worked for more than 2 years), strategies for enhancing job satisfaction by providing the environment where they can show their maximum abilities.

This study was attempted to identify the factors affecting profitability of general hospital in Kyung-In Region. Operating profit to gross revenues and net profit to gross revenues were used as a proxy indicator for profitability of hospitals. The unit of analysis was hospital, and the data were collected 5 years data from 20 hospitals. The major findings are as follows; (1) The average operating profit rate was 1.03% and the net profit rate was -5.00% in twenty hospitals in the Kyung-In Region for the last five years. In terms of maximum surplus, the operating profit rate was 14% and net profit rate was 3.40%. In terms of maximum loss revenue, the operating profit rate was -16.56% and the net profit rate was -22.83%. (2) Since the year 1993, which was the starting year of this study, the operating profits and the net profits consistently decreased. (3) Analyzing the difference in profits among various hospital groups, the tertiary hospital group and the 501-1000 beds group exhibited the highest in operating profit rate. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited the highest in operating profit rate. There is a statistically significant difference in those groups(p<0.05, p<0.01). (4) In the health care delivery system, the profit gain in the secondary hospital was 51.5% and in the tertiary hospital was 72.4%. Based on the number of beds in each hospital group, the highest profit gain was 75.0% in the over 1001 beds group, and 71.4% in the 501-1000 beds group. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited 88.6% surplus. (5) According to the surplus difference based on the analysis of health care utilization, a group with over 31 patients in bed turnover rate, a group with over 96% in bed occupancy rate and group with over 9% in emergency cases to outpatient visits exhibited the highest profit gains. In addition, a group with over 301 patients in daily outpatient visits per 100 beds and group with 11-12 days average length of stay exhibited the highest profit gains. These results are statistically significant(p<0.05, p<0.01). (6) According to a stepwise regression analysis, the variables measuring the bed turnover rate, number of licensed beds, and number of outpatient visits per specialist explain 34.1% of the variation in operating profits. In terms of net profits, the new outpatient visits, the bed turnover rates and the number of general bed variables explain 30.6%. These results are statistically significant(p<0.01).

This study was conducted to analyze the medical charges of the elderly dementia inpatients, to identity their characteristics, and there by to evaluate feasibility of the per diem payment system for the patients. Data on medical charges of the patients were collected from the National Federation of Medical Insurance and sample hospitals from October through December 1997. The data were analysed in order to find the characteristics and test hypotheses postulated. The results are summarized as follows; Firstly, there was no difference statistically in between disease groups and between the dementia inpatients belonging to each disease group. Secondly, the amount of the non-insurance medical charges of the elderly dementia inpatients is considerably high compared to the insurance medical charges paid by the patient, which implies that some measures are to be prepared by the Government. Finally, medical charges per inpatient day of the dementia patients are not different statiscally by sex, by age group, and by disease group. This result supports the feasibility of the per diem payment system for the elderly dementia inpatients.

This research has a purpose to develop strategies for application and introduction of activitiy based costing for Korean hospitals. A 700 bed-sized general hospital in Taejon was chosen to conduct this study. The conventional costing and ABC methods were simultaneously applied to the Obstetrics & Gynecology department, using data surveyed from June 21 to 30, 1998. The difference of two costing methods' results were analyzed and ABC's superiority was recognized. It showed that the new ABC model was more rational, fair, and objective in allocating indirect costs. The strategies to introduce ABC model to hospitals were suggested as followings: 1)a committee to manage ABC should be organized; 2)education for the employees about costing and cost saving should be provided; 3)the computerized ABC program should be developed; and 4)more advanced and rigourous methods to identify activities and measure the resource consumption should be developed.

The overall objective of this article is to identify the strategic type of Korean hospitals in terms of Porter's framework and to examine differences in performance of the hospitals across strategic types. A survey was conducted through structured questionnaire for 739 hospitals in Korea and the data from 120 hospitals were utilized in the final analysis. Study results indicate that the most frequently used strategy was 'stuck-in-the-middle strategy'(26.7%), followed by 'focused cost leadership strategy'(24.0%), 'focused differentiation strategy'(20.8%), 'cost leadership strategy'(15.8%), and 'differentiation strategy'(13.7%). Overall, 'focused differentiation strategy' showed superior performance in terms of profitability of services, ability to retain patients and growth in revenue, while 'differentiation strategy' produced relatively low performance in general. Implications of these findings are also discussed.

This study was performed to assess the financial performance of medical institutions and examine the affecting factors in Taegu metropolitan and Kyungpook province. The major results are as follows ; The liability to total assets was significantly different according to the ownership type of medical institution. It was the highest in the case of juridical person having a special status. The total assets turnover and value added to total assets were significantly different according to the type of medical institution, period of establishment, and ownership type of medical institution. They were higher in the tertiary medical institution, in private hospital and university hospital, and they were increased with establishment period of medical institution. The growth rate of patient revenues were significantly different according to the type of medical institution, period of establishment, and the growth rate of adjusted inpatient days were significantly different by period of establishment. The return on assets and net profit to gross revenues were the highest in private hospital. Private hospital went into the black, but other hospitals went into the red figures. According to the multiple regression analysis for the net profit to gross revenues, ownership type, period of establishment, and management strategy of medical institution were significant It was higher in private hospital and medical institution with prospector management strategy, and it was increased with establishment period of medical institution. In multiple logistic regression analysis for the status of financial performance in medical institution, period of establishment, management strategy of medical institution were significant It was better in medical institution with prospector management strategy and longer period of establishment.

This study aims to investigate the determinants of service quality and the relationships of service quality, customer satisfaction, word of mouth and subsequent purchase intention of medical service. SERVQUAL, an instrument developed by the marketing area, is offered as a possible measure of medical service quality. SERVQUAL measures service dimension of tangibles, reliability, responsiveness, assurance and empathy. The questionnaire method is used in this study. A survey is conducted on patients who are randomly selected. The questionnaire are sent to 300 patients and 208 are available. The objectives of this study were: 1) to find out the influence of determinants of service quality on medical service. 2) to investigate the relationship of medical service quality and customer satisfaction. 3) to analyze the relationship of customer satisfaction and favorable word of mouth, ubsequent purchase intention 4) to find out the gap perceived service quality between secondary and tertiary hospital. The results of this study are summarized as follows: 1) Reliability, responsiveness and assurance have a positive impact on the medical service quality. 2) Medical service quality has a positive impact on the customer satisfaction. 3) Customer satisfaction has a positive impact on the favorable word of mouth and subsequent purchase intention. 4) There is no gap between secondary and tertiary hospital of perceived service quality.

The objectives of this research are to examine the factors influencing the employees' satisfaction and to investigate that the employees' satisfaction effects the organizational commitment on seven National University's hospitals. The data for this analysis were collected by questionnaire survey. 657 usable questionnaires were returned, a 78.2%, response rate. The major statistical methods used for the analysis are factor analysis, t-test and hierarchical multiple regression. The findings suggest that four components of job satisfaction are selected: these are "task", "organizational operation system", "opportunity of development", "interpersonnel". Highly satisfied employees turn to organizational commitment such as responsibility of organization and retention. Futhermore the findings suggest that responsibility is affected by work period, task satisfaction, opportunity of development. And retention is affected by work period, role as teaching hospital, and task satisfation. This study concludes with a discussion of the managerial relevance of the findings and future research directions.