• Health Policy and Management
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• v.18 no.2
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• pp.19-38
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• 2008

Financial ratios are key indicators of an organization's financial and business conditions. Among various financial indicators, profitability, financial structure, financial activity and liquidity ratios are frequently used and analyzed. Using the structural equation modeling(SEM) technique, this study examines the structural causal relationships among key financial indicators. Data for this study are taken from complete financial statements from 142 hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1998 to 2001 for the purpose of accrediting teaching hospitals. In order to improve comparability, ratio values are standardized using the Blom's normal distribution. The final model of the SEM has four latent constructs: financial activity(total asset turnover, fixed asset turnover), liquidity(current ratio, quick ratio, collection period), financial structure(total debt to equity, long-term debt to equity, fixed assets to fund balance), and profitability(return on assets, normal profit to total assets, operating margin to gross revenue, normal profit to gross revenue). While examining several model fit indices(Chi-square (df) = 178.661 (40), likelihood ratio=4.467, RMR=.11, GFI=.849, RMSEA=.157), the final SEM we employed shows a relatively good fit. After examining the path coefficient of the constructs, the financial structure of the hospital affects the hospital's profitability in a statistically significant way. A hospital which utilizes its liabilities, more specifically fixed liabilities, and makes a stable investment decision for fixed assets was found to have a higher profitability than other hospitals. Then, the standard path coefficients were examined to directly compare the influence of variables. It was found that there were no statistically significant path coefficients among constructs. When it comes to variables, however, statistically significant relationships were found. between. financial activity and. fixed. asset turnover, and between profitability and normal profit to gross revenue. These results show that the observed variables of fixed asset turnover and normal profit to gross revenue can be used as indicators representing financial activity and profitability.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.145-156
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• 2010

The purpose of this study is one of high price medical equipment wished to grasp propriety factor about the MRI introduction, analyzing payability through cost accounting into compensation. It was investigated from January 1 to December 31, 2007 about the MRI of a General Hospital. Expectation availability was 23.2 cases, but actual availability did achievement more than 196.1% with 45.5 items. It is estimated that there are a lot of occurrence cases because great reasons that actual availability increases more than expectation availability is excellent resolving power than a CT, and is device that prefer to reason back that radiation damage is less in person body. The followings show the main results of this study. 1. The MRI was construed in order of cost accounting, wave and personnel expenses 45.4%, administrative expenses 53.0%, and material costs 1.6%. 2. According to CVP (Cost-volume-profit) analysis, BEP (Break Even Point) profit is 173,931,428 won for 11 months, and break even usage number of items are 37.5 cases, and separation usage number of items were confirmed by 1.4 cases. Therefore, was construed that can achieve BEP within 11 months though usage number of items keeps 1.4 items day to create the MRI's hospital operation profit. 3. Estimated limit profitability appears high by 96.7%, exceed fixed charges even if when is non-benefit and when it is benefit consider variable, is judged that the MRI's addition induction helps in hospital management enhancing earning rates.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.490-502
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• 1998

This study purports to find the predictor of hospital bankruptcy in Korea and to examine the predictive power of the discriminant function model of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 31 bankrupt and 31 profitable hospitals of 1, 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the discriminant function model of hospital bankruptcy was developed. The major findings are as follows 1. As for profitability indicators, net worth to total assets, operating profit to total capital, operating profit ratio to gross revenues, normal profit to total assets, normal profit to gross revenues, net profit to total assets were significantly different in mean comparison test in 1, 2, and 3 years before hospital bankruptcy. With regard to liquidity indicators, current ratio and quick ratio were significant in 1 year before bankruptcy. For activity indicators, patients receivable turnover was significant in 2 and 3 years before bankruptcy and added value per adjusted inpatient days was significant in 3 years before bankruptcy. 2. The discriminant function in 1, 2, and 3 years before bankruptcy were; $Z=-0.0166{\times}quick$ ratio-$0.1356{\times}normal$ profit to total assets-$1.545{\times}total$ assets turnrounds in 1 year before bankruptcy, $Z=-0.0119{\times}quick$ ratio-$0.1433{\times}operating$ profit to total assets-$0.0227{\times}value$ added to total assets in 2 years before bankruptcy, and $Z=-0.3533{\times}net$ profit to total assets-$0.1336{\times}patients$ receivables turn-rounds-$0.04301{\times}added$ value per adjusted $patient+0.00119{\times}average$ daily inpatient census in 3 years before bankruptcy. 3. The discriminant function's discriminant power in 1, 2, and 3 years before bankruptcy was 77.42, 79.03, 82.25% respectively.

• Journal of the Korean Data and Information Science Society
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• v.17 no.4
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• pp.1271-1278
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• 2006

Recently, a profit analysis in hospital management is considered as an important marketing concept. When spatial variability is presented, we must analyze the hospital data with spatial statistical methods. In this study, we present a regression model using spatial covariance for adjustment. And we compare the nonspatial model with spatial model.

• Health Policy and Management
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• v.11 no.4
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• pp.38-53
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• 2001

The price of the hospitals' services is regulated by the governmental health insurance reimbursement schedule in Korea. On the other hand, the emphasis on the quality of care of hospitals service is ever increasing. Under the environment, hospitals have to understand the effects of the activities to improve quality of care on efficiency and on financial performance so that they develop a management strategy that allows quality of care, operational efficiency, and financial achievement simultaneously. This study investigates the relationship among the concepts. The sample for the study includes 23 hospitals that have more than 300 beds. The concept of quality of care is measured by the score reported by the Hospital Standardization Survey (HSS) instituted by Korean Hospital Association. Efficiency is measured by the ratio of number of employee to the number of patients served. Financial performance is measured by the financial ratios indicating the profitability of a hospital. An analysis is performed using the multiple regression. The results show significant positive relationships between the HSS score and efficiency indicators, md between the HSS score and profit measures. However, the significant positive relationship between the HSS score and profit measures disappeared when efficiency indicators were introduced to the model. This study concludes that the structural quality of a hospital has a positive effect on efficiency of the hospital and that the structural qualify indirectly affects the financial performance of a hospital through the improvement of efficiency. Based on the findings, the implications on hospital management and health policy are discussed.

• Health Policy and Management
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• v.20 no.3
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• pp.123-137
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• 2010

The main purpose of this article is for deriving functions related to the prediction of the closure of the hospitals, and finding out how the discriminant functions affect the closure of the hospitals. Empirical data were collected from 3 years financial statements of 41 private hospitals closed down from 2000 till 2006 and 62 private hospitals in business till now. As a result, the functions related to the prediction of the closure of the private hospital are 4 indices: Return on Assets, Operating Margin, Normal Profit Total Assets, Interest expenses to Total borrowings and bonds payable. From these discriminant functions predicting the closure, I found that the profitability indices - Return on Assets, Operating Margin, Normal Profit Total Assets - are the significant affecting factors. The discriminant functions predicting the closure of the group of the hospitals, 3 years before the closure were Normal Profit to Gross Revenues, Total borrowings and bonds payable to total assets, Total Assets Turnover, Total borrowings and bonds payable to Revenues, Interest expenses to Total borrowings and bonds payable and among them Normal Profit to Gross Revenues, Total borrowings and bonds payable to total assets, Total Assets Turnover, Total borrowings and bonds payable to Revenues are the significant affecting factors. However 2 years before the closure, the discriminant functions predicting the closure of the hospital were Interest expenses to Total borrowings and bonds payable and it was the significant affecting factor. And, one year before the closure, the discriminant functions predicting the closure were Total Assets Turnover, Fixed Assets Turnover, Growth Rate of Total Assets, Growth Rate of Revenues, Interest expenses to Revenues, Interest expenses to Total borrowings and bonds payable. Among them, Total Assets Turnover, Growth Rate of Revenues, Interest expenses to Revenues were the significant affecting factors.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.71-92
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• 2005

The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.

• Health Policy and Management
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• v.12 no.2
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• pp.43-75
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• 2002

This study focuses on the factors that make the financial structure of hospitals in Korea different, and on recommended courses of action that could be very helpful to hospitals in maintaining a sound financial structure. Data used in this study were collected from 132 hospitals with complete general data of present conditions as well as financial statements. They were chosen from the 174 hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variable in this study is financial structure. It consists of liabilities as against total assets (total liabilities to total assets, short-term liabilities to total assets, long-term liabilities to total assets, short-term borrowings to total assets, long-term borrowings to total assets). The independent variables are ownership type, hospital type, location, whether or not a representative is a director of the hospital, the possibility of changing a hospital director, bed size, period of establishment, asset structure, profitability, growth, tax shields, business risk, competition. The factors that appear to have the strongest impact on the liabilities to total assets of all the hospitals sampled are ownership type, hospital type, profitability, tax shields, and business risk. It was found that not-for-profit private hospitals and for-profit private hospitals have more liabilities than public hospitals, and tertiary medical institutions have less liabilities than the secondary general hospitals. Moreover, hospitals earning more at the expense of high business risk have a distinct tendency to lower liabilities. Concerning the current ratio, it was found that factors such as ownership type, hospital type, period of establishment, asset structure, and business risk are the more significant variables. The current ratio of public hospitals is higher than that of both not-for-profit private hospitals and for-profit private hospitals, and the current ratio of tertiary medical institutions is higher than that of general hospitals. As business risk is higher in hospitals compared to other businesses, the current ratio becomes higher; this is because it is assumed that for fear of bankruptcy, hospitals lessen liabilities to total assets. On the other hand, as hospitals become older, the fixed assets to total assets become lower. It is remarkable that in hospitals, the factors affecting liabilities to total assets have an opposite regression coefficient sign against factors affecting current ratio. It brings out the same results borne out by the old financial theories and researches, in which a lot of the liabilities of hospitals are considered as the cause of worsening liquidity. Therefore, it is very important for hospitals to maintain a sound financial structure in order to survive using the rational acquisition and maintenance of capital.

• The Korean Journal of Health Service Management
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• v.12 no.1
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• pp.1-11
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• 2018

Objectives : The purpose of this study was to identify the relationship between decision-making types, public entrepreneurship, and performance management of local public hospital directors. Methods : A questionnaire survey was carried out to assess the dependent variables of directors' decision-making types and public entrepreneurship. The analysis of management performance was carried out through a comparison between 2016 results of, data of variation rate on medical revenue and change rate on medical profit and results in 2015. Results : Results indicated that local public hospital directors who used rational decision-making showed better performance management. The analysis showed that enterprise had a greater positive effect (+) on variation rate of medical revenue than that of innovation. However, innovation had a higher positive effect (+) on change rate of medical profit than that of enterprise. These results suggest that innovation and enterprise have a major influence on performance management. Conclusions : The survey used for this study suggests that an education and training program is needed to improve public hospital directors' ability for rational decision-making, public entrepreneurship and performance management. Additionally, the policy change guaranteeing autonomy within the proper range is demanded that Local Public Hospital Director having spirit of innovation and enterprise achieves peak capacity and have responsibility for management.