• 한국병원경영학회지
• /
• 제14권1호
• /
• pp.36-61
• /
• 2009

This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

• 한국병원경영학회지
• /
• 제7권4호
• /
• pp.123-151
• /
• 2002

The objective of this study is to analyze the causal relationship of hospital inpatient's perceived quality, overall satisfaction, service value, and future intention to revisit. To carry out this objective, first we analyzed the dimensions of inpatient care service quality using SERVQUAL scale. The SERVQUAL scale is based on the gap theory, that is, the difference of patients' expectations and the actually received medical care service in hospital. On the basis of this theory, we measured the inpatient's perceived service quality and overall patient satisfaction. Data was gathered from a self-administered questionnaire at a 980 bed university hospital in Inchon City. These questionnaire measuring the service quality were distributed to 250 inpatients. The response rate was 66.4%. A total of 166 questionnaires was finally analyzed. To categorize medical service quality, the factor analysis was performed on 42 items. The reliability and validity of these items was evaluated. Finally to test 6 hypotheses, we analyzed the causal relationship of service quality, overall satisfaction, service value, and intention to revisit through the structural equation modeling(SEM). The major results of this study are as follows. First, the dimension of inpatient service quality was categorized into 7 dimensions, that is, personal caring, communication, access, physical environment, facilities and equipment, cleanliness, appropriateness and health status. Second, the reliability and validity of inpatient service quality items was satisfied. Third, as a result of structural equation modeling, the effect of inpatient's perceived service quality on overall satisfaction, service value, and intention to revisit was statistically significant. And total effect on intention to revisit as the core endogenous variable was perceived service quality(1.100), patient satisfaction(0.006), and service value(0.605).

• 한국임상보건과학회지
• /
• 제4권2호
• /
• pp.582-592
• /
• 2016

Purpose. For more effective hospital management, it analyzes the trend through general characteristics, balance sheet, income statement, and financial ratio analysis, grasps the causes of the problems, and analyzes management of the hospital in order to use the result as baseline data for development of the hospital in the future. Methods. The collected data of 3 years from 2011 to 2013 about 3 tertiary hospitals in metropolitan cities from Alio (provider of public institution information; www.alio.go.kr), Health Insurance Review & Assessment Service (www.hira.or.kr), and the website of the Ministry of Health and Welfare (www.mw.go.kr) were analyzed and general characteristics, balance sheet, income statement, and financial ratio, analysis are used as data. Results & Conclusions. From the result of data analysis from 2011 to 2013, general characteristics, balance sheet, income statement, financial ratio analysis, and pie charts could lead to conclusions as follows. In the result of comprehensive analysis, the 3 tertiary hospitals showed increase of fixed expense due to extension of the buildings and so did the scale of fund and asset. Although medical revenue increased, the margin of increase for medical expense was greater than that of medical revenue, which consequently led to loss. In prediction for the 3 tertiary hospitals based on characteristics so far, it is expected to see improved revenue structure after building extension is completed, but it is necessary to exert management effort to maintain its optimal level by enhancement in stability of management and inventory turnover through management of inventories.

• 보건행정학회지
• /
• 제30권2호
• /
• pp.178-184
• /
• 2020

Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

• 보건행정학회지
• /
• 제26권4호
• /
• pp.289-304
• /
• 2016

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

• 보건의료산업학회지
• /
• 제7권4호
• /
• pp.143-151
• /
• 2013

The purpose of this study was to analyze the socio-economic factors, the factors affecting the private insurance, utilizing Korea National Health & Nutrition Examination Survey 2011. Findings of the study can be summarized as follows. First, participants with private insurance are young, high monthly income, low prevalence of chronic illness. Second, participants with private insurance and chronic illness were young and high monthly income. Third, Average monthly household income, the higher the age is younger. Private insurance and national health insurance was higher subscription rate. Consequently, participants with private insurance and uninsured of the major differences is the age and the average monthly income. Elderly, low income are needed health promotion and disease prevention for expanded medicare, welfare policies.

• 보건의료산업학회지
• /
• 제14권1호
• /
• pp.161-176
• /
• 2020

Objectives: The purpose of this study was to investigate the effects of health status and health behaviors on health-related quality of life in Korean adults. Methods: The study was based on the 2017 National Health and Nutrition Survey. Of the total 8,127 people, 5,780 (71.1%) participated: 2,553 (44.2%) were male and 3,227 (55.8%) were female. The variables for this study were demographic factors, disease count, subjective health status, health behaviors, and health-related quality of life (measured by the EQ-5D Index). Results: After analysis, the statistically significant factors associated with health-related quality of life were gender, age, income, education, daytime health status, number of comorbidities (6 or more) and stress. Conclusions: Seven demographic factors have been identified as having a significant impact on health-related quality of life, categorized by model, gender, age and income. Therefore, it is possible that quality of life can be improved through proactive management and by improving subjective health status and health behaviors while in considering of demographic and sociological factors by providing indicators as per gender and age.

• 보건의료산업학회지
• /
• 제11권4호
• /
• pp.77-88
• /
• 2017

Objectives : To examine the factors associated with the use of the prenatal care services provided by the Ministry of Gender Equality and Family by married migrant women in Korea. Methods : We employed data from the 2015 Nationwide Multiculturale Family Survey. We selected 19- to 39-year-old married immigrant women with children aged 5 years or less for the study (N=1,579). We included four predisposing factors, six enabling factors, and two need factors based on the Andersen's Health-care Utilization Model. Results : Only one third of married immigrant women(31.6%) used prenatal care service and 45.9% of them reported prenatal care service needs. Area of residence, country of birth, and Korean language proficiency were significantly associated with prenatal care service use. Further, age, country of birth, length of time in Korea, household income, and discrimination experience were significantly associated. Conclusions : Findings suggest the need to develop strategies to improve accessibility to prenatal care service use especially for married immigrant women from developing countries, low-income families, having poor Korean language proficiency or having discrimination experience.

• 보건의료산업학회지
• /
• 제3권2호
• /
• pp.55-64
• /
• 2009

The purpose of this study was to examine the use of skincare & obesity clinics, customer satisfaction with franchise and non-franchise skincare & obesity clinics and customer selection criteria in the region of Busan in a bid to suggest some of the right directions for marketing strategies for the inauguration of skincare & obesity clinics. The subjects in this study were 240 users of 16 different skincare & obesity clinics selected from Busan. Out of the clinics, four franchise clinics and four non-franchise clinics were selected from the major commercial districts, and four franchise clinics and four non-franchise clinics were selected from the residential areas. Concerning the influence of three leading factors on customer satisfaction, all the service price, material service and human service had a significant impact on customer satisfaction in the franchise model for the commercial districts. In the case of the franchise clinics in the residential areas, only service price exerted a significant influence on customer satisfaction. In terms of the non-franchise model for the commercial districts, customer satisfaction was under the significant influence of human service and material service, and that was significantly affected by human service and service price in the non-franchise model for the residential areas.

• 보건의료산업학회지
• /
• 제12권4호
• /
• pp.139-154
• /
• 2018

Objectives: The aim of this study was to examine factors influencing health-related quality of life of waged workers. Methods: This study used data from the Seventh Korea National Health and Nutrition Examination Survey. Data were analyzed with the $x^2-test$, t-test, ANOVA, and multiple regression. Results: The significant predictors of health-related quality of life were depression, subjective health status, age, activity limitation, education, worker status, monthly income, drinking, smoking, physical injury, stress, and moderate physical activity. Conclusions: Personal health characteristics, psychological characteristics, socioeconomic characetrictics and working characetrictics affect health-related quality of life. Health-related quality of life is also affected by social structural problems such as socioeconomic factors and employment instabilitye. In addition to the development of health care programs to improve health-related quality of life of twaged workers, policy changes are needed to improve the social structure.