• 한국병원경영학회지
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• 제12권3호
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• pp.20-46
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• 2007

Given the pressures to promote the efficient utilization of medical resources, hospitals have developed cost accounting systems in several countries. This study discusses the recent development and problems of hospital cost accounting practices in three countries: UK, US, and Japan. first, we discuss a cost accounting structure and detailed pictures of costing practices. Second, problems of current systems arc reviewed and then possible remedies are discussed. Third, we provide implications for implementing the systems(especially ABC). finally, we assert that infrastructure(hospital information systems, database, etc.) must be established and the target level of costing has to be considered before organization-wide application.

• 한국병원경영학회지
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• 제6권2호
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• pp.3-21
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• 2001

Although the accounting system is a very useful information system for manager, that of the National University Hospitals is not settled until now. Specially, when it will adapt the responsibility management system itself, it will more important tools for them. The purpose of this research is to make the standard accounting system for National University Hospital. It was surveyed the 7 National University Hospital's accounting system, and compared to that of Private University Hospital. The results are fellows; First, it must be match financial report with budgeting system. By comparing to each other, it can make to evaluate the performance of hospital. Second, it must make same format and contents in financial report among 7 hospitals. Specially, the cost information is needed to be made more details. This research suggest the new direction to make the basic information form. It was confirmed with financial manager in private university hospital. We hope it will contribute to make the new accounting system for National University Hospital.

• 한국병원경영학회지
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• 제13권2호
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• pp.1-19
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• 2008

BSC(balanced scorecard) is expected of the effective integrated tool of the management problem such as links of the management vision, the strategy, and the business scheme. This study discusses the recent development and problems of hospital BSC practices in in several countries. First, the article discuss the recent development and problems of hospital BSC implementation. Second, we review the links of strategic alignment with hospital's strategy and BSC on weight design, organizational culture and hospital performance. Finally, we explore hospital BSC framework that clarified easy to understand integrative approach to hospital BSC research using contingency theory model.

• The Journal of Asian Finance, Economics and Business
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• 제9권4호
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• pp.273-285
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• 2022

Using data from a departmental profit and loss management questionnaire survey conducted for a group of hospitals consisting of various establishment entities, this study evaluates the effectiveness of departmental profit and loss management practices, such as break-even analysis, based on objective performance data. The study also examines whether the implementation of departmental profit and loss accounting is still effective in improving profitability in the financial year 2021 and whether the effectiveness of the implementation of departmental profit and loss accounting is robust. This study reconfirmed that the implementation of departmental profit-and-loss accounting has a positive effect on objective financial performance in hospitals and that the effect of improving profitability can be enhanced by implementing it monthly with high frequency and regularity and by using the accounting results more actively. It was also found that the department's implementation of break-even analysis had a positive impact on financial performance, which was enhanced by more active use of the data. Given the current economic climate, a hospital organization's active participation in income statement management, not only for the hospital as a whole but also for each department, would be an effective management activity.

• 한국병원경영학회지
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• 제19권1호
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• pp.32-42
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• 2014

It is necessary to calculate prime cost of medical services accurately in order to evaluate the adequacy of medical fee. This paper aims to identify cost analysts' perception on prime cost of medical services and needs in establishing a cost accounting system in hospitals, proposing future directions and guidelines for the calculation of medical fee. A self-administered questionnaire and telephone survey on operation of a hospital cost-accounting system was conducted in November, 2012, among cost analysts currently working in the hospitals and hospital administrators planning to implement the hospital cost-accounting system. Our study shows that most of the cost analysts were aware of the importance of calculating prime cost and responded that collection of the prime cost data from government is necessary although they are less likely to provide the data in the future concerning the risk of data misuse and data security. They also responded that lack of budget allocation and excessive workload were the main reasons for not estimating the prime cost and operating cost management information system. Results show that hospital cost analysts considered the data accuracy is the most critical factor in calculating prime costs of medical services. However, there was no investment budget allocated in some hospitals or limited to less than 100 million, indicating that hospitals are reluctant to invest on implementing the cost accounting system. Respondents stated the organization that collects the prime cost of medical services among hospitals should display strong analytical capabilities, ensure data security, and maintain independence, which is most demanded. There are 57 hospitals that calculated the prime cost of medical services for 2012 by each medical department and 20 hospitals that calculated the prime cost by fee-for-services, aiming to establish a cost accounting system. Our results indicate that hospitals should voluntarily provide the accurate prime cost for medical services in order to properly evaluate the adequacy of medical fee. Consequently, it is critical to establish an independent organization to collect and appraise the data. It is also recommended that government should implement various policies to encourage hospitals to participate in the data collection to achieve the data accuracy and representativeness.

• 대한병원협회지
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• 제24권9호통권227호
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• pp.31-43
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• 1995

• The Journal of Asian Finance, Economics and Business
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• 제7권10호
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• pp.109-117
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• 2020

This study aims to examine the effects of factors related to management accounting systems and managerial performance. The factors include budgetary participation, decentralization, and management style. Furthermore, this research investigates the consequences of the management accounting systems on managerial performance and the direct effect between management style and budgetary participation on managerial performance. Survey questionnaires were distributed to both public and private hospitals in Palembang, the South Sumatera region, Indonesia. The sample consisted of 62 respondents from 15 hospitals Target respondents were all managers in hospitals, including financial managers, service managers, human resource managers, quality managers, and other managers. The questionnaire was distributed online to each hospital, and approximately five or more questionnaires were hardcopies. This research was conducted over less than six months. The data obtained were processed via excel files, then checked for conformity, and analyzed by partial least square (PLS) software with descriptive statistics. This study uses path analysis, which that is structural equation modeling (SEM). The findings show that management style, decentralization, and budgetary participation significantly affect management accounting systems. However, management style and budgetary participation did not influence managerial performance. Finally, the findings indicate that management accounting systems are positively affected by managerial performance.

• 한국병원경영학회지
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• 제21권1호
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• pp.1-13
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• 2016

As the importance of strengthening the competency of managers who are in charge of cash collection and disbursement, and preparing for financial statements becomes more visible, this study examined the competency of middle-level managers of accounting department in general hospitals in Korea. Based on the literature, competency was measured by seven components: achievement and action, service, influence, management, cognition, individual effectiveness, and change management. Survey questionnaires included the respondents' perceived importance and performance of each of the seven components of competency. A total of 84 managers from 29 general hospitals responded to the survey between October 2015 and November 2015. Descriptive statistics, mean comparison (t-tests and ANOVAs), and multiple linear regression were conducted. The results of this study are as follows. Overall perceived importance of the competency was 4.16, while the performance was 3.87, and thus, the difference was 0.29. Among the seven components of the competency, cognition and change management had higher scores in terms of difference between the importance and performance. The regression analyses found that female managers had higher perceived importance and performance of competencies in achievement and action, and influence compared to male counterparts. In addition, participants in this study responded that main reasons for the gap between the perceived importance and performance are low compensation, lack of support, lack of knowledge, insufficient technical experience, excessive workload, and regulations. The results of this study can be used when designing capacity building training opportunities for the hospital accounting department. Also, the managers may evaluate themselves and look at the areas where they can narrow the gap between the perceived importance and performance of the competency that is required for today's leading managers.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.332-339
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• 2023

Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

• 한국병원경영학회지
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• 제6권2호
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• pp.37-69
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• 2001

A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.