• 한국산학기술학회논문지
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• 제21권2호
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• pp.470-478
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• 2020

본 연구에서는 단일 환산지수 체계를 유형별 외래 및 입원 환산지수로 분리하기 위한 이론 모형을 설계하였다. 그리고 가상 자료를 바탕으로 외래 및 입원 환산지수와 조정계수를 산출하였다. 본 연구에서의 중요한 결론은 다음과 같다. 첫째, 외래·입원 환산지수 개념을 도입하고 설계함으로써 의원은 외래, 병원은 중한 환자 위주의 입원 기능에 집중하도록 유도할 수 있는 최소한의 인센티브 도구를 도입할 수 있다. 둘째, 환산지수를 분리함으로써 상급종합병원을 비롯한 대형병원의 외래 진료비 수입이 목표 진료비 예산 이상으로 증가하더라도 병원수익 증대에 큰 도움이 되지 않도록 보상 체계를 설계할 수 있는 방안을 도입해 자원 배분 동기를 부여할 수 있다. 셋째, 단일 환산지수보다 다양한 요소들에 대한 명시적인 계약이 가능해져 급증하는 진료비에 대한 적절한 관리 수단으로 활용할 수 있다. 마지막으로 외래 및 입원 환산지수 분리 계약은 공급자의 행위론적인 변화를 유도해 의료전달체계를 정립하는데 기여할 수 있는 정책적인 도구로 활용될 수 있을 것이다.

• 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.

• 대한간호
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• 제33권1호
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• pp.65-79
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• 1994

The purpose of this study was to describe the job retainment factors and the level of job satisfaction, and to identify the relationship between job retainment and the level of job satisfaction among the registered nurses working in hospitals. Four hundred eight registered nurses currently employed at 8 hospitals in Seoul were surveyed for the study. The 39 item, 5 point likert scale questionnare was developed by the researcher. The internal consistency of job satisfaction was. 86 and that of job retainment was. 90 in Cronbach's alpha test. The data sas collected from July 15 to July 30, 1993. The SPSS/PC+statistical program was used for data analysis. The descriptive analysis of the characteristics of the subjects, the level of job satisfaction and the job retainment factors was done. The relationship between the job satisfaction level and the job retainment factors was tested with. the Pearson Correlation Coefficient analysis, and thd differences of job retainment scores among the sample was tested with t-test and ANDVA. The results of the study were summarized. 1. The mean age of the subjects was 29.7 years, 41.7% of them were married. 71.1% of them were 3 years course graduates, 71.8% of them were staff nurses, and the mean duration of experience was 6 years. 2. The factors related to professionalism(3.43), society(3.31), and interpersonal relationship(3.29) were significant in job retainment. The maximum score was 5.0 Two other factors, personal(3.05) and organization(2.83) factors, also showed relatively high scores. 3. The factors to the job satisfaction showed similar pattern as job retainment: professionalism (3.47), society (3.33), finance(3.31), interpersonal relationship(3.02), and organization(2.72). 4. Society related factors(r=.7420, p<.00l) and professionalism(r=.7249, p<.00l) had high correlation with job retainment. Personal(r=.6372, p<.001) and organizational(r=.3597, p<.001) factors had moderate relationship to job retainment. Finance(r=.3597, p<.00l) had significant but weak relationship to job retainment. 5. Age, marital status, job position, departmental involvement, experience, and continuity of employment of the sample showed significant differences in job retainment. However, the period of job retainment, number of children, educational level, type of hospital, previous employment experience were not significant. 6. lndiviuals older than 40 years of age, who were married, who held the position of charge or head nurse position, who worked in central supply or nursing administration showed significantly high job retainment score. This research indicates that the professionalism is the most significant factor in job retainment. In order to retain more experienced nurses, it is important to improve the profesionalism among nurses.

• 한국콘텐츠학회논문지
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• 제20권10호
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• pp.510-521
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• 2020

최근 의료기관의 회계에 대한 투명성이 강조되고 있다. 그러나 현행 제도상의 문제와 구조적인 한계로 인해 국내 병원 등의 재무상태에 대한 진단이 부족한 실정이다. 본 연구는 국내 374개소 병원급 이상 의료기관의 100병상당 재무제표를 기초로 하여 병원 규모별 잉여현금흐름(FCF)을 잉여현금흐름가설의 관점에서 분석하였다. 의료기관의 당기 손익계산서를 통하여 영업현금흐름(OCF)을 도출 후, 전기·당기 재무제표와 OCF를 통해 FCF를 분석하였으며 재무 변수들 간의 상관관계를 확인하였다. 분석결과, 첫째, 160~299병상과 300병상 이상의 규모의 병원은 상대적으로 높은 FCF를 보유하였다. 둘째, 상급종합병원, 160병상 미만, 병원급의 경우 음(-)의 FCF를 보였다. 이에 따라 병원 규모에 따른 FCF의 격차를 줄여 적정 수준으로의 유지가 필요할 것으로 판단된다. 본 연구는 병원 규모에 따른 FCF 분석을 최초로 수행하였다는 점에서 의의가 있다. 향후 의료분야에서 새로운 회계 정책을 설립 시, 의료기관의 규모에 따른 차별화된 전략을 수립하는 데에 정보 가치가 있을 것으로 기대된다.

• 한국병원경영학회지
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• 제12권1호
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• pp.1-30
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• 2007

The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.

• 한국병원경영학회지
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• 제22권1호
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• pp.40-50
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• 2017

The purpose of this study is to develop the KPIs(Key Performance Indices) needed to improve management and strategy in the dental clinic based on the four perspectives of BSC(Balanced Scorecard). The questionnaire was conducted on 52 dentists approved by Dental Managment Research Committee in Seoul National University as a panel. Using the Delphi technique, the top five KPIs for each point of perspective in BSC were extracted from KPI pools. In the third survey, the top five KPIs of all points were compared with each other through AHP(Analytic Hierarchy Process) method, and priority and overall importance rankings were calculated. The biggest difference in the three level AHP results was the customer perspective took priority to others. In the second survey, the financial perspective, which was number one, was pushed back. The overall significance of KPIs was in the order of customer, internal process, finance, learning and growth perspective, with the exception of medical profits (5th of 20) and new patient growth (10th of 20). We were able to overcome the limitations of the Delphi Technique with the AHP method. In general, the financial perspective in BSC is known to be the most important, but we conclude that the customer perspective is more important through the pairwise comparison survey. In the current dental service market, which is a long-term recession, excessive competition, customer satisfaction and customer relationship management seem to be the first goal to pursue in dental clinic.

• 한국병원경영학회지
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• 제14권4호
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• pp.124-148
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• 2009

Objectives : The purpose of this study was to investigate influencing factors on physician's intention to use cyber salesperson(cSP) to promote ethical drugs of pharmaceutical company. We considered influencing factors based on technology acceptance model(TAM) such as usefulness, easy of use, and attitude about cSP, and included trust and joyfulness of cSP. Methods : Measure items were developed from the previous studies. Data were collected from 1,012 physicians by using web-based self-administered structured questionnaire. Results : The major findings were as follows; First, attitude and intention to use cSP were not significantly varied by socio-demographic variables, such as sex, age, location, and Internet surfing time per day. Also, physician's characteristics such as training and professional level and type of employment were not significant to the variation of attitude and intention to use cSP. Second, structural equation modeling(SEM) analysis shows that usefulness and joyfulness were influencing factors of intention to use. Attitude was revealed as significant mediating factor to intention to use. Usefulness has indirect effect on intention to use via attitude. However, trust has not significant effect on intention to use, due to suppression effect. Conclusions : This results implies that cSP will be a useful agent to promote the ethical drugs to physician. Usefulness and joyfulness should be considered as important factors in designing and operating cSP in the Internet.

• 한국병원경영학회지
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• 제8권1호
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• pp.1-23
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• 2003

General drug prices involve three stages: shipment stage, wholesaler stage and retail stage. Policies on drug price differ from country to country. Shipment stage prices are tightly regulated in countries like France and Netherlands. They are free in only a minority of advanced countries, even if these include some major players such as the US, Germany and, in a very limited sense, Japan. The situation in the UK is very complex with a semi-free system, where drug companies are free to set their own prices but cannot exceed a predetermined profit ceiling. Mark-up at both wholesaler and retail stages is formally admitted in most countries observed. Apart from the general drug prices, reimbursement price of insured drugs has been major policy concerns. Most countries reviewed in this study has exerted some control over reimbursement prices, but differ both in the way how and in the extent to which prices are admitted or fixed. Price fixing has been used in France and Japan. Some countries have transformed their system over time, particularly to move to reference pricing in the last decade. This mechanism has empowered the customer, and improved price competition on the market. Referring to the drug price policies in the advanced countries, this study makes some suggestions for the redirection of Korean price policy for reimbursement drug in health insurance as follows: to match appropriate policy tools to each policy goal; to maximize market mechanism through effective reimbursement price fixing which admits mark-ups in wholesaler and retail prices; to introduce reference pricing system in order to redirect patient's demand with a financial incentive to choose the best-priced drugs and to save the finance of health insurance; and to strengthen surveillance and monitoring mechanism in the drug market.

• 한국산학기술학회논문지
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• 제10권6호
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• pp.1304-1316
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• 2009

본 연구는 효율성에 기초한 환산지수의 도입 가능성을 알아보기 위한 기초 연구로 시도되었다. DEA 효율성지표와 환산지수가 전공의 수련교육을 실시하고 있는 60 개 병원을 그룹화하는데 얼마나 유용하게 사용될 수 있는가를 고찰하였다. 이러한 목적을 달성하기 위해 자료수집이 가능한 표본병원의 환산지수와 AHP 개념을 도입해 DEA 모형의 투입변수와 산출변수를 선정하였다. 그 결과 병상규모가 클수록 규모적 비효율성이 큰 것으로 나타났으며 기술적으로 또는 규모적으로 비효율적인 병원일수록 환산지수가 더 큰 것으로 나타났다. 환산지수와 효율성지표는 수련병원을 병원의 종별에 따라 종합전문병원과 종합병원으로 구분하는데 유용하게 사용될 수 있었다. 또한 DEA 효율성을 구하는 과정에서 독립변수로 사용된 투입 산출변수를 판별함수에 도입하였음에도 불구하고 환산지수와 효율성지표는 판별함수를 구성하는 주요 변수로 작용함을 확인하였다. 따라서 만약 모집단을 대표할 수 있는 많은 표본을 기초로 보다 명확한 결과를 얻을 수 있다면 건강보험의 수가계약제 하에서 효율성 개념을 바탕으로 한 환산지수계약의 도입을 신중하게 고려해 볼 수 있다.

• 한국산학기술학회논문지
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• 제11권7호
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• pp.2406-2419
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• 2010

본 연구는 의료기관평가점수의 유용성을 높이기 위한 목적으로 수행되어 2004년부터 2008년까지 공시된 의료기관평가점수를 바탕으로 효율성지표를 이용해 환산지수를 추정하는 모형을 구축하였다. 의료기관평가영역별로 부여된 다양한 평가항목점수를 AHP를 통해 축약하고 이를 DEA_AR모형에 사용함으로써 추가적인 정보를 제공하는 유용한 예측모형을 구성할 수 있었다. 의료기관평가점수와 신임병원자료, 건강보험공단 자료를 연결해 분석 가능한 자료를 생성하고 DEA, 요인분석, 일반 선형모형을 이용해 환산지수, 효율성, 환산지수와 효율성을 결합하는 모형을 제시하였다. 개별 병원의 투입물과 산출물 뿐 만 아니라 의료기관평가점수, 종별구분, 지역별 분포 등이 환산지수의 영향변수로 파악되었다. 따라서 본 연구에서 제시된 AHP와 DEA_AR을 기반으로 한 효율성지표를 사용해 환산지수를 구하고 이를 수가계약에 활용함으로써 보건의료에 기여할 것으로 판단된다.