• Health Policy and Management
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• v.18 no.3
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• International Journal of Quality Innovation
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• v.10 no.1
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• pp.77-87
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• 2009

The main aim of the paper is to provide an empirical analysis on patient satisfaction as an indicator of service quality in Malaysian public hospitals. Self-administered questionnaires were administered to patients by convenience sampling. Two sets of questionnaires were used, one for inpatient and another one set for outpatient. Selection of hospitals was made according to states in Peninsular Malaysia. 23 hospitals covering all state level hospitals, the National Referral Centre and selected district hospitals were chosen as respondent hospitals. Two dimensions of service quality emerged, namely clinical and physical dimension of service. Both outpatient and inpatient were found to be more satisfied with clinical dimension of service than physical dimension. For outpatient satisfaction, there was positive correlation between waiting time and patient satisfaction. Patient satisfaction was also found to be higher in the smaller district hospitals than in the larger state hospitals. For clinical dimension of service, patients were satisfied with the services of doctors and nurses, while for physical dimension of service, patients were satisfied with the cleanliness of the facilities. The ability of the research to be conducted by random sampling was inhibited by the reluctance of patients to cooperate, which led to the use of convenience sampling. Studies have also shown that patients are reluctant to express their feelings on services provided by their caregivers. The study provides primary data for a nationwide study on patient satisfaction in Malaysian public hospitals, for both inpatient and outpatient.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.135-144
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• 1994

The purpose of this study compares determinants of eldery medical cost inflation with those of other age groups by analysing aggregated data with a deterministic model. The deterministic model of per capita medical cost inflation consists of increases in price, intensity of services, and medical utilization. We used a time series data($1985{\sim}1991$) from National Medical Insurance and analyzed by age groups. In total population, the average increase rates of inpatient and outpatient medical costs were respectively 9.5% and 8.8% during 6 years and the major cause of inflation was the increase in service intensity in both of inpatient and outpatient cases. But in the population of 65 years old and over, the average increase rates of inpatient and outpatient medical costs were respectively 13.8% and 14.8% and the major cause of inflation was the increase in per-capita medical utilization in both of inpatient and outpatient cases. Also, the increase in service intensity of 65 years old and over was the highest of other age groups. This pattern was similar during study periods. We concluded that the level of medical cost-inflation and the determinants in eldery was the highest-especially in per capita medical utilization, therfore, the inflation of medical costs in eldery will be higher than other age groups for the furture in Korea.

• The Korean Journal of Health Service Management
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• v.6 no.3
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• pp.209-218
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• 2012

The purpose of this study was to provide the effective pain management care for post operative patients through understanding patient's knowledge and attitude about pain-management. The data was collected by distributing structured questionnaires to 200 inpatients in 2 secondary hospitals located in Ulsan, beginning June 28, 2010 to August 11, 2010, and analyzed by t-test, ANOVA, Pearson correlation coefficient. The level of Knowledge about pain management postperations was $6.44{\pm}2.03$. The level of attitude about pain management postperations was $6.92{\pm}1.78$. The significant differences were founded within the inpatient's knowledge about pain management according to the inpatient's demographic data:Age(F=5.55, p=.01), Marital status(t=-2.17, p=.03). The significant differences were founded within the inpatient's attitude about pain management according to the inpatient's demographic data:Job(F=3.45, p=.03). Developing educational material and guidebooks is needed to form more positive about pain-control after operations. This study researched only inpatient's knowledge and attitude about pain-management, but researching nurses, doctors, inpatients and family member's knowledge and attitude should be included in following studies.

• The Korean Journal of Health Service Management
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• v.8 no.2
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• pp.11-22
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• 2014

This study purposed to analyze the regional variation of the local-out rates of inpatient services. Multiple data sources collected from National Health Insurance Corporation and statistics Korea were merged to produce the analysis data set. The unit of analysis in this study was city, Gun, Gu, and all of them were included in analysis. The dependent variable measured the local-out rate of inpatient cost in study regions. Local environments were measured by variables in three dimensions: provider factors, socio-demographic factors, and health status. Along with the traditional ordinary least square (OLS) based regression model, geographically weighted regression (GWR) model were applied to test their effects. SPSS v21 and ArcMap v10.2 were applied for the statistical analysis. Results from OLS regression showed that most variables had significant relationships with the local-out rate of inpatient services. However, some variables had shown diverse directions in regression coefficients depending on regions in GWR. This implied that the study variables might not have consistent effects and they may varied depending the locations.

• Health Policy and Management
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• v.33 no.3
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• pp.253-263
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• 2023

Background: The purpose of this study was to explore the relationship between the local extinction index and total medical service utilization. Methods: A fixed effects model in panel analysis was performed for the 228 administrative districts in Korea. The statistical yearbook on the usage of medical services by region and Korean Statistical Information Service data were used from 2010 to 2019 for analysis. Medical service utilization was represented by the number of visits day, the number of inpatient days, and medical charges. Control variables were selected by using an Anderson model. The local extinction index was calculated using resident registration population data. Results: Descriptive statistics showed that the number of areas at risk of extinction increased from 61 to 95 for the study years. In addition, the number of visits, the number of inpatient days, and medical charges all increased during the study years. After controlling for variables affecting medical service utilization and doing a panel fixed effects model, the result suggested that a one-step increase in the local extinction index was significantly associated with a 12.29% decrease in medical charges of inpatients, a 7.33% decrease in medical charge of outpatient, a 5.21% decrease in the number of inpatient day, and a 5.54% decrease in the number of visits day. Conclusion: This study showed that the higher the region's extinction risks, the higher the region's total medical service utilization. The results of this study suggested that there was a disparity in medical service utilization between areas at risk of extinction and areas not at risk of extinction, so measures should be taken to address this disparity.

• Health Policy and Management
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• v.3 no.1
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.345-352
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• 2020

This study conducted a survey targeting 414 medical institution workers to identify the impacts of their emotional labor and the recognition level of medical service fee reduction influencing the reduction rate. The results were as follows. First, a review of the difference in the reduction rate by socio-demographic characteristics revealed that in both inpatient and outpatient reduction rate, there is a significant difference in the occupational description, working history at the current hospital, and the numbers of approved beds. Second, there is a correlation between emotional labor, the recognition level of medical service fee reduction, and the reduction rate. As a result of the analysis, there is a significant positive correlation between emotional labor and outpatient reduction rate, a significant negative correlation between the recognition level of medical service fee reduction and inpatient reduction rate, and a significant negative correlation between the recognition level of medical service fee reduction and outpatient reduction rate. Third, emotional labor has a significant positive effect on the inpatient reduction rate, and the recognition level of the medical service fee reduction has a negative effect on the inpatient reduction rate. The emotional labor also has a significant positive effect on outpatient reduction rate, and the recognition level of the medical service fee reduction has a significant negative effect on outpatient reduction rate.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.143-160
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• 2003

Due to the dramatic and situational change in medical industry, it has became very important to keep existing patients and to attract new patients by monitoring the medical consumer's expectation and various needs and ensuring the patients' satisfaction. This study regards the patients' satisfaction as the final object of medical service. So the object of this study is to provide useful data for the decision making and medical service marketing by exploring the problems generated by the cognition difference for the medical service between inpatients and outpatients, by responding for the problems and by examining the relationship between the satisfaction with the medical service and revisiting. To achieve the object of this study, literature research and empirical analysis were used. I establish the research model based on the existing service marketing and some hypotheses were chosen for the empirical analysis. As a result of empirical analysis for the five hypotheses, two hypotheses were chosen. First, there was cognition difference about accessibility and convenience between inpatient and outpatient. I guess that the satisfaction degree of inpatient is higher than the outpatient because the inpatient has the reliability for the hospital and determines the hospitalization or emergent coming to hospital. Second, the fifth hypothesis, "the satisfaction of patient will influence the revisiting." was chosen. The hypothesis is not only coincident with existing scholars and studies but also it provides the meaningful points for medical service marketing. The result shows that the parties concerned with hospital management should endeavor for the patient satisfaction in medical service, and that hospital management should be medical consumer centered. To measure the quality of medical service, the cognition differences for accessibility, convenience, physical environment, and human service were evaluated and the result shows that the cognition difference for the accessibility and convenience was outstanding. The analysis shows that there was cognition difference in the four categories among six subcategories in the human service -- the attitude of medical technologist, the attitude of doctor, the length of time for doctor's diagnosis for the patient and doctor's explanation. Therefore, I think that further study is required for the cause analysis for service categories which have cognition difference between inpatient and outpatient. I think the result will be very useful. Through this study, the relationship between patient satisfaction with the medical service and revisiting was verified. And it suggests that, to face the changing medical environment actively and to improve the quality of medical service, marketing strategy should be focused not on medical service providers but on medical service consumers and that the further studies for the medical consumer should be continued.

• Journal of the Korea Convergence Society
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• v.7 no.4
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• pp.59-66
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• 2016

This study analyzed the relationship between the convergence performance in hospital. This study examined previous research and calculated centralized index using diagnosis related groups. In addition, multiple regression analysis was used based on LOS in order to understand the effect of focused strategy which quality of medical inpatient service. The centralized level was examined by analyzing national inpatient sample data using 'Internal Herfindahl-Hirshman index' This study is significant because it reviewed medical inpatient service quality by measuring hospital centralized level which has been rarely studied before Korea.