• 한국엔터테인먼트산업학회논문지
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• 제14권4호
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• pp.381-392
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• 2020

본 연구는 라이프 스타일에 따른 의료기관 종사자의 환경요인과 직무만족도가 삭감률에 미치는 영향에 대한 연구이다. 연구의 자료는 전라남·북도 병원급 이상 의료기관 종사자들을 대상으로 직접 설문조사를 통해 얻어진 575부의 설문지를 최종 분석자료로 이용하였으며, 연구의 결과는 다음과 같다. 첫째. 인구사회학적 특성에 따라 환경요인차이, 직무만족도 차이, 삭감률(입원/외래) 차이를 분석한 결과 의료기관의 환경요인은 연령, 결혼유무, 직급과 근무 년 수에서 유의한 차이를 보였으며, 직무만족도는 연령, 결혼유무, 직종과 소득에서 유의한 차이를 보였다. 입원 삭감률은 연령, 학력, 직종과 근무 년 수 외래 삭감률은 연령, 결혼유무, 직종, 직급과 근무 년 수에서 유의한 차이를 보였다. 둘째, 환경요인과 직무만족도와 삭감률의 상관을 알아보기 위해 상관관계 분석을 실시한 결과 입원 삭감률과 직무만족도는 부적 상관, 입원 삭감률과 환경적 요인은 부적 상관, 외래 삭감률과 직무만족도는 부적 상관, 외래 삭감률과 환경적 요인, 직무만족도와 환경요인은 정적 상관이 유의하게 있는 것으로 나타났다. 셋째, 환경요인과 직무만족도가 삭감률에 미치는 영향을 알아본 결과 환경요인은 입원 삭감률에 부적 영향, 직무만족도는 입원 삭감률에 부적 영향, 환경 요인은 외래 삭감률에 정적 영향을 유의하게 미치고, 직무만족도는 외래 삭감률에 부적 영향을 유의하게 미치지 않는 것으로 나타났다.

• 보건행정학회지
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• 제29권4호
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• pp.513-522
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• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• 한국병원경영학회지
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• 제8권3호
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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.

• 디지털융복합연구
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• 제13권7호
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• pp.259-268
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• 2015

본 연구는 일당진료비와 삭감율의 차이와 변동요인을 파악하고 이를 중심으로 요양급여비 관리대책 수립에 필요한 기초자료를 제공할 목적으로 수행되었다. 전국 종합병원 50개소의 감염성 장염(A09.0) 질환의 1년 동안 평균 일당진료비와 평균 삭감율을 입원과 외래로 구분 조사하였고 결과는 다음과 같다. 입원 일당진료비는 의료기관의 총인원, 외래 일당진료비는 병상수, 입원 삭감율은 병상수와 총인원에 상관이 있는 것으로 나타났다. 의료기관 정보가 일당진료비에 미치는 영향은 입원과 외래 동일하게 의료기관의 총인원에 정적(+) 영향을 미치는 것으로 나타났다. 이러한 삭감율과 일당진료비에 대한 연구는 의료기관의 효율적이고 합리적인 의사결정을 돕고, 요양급여비 정책의 우선순위를 결정하는데 중요한 근거가 될 것이다.

• 한국병원경영학회지
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• 제19권3호
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• pp.11-28
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• 2014

This study, targeting Korean tertiary hospitals and general hospitals, aims to analyze how value chain model in health and medical institution suggested by Duncan and else influences on hospital management. A survey was conducted to verify the actual proof analysis of this study model. 880 questionnaires were distributed to entire 88 hospitals and 739 copies were returned from 76 hospitals. This study mainly consists of three steps to analyze the effect value chain activity has on management performance of general hospitals. For the first step, we analyzed the effects service delivery activity has on management performance. For the second step, we analyzed the effects service support activity has on management performance and for the third, we analyzed the effects interaction between service delivery activity and service support activity has on management performance. The main results of this study are as follows. First, in terms of the management performance of scale, the factors which influenced on daily charge of outpatient were service activity before treatment, at the moment of treatment and value chain activity, while more important factors in daily charge of inpatient were organizational culture, organizational structure and value chain activity. In terms of management performance of quality, the factors which influenced on the first medical examination rate of outpatient were service activity before, at the moment of and after treatment, while activity at the moment of treatment, organizational structure, and value chain activity which is interaction were more important factors in average length of stay. In terms of non-financial performance, the management performance factors which influenced on job satisfaction were service activity at the moment of, after the treatment and value chain activity, while organizational culture, strategy resources and value chain activity which is interaction were more important factors in job commitment. Secondly, all the service support activity, service delivery activity and value chain activity had statistically significant effect on management performance. Among the three factors, service support activity had relatively high effect than others.

• 보건행정학회지
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• 제17권2호
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• pp.33-51
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• 2007

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disabled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

• 한국병원경영학회지
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• 제2권1호
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• pp.96-113
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• 1997

This study was performed to analyze of market segmentation of outpatient services on the based of consumption values. Self-reported questionnaires of six hospital outpatients 600 were analyzed by six consumption values categories: functional values, social values, emotional value, rarity value, situational values, health related values. The main results of this research is as following; 1. The consumption values were significantly different in that sociodemographic characteristics. Especially, the more older aged group, farmer and married people, the more they preferred to functional value, social value, emotional value and rarity value than younger aged group and unmarried people. But in the cases of situational vaue, younger aged people and white-callar workers recognized more positively. Also, housewives, married people and female recognized more positively than white-callar workers, unmarried people and male. 2. In the results of CHAID analysis, market of general hospital were analyzed by 9 categories and major market were groups who ignored or were unconcerned about newness/classiness and preferred to nearness to residence. The market of university hospital were analyzed by 8 categories and major market were groups who considered to reliability/social reputation importantly. The market of corporate hospitals were analyzed by 8 and major market were group who considered to classiness/newness importantly. Therefore, above results show that health care market can be divided to various market by demand and market segmentation is very important for marketing strategy.

• 보건행정학회지
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• 제22권4호
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• 기본간호학회지
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• 제16권2호
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• pp.232-241
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• 2009

Purpose: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). Method: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). Results: The mean score for importance was $2.58{\pm}0.29$, for difficulty, $2.11{\pm}0.31$, and for frequency, $2.18{\pm}0.31$. OPD nurses recognized 'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as 'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p=.026; F=4.089, p=.018) and hospital size (F=4.274, p=.006; F=3.154, p=.025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. Conclusion: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate 'preparation for medical service', and 'management of facility and environment' to nonmedical health-care workers.

• 대한치과마취과학회지
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• 제5권1호
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• pp.15-21
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• 2005

Autism is characterized with an abnormality of reciprocal social relatedness and of communication development. Also, autistic children show repetitive and stereotypical behavior pattern and deficiency of endurance against change. Dental problems related to autism are self-injury and trauma from accidents. Sometimes self-injury is due to discomfort resulting from restoration and local anesthesia. Also, gingivitis and multiple caries are common because of poor oral hygiene. Autistic children are anxious about visual and auditory stimuli because they don't understand the dental procedure. If the face of any changes in their daily life, their behavior becomes uncontrollable. In a setting such as the outpatient office, an autistic child's uncontrollable behavior makes it difficult to carry out proper treatment. If they need treatment under general anesthesia, it is very difficult to manage them in a ward as they are severly anxious about being admitted to a hospital. Therefore it is necessary to treat these children according to a specific management program under general anesthesia in an outpatient office. This case study reports of a 14 year old autistic teenager who although became uncontrollable because of the pain from multiple caries and from anxiety of the dental treatment eventually received treatment under general anesthesia and under conscious sedation in an outpatient office.