• Health Policy and Management
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• v.17 no.2
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• pp.18-32
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• 2007

The purpose of this study was a quantitative analysis for the influence of physician's assistants on national health insurance revenue and number of patients in clinic. The data was derived from the Korean national health insurance. That was complete enumeration. Dependent variables were measured by national health insurance revenue and number of patients. Independent variables were reported physician's assistants that the number of nurse, nurse-aid, technologist of clinical laboratory, physical therapist and radiologist in clinic. Confounding variables were classified by demand(region, number of inhabitants, number of clinics, number of bed per a hundred thousand persons) and supply(sex and age of representative, number of bed, subjective of medical treatment). On the multiple regression analyses, the physician's assistants that nurse, nurse-aid, technologist of clinical laboratory and physical therapist were statistically significant for outputs. But radiologist was statistically significant only for number of patient.

• Journal of Korean Public Health Nursing
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• v.30 no.1
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• pp.122-135
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• 2016

Purpose: The aim of this study was to examine relationships between occupational stress, burnout and job satisfaction of PAs(Physician Assistant). Methods: This study was a descriptive study, and 136 PAs were recruited from hospitals in B metropolitan city. The study was approved by KUIRB, and data were collected from September to October, 2013. Results: A strong positive correlation was observed between occupational stress and burnout (r=.715, p<.001). Strong negative correlations were observed between occupational stress and job satisfaction (r=-.761, p<.001), and between burnout and job satisfaction (r=-.624, p<.001). Conclusion: An intervention program should be developed for PAs to reduce occupational stress and burnout in the health care environment.

• Korean Journal of Occupational Health Nursing
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• v.28 no.3
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• pp.176-185
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• 2019

Purpose: The purpose of this study was to identify the effects of job stress, emotional labor, and positive psychological capital on the job satisfaction of physician assistants (PAs). Methods: The sample consisted of 166 PAs working in general hospitals in B city, Y city, and C city. Data were analyzed through the SPSS/WIN 18.0 program using t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and multiple regression. Results: The factors of job stress (${\beta}=-.488$, p<.001), positive psychological capital (${\beta}=.188$, p=.004), and total clinical career (${\beta}=-.147$, p=.014) had the greatest influence on the level of job satisfaction experienced by the PAs. The total explanatory power was 49.9%. Conclusion: It was found that job stress, positive psychological capital, and total clinical career were influencing factors in the job satisfaction of PAs. Therefore, to improve their job satisfaction, it is necessary to develop strategies to manage the job stress experienced by PAs, and to strengthen and develop positive psychological capital.

• Journal of Preventive Medicine and Public Health
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• v.24 no.2 s.34
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• pp.171-180
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• 1991

Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The mar results were as follows. First, physicians were more prevalent $35{\sim}44$ group (30.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization,'city (78.0%) in geographical location. Age group of 35-54 and specialist were mere prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatients load of all physician were 77.1 persons on average. Age group of $35{\sim}44$ had the most outpatient load (90.3 persons) among all age group, $6{\sim}10$ years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factors-number of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.

• The Journal of the Korea Contents Association
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• v.14 no.10
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• pp.583-595
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• 2014

Hospitals in Korea have been increasingly using physician assistants (PA) as an alternative way of dealing with the shortage of residents. However, some incidents of a Physician's Assistant practicing beyond their legal scope require closer examination of the current PA's roles and functions. This study is a web-based survey designed towards targeting physician assistants in Korea (KPA) who practice delegated tasks under a physician's license. Currently, there are 2,125 KPAs working in 141 general hospitals and medical centers. Data from 704 nurses from who responded to the questionnaire were analyzed with descriptive statistics using the SPSS 12.0 program. Their mean age is 32.5 years with 8-10 years of clinical experiences, with males being more likely to be a PA. Despite of KPAs providing medical services and performing invasive procedures, only 13% of KPAs are licensed APNs (advanced practice nurse). KPAs have a low job satisfaction due to a lack of rewards and the necessity for providing illegal practices, and are experiencing identity confusion. The current KPA system is a transitional product of the change from the hierarchial structure to a more collaborative relationship between the medical and nursing departments. Providing adequate education and training, establishing protocols with legal protection, and developing professional independent scope of care are recommended to deliver safe and efficient medical services.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.15-27
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• 2018

Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.197-208
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• 2018

Purpose: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. Methods: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. Results: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. Conclusion: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.131-141
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• 2017

Purpose: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. Methods: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. Results: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. Conclusion: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.

• Health Policy and Management
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• v.9 no.1
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• pp.156-177
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• 1999

The current method of rate adjustment for inflation is based on the evaluation of the financial performance of hospitals. The method has the disadvantage such as too complicated, expensive process as well as low reliability. This study, therefore, develops the 'Korean Medical Insurance Economic Index(MIEI)' as a new model for the rate adjustment with the use of the macro economic indices. In addition, we calculate the 1992∼1998 rate adjustment with the MIEI, and examines the validity of the MIEI by comparing with the conventional method. Medical costs are classified into nine categories : physician salaries, nurse·pharmacist·medical technician salaries, assistants & others salaries, material cost(by imports), material cost(by domestics), depreciation & rent paid(by imports), depreciation & rent paid(by domestics), power utilities, other administrative costs. Then the category weight which is the ratio of category in the total cost is calculated. Macro economic indices are selected for each cost category in order to reflect the concept of the each cost category and inflation during the year of 1992∼1998. Finally MIEI which integrate all category according to the category weight and selected macro indices is calculated. The mean of hospital MIEI which weighting by amount paid by insurers was cacluated. The result from the application of empirical data to the MIEI model is very similar to that of the current method. Furthermore, this method is very simple and also easy to get social consensus. This MIEI model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.