• Korea Journal of Hospital Management
• /
• v.4 no.2
• /
• pp.106-130
• /
• 1999

The main objective of this paper is to perform an empirical analysis on the relationship between various marketing activities and financial performance of Korean hospitals. A survey was conducted through structured questionnaire for 495 hospitals, and data from 218 hospitals were utilized in the final anaylsis.(response rate: 44%) Survey items include general characteristics of the hospitals(size, type, location), degree of competition, financial performance. marketing organization! budget, and level of various marketing activities in service development, access improvement, promotion, and pricing. We examine descriptive statistics of the response scores on marketing activities to evaluate the current status of marketing management of Korean hospitals, compare the results across hospital size, type and location, and perform regression analysis to investigate the relaionship between marketing and financial performance. Major findings are as follows: 1) About 46% of the responding hospitals have marketing departments although they are named as 'planning' or 'PR' departments, and the marketing budget on average represents 1.74% of the total expenditures. 2) Average level of marketing activities is calculated to be about 3.32 on 5-point scale, meaning that Korean hospitals implement their marketing programs 'somewhat actively'; however, the scores on the areas of marketing plannning and strategy are relatively low. 3) Large hospitals tend to be more active in marketing than small hospitals, and public hospitals' activities in marketing are not lower compared to private hospitals. 4) Level of overall marketing activities is positively related with financial performance measured by various finacial indicators except for profitability, implying that marketing is successful in revenue generation but needs to be more cost-effective. Also, when the marketing variables are separately included in the regression, no significant relationship is found, which means that various marketing activities are more effective when they are collectively implemented.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.44 no.6
• /
• pp.275-281
• /
• 2018

Objectives: Isolated mandibular fractures contribute to approximately 45% of maxillofacial traumas. Improper management of mandibular fractures can cause myriad potential complications and can lead to serious functional and aesthetic sequelae. The objective of the study is to design a stepwise approach for managing isolated mandibular fractures using open reduction and internal fixation (ORIF) with regional anesthesia on outpatient basis. Materials and Methods: Patients with isolated mandibular fractures presenting to the department of maxillofacial surgery were selected for ORIF under regional anesthesia based on occlusion, age, socioeconomic status, general condition, habits, and allied medical ailments. Standard preoperative, intraoperative, and postoperative protocols were followed. All patients were followed up for a minimum of 4 weeks up to a maximum of 1 year. Results: Of 23 patients who received regional anesthesia, all but one had good postoperative functional occlusion. One patient was hypersensitive and had difficulty tolerating the procedure. Two patients developed an extraoral draining sinus, one of whom was managed with local curettage, while the other required hardware removal. One patient, who was a chronic alcoholic, returned 1 week after treatment with deranged fracture segments after he fell while intoxicated. Conclusion: With proper case selection following a stepwise protocol, the majority of mandibular fractures requiring ORIF can be managed with regional anesthesia and yield minimal to no complications.

• Journal of Korean Academy of Nursing
• /
• v.27 no.4
• /
• pp.796-806
• /
• 1997

The majority of studies on breastfeeding consists of descriptive correlational studies identifying the incidence and correlates of breastfeeding. The theory of planned behavior has been shown to yield great predictive power for behavioral goals over which individuals have only limited control such as improving school grades and weight loss. The purpose of this study was to test the "theory of planned behavior" in the prediction of breastfeeding of mothers who delivered vaginally, One hundred mothers who delivered vaginally in one general hospital in Seoul and one general hospital and three private hospitals in Taejeon participated in this study. The instruments used for data collection in this study were developed by the researchers following the guidelines suggested by Ajzen & Fishbein(1980) and Ajzen & Madden(1986). The instruments included measurement of attitude, subjective norm, perceived behavioral control and intention. The collected data were analyzed using descriptive statistics, Pearson product moment correlation, hierachical multiple regression and logistic regression. The results are as follows ; 1. Intention to breastfeed correlated significantly with attitude, subjective norm and perceived behavioral control. Both attitude and subjective norm did not make a significant contribution to the prediction of intention, but the addition of perceived behavioral control to the regression equation greatly improved the model's predictive power, increasing the R²from .05 to .52. 2. Intention to breastfeed alone had a significant predictive effect on actual breastfeeding, resulting in a regression coefficient of .16(X²=8 60, p<.01), but when perceived behavioral control was added to the equation, intention was not a significant predictive variable and only perceived behavioral control showed significant predictive power on actual breastfeeding, resulting in a regression coefficient of .12(X²=4.69, p<.05). In sum, breastfeeding behavior lent only partial support to the second version of the theory of planned behavior, and because perceived behavioral control had a strong effect on intention to breastfeed and actual breastfeeding, It would be desirable to develop nursing intervention programs which focus on strengthening the perceived behavioral control for the promotion of breastfeeding.

• Korea Journal of Hospital Management
• /
• v.9 no.2
• /
• pp.1-22
• /
• 2004

This study was designed to suggest a learning organization in a medical center by examining the factors to influence effectiveness of the learning organization. We collected the data of 586 persons who participated once or more times in the learning organization managed from 2000 to 2002 by Y Medical Center located in Seoul, and included the data of 285 persons in the final analysis. The results of the study are summarized as follows. First, as the results of examining the regression coefficients to predict the effectiveness of and satisfaction with the learning organization through the learning level, learning method and learning organization constructing level as the general variables, the important influential factors were shown as follows: 1)knowledge creation, knowledge storing, private learning, organizational learning, and learning organization construction of occupational and human levels as the factors to predict the working competency; 2) learning organization construction of the human level as the factors to assume the duty satisfaction; 3) gender, working years, private learning, team learning and organizational construction level for the prediction of the organizational commitment; and 4) medical technical service, knowledge creation, organization learning, and constructing level of the environmental and human levels for the assumption of the satisfaction with experience in the learning organization. Based on the study results of the effects in managing the learning organization, we can conclude the followings. First, the members who are in various working positions and occupations need to continuously participate in the learning organization. Second, to raise the organizational outcome from the management of the learning organization, it is necessary to establish systematic concepts in the constituents of the organizational effectiveness such as working competency improvement, duty satisfaction and organizational commitment, and the experience satisfaction of the learning organization. Finally, the future of the organization depends on the learning competencies of the organization members. To continuously exist and develop the organization, the private learning of the organizational members should be constantly spread and shared over the organizational level, and the usual innovations such as repetitive and habitual organizational learning should be generally tried out throughout the whole field of the management.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.19
• /
• pp.8489-8493
• /
• 2014

Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

• The Journal of Internal Korean Medicine
• /
• v.38 no.3
• /
• pp.319-326
• /
• 2017

Objective: The purpose of this study was to survey the general perspectives of cancer patients on Korean medicine (KM) treatments. Method: The after focus-group discussion consisted of six cancer patients. The questionnaire items were decided. Fifty randomized cancer patients completed the online survey questionnaire regarding the perspectives of KM in cancer treatment. Results: Cancer patients considered KM to be a treatment performed both by KM doctors (92%) and by others (46%), such as private practitioners. Cancer patients thought of KM treatment as effective (68%) and safe (64%), but not scientific (60%). The answers of the cancer patients regarded whether the KM treatment experiences were different in purpose, satisfaction, and types of KM treatment. The experienced KM cancer patients thought of the optimal purpose of KM as alleviating symptoms or side effects (73.7%). Experienced patients were more satisfied with KM and they preferred acupuncture and moxibustion to thermotherapy. Conclusion: Cancer patients consider KM treatment effective and safe, but not scientific. Cancer patients who are experienced with KM are favorable to KM treatment. The direction of future studies of KM in cancer care should be considered based on these findings.

• Korea Journal of Hospital Management
• /
• v.28 no.1
• /
• pp.37-51
• /
• 2023

Purposes: There exist many non-covered services that the National Health Insurance does not cover, and thus, their prices are set by individual health care providers. However, little study has been done to investigate how hospitals set prices for those services. The purpose of this study is to examine the relationship between ownership, profitability, and prices of those services for a sample of general hospitals. Methodology/Approach: Data regarding the prices of major non-covered services (e.g., upper-level hospital room fees, MRI, Da 7inci robot surgery, and LASIK) were obtained from the Health Insurance Review and Assessment Service and the financial information, as well as other characteristics, were derived from the financial reports from the Korea Health Industry Development Institute. Descriptive statistics, t-tests, and multiple linear regression analyses were used to test the relationship between the independent variables and the dependent variables. Findings: Hospitals owned by private universities appeared to have higher prices for non-covered services while regional public hospitals tend to have lower prices. Profitability, measured by operating margin, was not significantly related to the prices. Hospitals that charge higher prices were more likely to be located in the capital area (Seoul, Incheon, and Gyeonggi), and to employ larger number of personnel. Practical Implications: Public hospitals tend to charge lower prices for non-covered services. Relative market power appears to be related to pricing. Further research is needed to investigate whether such a relationship varies over time and its effects on the quality and access.

• Journal of Radiation Protection and Research
• /
• v.32 no.2
• /
• pp.89-96
• /
• 2007

Radiation safety managements in medical institutions are needed to protect certain radiation damages as a part of National Coalition. This study investigates the characteristics of self-efficacy that become the major factor on the knowledge, attitude, and behavior on the radiation safety management of radiation workers as an approach of educational aspects and analyzes the relationship between such factors to provide basic materials for improving the activity level of radiation safety managements. In order to implement the goal or this study, a survey was performed for 1,200 workers who were engaged in radiation treatments in medical centers, such as general hospital, university hospital, private hospital, and public health center for 42 days from July 23,2006. Then, the results of the analysis can be summarized as follows: 1. Average scores on knowledge, attitude, and behavior in the radiation safety management were presented as $75.76{\pm}11.20$, $90.55{\pm}8.59$, $80.58{\pm}11.70$, respectively. Also, the average score of self-efficacy was recorded as $73.55{\pm}9.82$. 2. Knowledge levels in the radiation safety management showed significant differences according to the sex, age, marriage, education, and experience. Also, males of married, older, highly educated, and largely experienced represented high knowledge levels. Attitude levels in the radiation safety management showed certain significant differences according to the type of medical centers in which private hospitals showed a relatively low level compared to that of high levels in university hospitals. Behavior levels in the radiation safety management also represented significant differences according to the age, marriage, education, experience, and types of medical centers. Factors in married, general hospital, older, highly educated, and largely experienced showed high behavior levels. In addition, the self-efficacy showed certain differences according to the marriage and types of medical centers. Factors in married and general hospital demonstrated high self-efficacy levels. 3. Relationship between knowledge, attitude, behavior, and self-efficacy on the radiation safety management showed statistical differences according to the relationship between the knowledge and the attitude, the knowledge and the behavior, the attitude and the behavior, the attitude and the self-efficacy, and the behavior and the self-efficacy. The relationship between the behavior and the self-efficacy was represented as r = 0.482, which was the strongest relationship in such factors. Also, the knowledge and self-efficacy didn't show certain relationships.

• Health Policy and Management
• /
• v.5 no.1
• /
• pp.31-58
• /
• 1995

The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

• Health Policy and Management
• /
• v.29 no.2
• /
• pp.105-111
• /
• 2019

On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.