To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.
The purpose of this research is to explore differences between small and medium-sized companies and large-sized companies in the impact of human resource innovativeness(HRI), learning orientation(LO), and HRI-LO interaction on innovation effect and business performance. Although learning orientation has long been considered as a key factor influencing good performance of a business, little research was devoted to exploring the effect of HRI-LO interaction on innovation effect and business performance. In this study, it is investigated whether there is a synergy effect between innovative human workforce and learning orientation corporate culture, in addition to each by itself, to generate good business performance as well as a success of new innovations in the market. Research hypotheses were as follows, including H1) human resource innovativeness(HRI), learning orientation(LO), and interactions of HRI and LO(HRI-LO interaction) positively affect innovation effect, H2) there is a difference of the effect of HRI, LO, and HRI-LO interaction on innovation effect between large-sized and small-sized companies, H3) HRI, LO, HRI-LO interaction, innovation effect positively affect business performance, and H4) there is a difference of the effect of HRI, LO, HRI-LO interaction, and innovation effect on business performance between large-sized and small-sized companies. Data were obtained from 479 practitioners through a web survey since the web survey is an efficient method to collect a national data at a variety of fields. A single respondent from a company was allowed to participate in the study after checking whether they have more than 5-year work experiences in the company. To check whether a common source bias is existed in the sample, additional data from a convenient sample of 97 companies were gathered through the traditional survey method, and were used to confirm correlations between research variables of the original sample and the additional sample. Data were divided into two groups according to company size, such as 352 small and medium-sized companies with less than 300 employees and 127 large-sized companies with 300 or more employees. Data were analyzed through t-test and regression analyses. HRI which is the innovativeness of human resources in the company was measured with 9 items assessing the innovativenss of practitioners in staff, manager, and executive-level positions. LO is the company's effort to encourage employees' development, sharing, and utilizing of knowledge through consistent learning. LO was measured by 18 items assessing commitment to learning, vision sharing, and open-mindedness. Innovation effect which assesses a success of new products/services in the market, was measured with 3 items. Business performance was measured by respondents' evaluations on profitability, sales increase, market share, and general business performance, compared to other companies in the same field. All items were measured by using 6-point Likert scales. Means of multiple items measuring a construct were used as variables based on acceptable reliability and validity. To reduce multi-collinearity problems generated on the regression analysis of interaction terms, centered data were used for HRI, LO, and Innovation effect on regression analyses. In group comparison, large-sized companies were superior on annual sales, annual net profit, the number of new products/services in the last 3 years, the number of new processes advanced in the last 3 years, and the number of R&D personnel, compared to small and medium-sized companies. Also, large-sized companies indicated a higher level of HRI, LO, HRI-LO interaction, innovation effect and business performance than did small and medium-sized companies. The results indicate that large-sized companies tend to have more innovative human resources and invest more on learning orientation than did small-sized companies, therefore, large-sized companies tend to have more success of a new product/service in the market, generating better business performance. In order to test research hypotheses, a series of multiple-regression analysis was conducted. In the regression analysis examining the impact on innovation effect, important results were generated as : 1) HRI, LO, and HRI-LO affected innovation effect, and 2) company size indicated a moderating effect. Based on the result, the impact of HRI on innovation effect would be greater in small and medium-sized companies than in large-sized companies whereas the impact of LO on innovation effect would be greater in large-sized companies than in small and medium-sized companies. In other words, innovative workforce would be more important in making new products/services that would be successful in the market for small and medium-sized companies than for large-sized companies. Otherwise, learning orientation culture would be more effective in making successful products/services for large-sized companies than for small and medium-sized companies. Based on these results, research hypotheses 1 and 2 were supported. In the analysis of a regression examining the impact on business performance, important results were generated as : 1) innovation effect, LO, and HRI-LO affected business performance, 2) HRI by itself did not have a direct effect on business performance regardless of company size, and 3) company size indicated a moderating effect. Specifically, an effect of the HRI-LO interaction on business performance was stronger in large-sized companies than in small and medium-sized companies. It means that the synergy effect of innovative human resources and learning orientation culture tends to be stronger as company is larger. Referring to these result, research hypothesis 3 was partially supported whereas hypothesis 4 was supported. Based on research results, implications for companies were generated. Regardless of company size, companies need to develop the learning orientation corporate culture as well as human resources' innovativeness together in order to achieve successful development of innovative products and services as well as to improve sales and profits. However, the effectiveness of the HRI-LO interaction would be varied by company size. Specifically, the synergy effect of HRI-LO was stronger to make a success of new products/services in small and medium-sized companies than in large-sized companies. However, the synergy effect of HRI-LO was more effective to increase business performance of large-sized companies than that of small and medium-sized companies. In the case of small and medium-sized companies, business performance was achieved more through the success of new products/services than much directly affected by HRI-LO. The most meaningful result of this study is that the effect of HRI-LO interaction on innovation effect and business performance was confirmed. It was often ignored in the previous research. Also, it was found that the innovativeness of human workforce would not directly influence in generating good business performance, however, innovative human resources would indirectly affect making good business performance by contributing to achieving the development of new products/services that would be successful in the market. These findings would provide valuable managerial implications specifically in regard to the development of corporate culture and education program of small and medium-sized as well as large-sized companies in a variety of fields.