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Regional Commitment Index of Hospitals (의료기관 특성별 지역환자구성비)

  • Kim, kyung-Ae;Ryu, See-Won;Kim, Young-Rhang
    • Health Policy and Management
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    • v.19 no.4
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    • pp.121-139
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    • 2009
  • Objectives : The purpose of this study was to investigate regional commitment index(RGI) of hospital in Korea, and the relationship RGI and hospital characteristics, such as foundation, region, size. Therefore, we are to suggest fundamental information to make and evaluate healthcare resource policy in hospital- and government-level. Methods : The 'Patient Survey 2002(administered by Ministry of Health and Social Welfare(MOHW)' was analyzed. We selected the patient data of the hospitals above 100 beds. Then, we calculated the RGI, number of same cases divided by all cases in each hospital. By using SPSS/win ver 14.0, statistical analysis such as t-test, ANOVA, correlational and regression analysis was carried out. Results : The results are as follows. 1. Overall mean and standard deviation of RGI were revealed as 0.805${\pm}$0.225 in inpatients, and 0.871${\pm}$0.184 in outpatient. The median of inpatients' and outpatients' RGI were 0.890 and 0.933. The RGI of inpatients of private hospitals were revealed significantly higher than that of the public(public: 0.727, private: 0.822). However, outpatients' RGI was not revealed as significantly different. 2. The RGI of general specialty hospitals were significantly lower than others, therefore we could think that more inpatients and outpatients of general specialty hospitals flowed in from others province or metropolitan cities than other hospital types. 3. The RGI of hospitals holding above 400 beds were significantly lower than others in inpatients and outpatients. 5. The RGI of hospitals were significantly different among sixteen province and metropolitan cities. The RGI inpatients of Gwangju and Daejon metropolitan city were lowest sub-group(0.659, 0.664), and the RGI inpatients of Jeju was revealed as highest, 0.979. 6. Available beds, total doctors, and total employees were negatively correlated with RGI of inpatients and outpatients. 7. The significant influencing factors to RGI of inpatients and outpatients were appeared samely such as available beds, wide healthcare region, hospital size, and foundation type. Conclusions : It is considered that RGI of hospital represent competitive power in healthcare market. Also, the competitive advantage and quality of hospital clustered by characteristics could made out by RGI. Therefore, the results of this study would be useful to develop and evaluate hospital policy of individual hospital or local government.

Status of Infectious Disease Inpatients at Long-Term Care Hospitals in Korea (국내 요양병원의 감염병 입원환자 실태 분석)

  • Bang, Ji Ya;Lee, Hanju;Son, Yedong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.134-143
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    • 2020
  • This study investigated the status of infectious disease inpatients at long-term care hospitals in Korea. A descriptive study was conducted on patients with 14 infectious diseases at 798 long-term care hospitals during 2016-2017. The number of infected patients, total admission days, and total medical expenses were higher in 2017 than in 2016. The most common infectious diseases were enterocolitis due to Clostridium difficile, influenza, and scabies. The number of hospitals with patients who had enterocolitis due to C. difficile and resistance to carbapenem was higher in 2017 than in 2016. Hospitals with 150-299 beds had higher numbers of infectious disease patients than those with under 150 or over 300 beds. Therefore, intensive efforts are needed to control the most common diseases at long-term care hospitals, such as enterocolitis due to C. difficile, influenza, and scabies. It is recommended to apply relevant guidelines related to infection control management as well as implement educational programs. It will also be necessary to develop applicable infection monitoring standards and support the facilities and health workforce of long-term care hospitals under 300 beds through an effective infection surveillance system.

Predictors of Turnover among New Nurses using Multilevel Survival Analysis (다수준 생존분석을 이용한 신규 간호사 이직 영향요인)

  • Kim, Suhee;Lee, Kyongeun
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.733-743
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    • 2016
  • Purpose: The purpose of this study was to examine factors influencing new graduate nurse turnover. Methods: This study was carried out as a secondary analysis of data from the 2010 Graduates Occupational Mobility Survey (GOMS). A total of 323 nurses were selected for analysis concerning reasons for turnover. Data were analyzed using descriptive statistics and multilevel survival analysis. Results: About 24.5% of new nurses left their first job within 1 year of starting their jobs. Significant predictors of turnover among new nurse were job status, monthly income, job satisfaction, the number of hospitals in region, and the number of nurses per 100 beds. Conclusion: New graduate nurses are vulnerable to turnover. In order to achieve the best health of the nation, policy approaches and further studies regarding reducing new graduate nurse turnover are needed.

Key Issues on Long-Term Care Hospitals in Korea (요양병원의 성장과 운영상의 주요 이슈)

  • Oh, Eun-Hwan
    • Health Policy and Management
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    • v.28 no.3
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    • pp.257-262
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    • 2018
  • This study reviews the advent of long-term care (LTC) hospitals and its key issues in Korea. For analysis, enforcement ordinances and enforcement rules related to LTC hospitals were reviewed. Official statistic data were used for quantitative analysis and Organization for Economic Cooperation and Development data were utilized for comparative analysis. Various references and expert interviews were conducted for status analysis. As of 2016, the number of LTC hospitals was 1,386 and the number of beds were 246,373. It showed the trend of increasing medical care costs and the cost of care at LTC hospitals increasing from 998.8 billion Korean won in 2008 to 4,745.6 billion Korean won in 2016, accounting for 7.3% of the total National Health Insurance expenditure. From the societal perspective, several issues were pointed out within the current health care system related to LTC hospitals: establishment of roles, concerns about the increase in medical expenses, and the quality of medical personnel.

Job Satisfaction Level and Related Factors among Korean Hospital Dietitians (전국 병원영양사의 직무만족도 현황 및 관련요인)

  • Jang, Eun Hee;Lyu, Eun Soon;Lee, Song Mi;Park, Yoo Kyung;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Young;Lee, Seung Min
    • Journal of the Korean Dietetic Association
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    • v.20 no.4
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    • pp.257-274
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    • 2014
  • The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

Status of Medical Care Psychiatric Quality Assesment in Busan (부산광역시 정신의료기관 적정성 평가지표 실태)

  • Kim, Soo Jeong;Park, Jae Hong;Kim, Seong Min;Cho, Kyoung Won
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.103-113
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    • 2018
  • Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.

An Analysis of Medical Expenses for In-patients in an Oriental Medical Hospital and Factors Affecting Them (한방병원 입원환자의 진료비와 이에 영향을 미치는 요인 분석)

  • Ko, Min-Seok;Choi, Joon-Young
    • Journal of Society of Preventive Korean Medicine
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    • v.15 no.1
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    • pp.71-87
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    • 2011
  • Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.

A Study of Laboratory Facilities, Equipment and Expenses for Practice in a Four-year Nursing Schools (4년제 간호대학(과) 실습 비 및 실습기자재 표준안 개발을 위한 기초조사연구)

  • Shin, Kyung-Rim;Park, Kyung-Sook;Ahn, Yang-Heui;Chaung, Seung-Kyo;Suh, Yeon-Ok
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.305-315
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    • 2003
  • Purpose: To describe the status of the laboratory facilities, equipment and expenses for practice in a four-year nursing schools and to analyze mandatory requirements for laboratory facilities and equipment. Method: A descriptive survey research design was used. The participants were 49 of the 4-year nursing schools across the nation. The data were collected by e-mail. The return rate for questionnaires was 63.3% (n=31). Result: In 2001 the total expenses for laboratory practice were 21,865,230 won and the average per student was 102,418 won. Types of laboratories included single and complex. The mean size for laboratories was $318.7m^2$ and mean size for laboratories for fundamental nursing was $161.1m^2$. The range for number of students in a laboratory class was 20-30 for eight universities (30.8%). Among required laboratory equipment, items that were deficient in 50% in the universities were mercury and aneroid sphygmomanometers for children, electronic sphygmomanometers, Bell type fetal stethoscopes, sheepskin, beds for children, for gynecology, and electronic hilo beds. Among the elective equipment, items that were deficient in 50% of the universities were $O^2$ tents, Blackmore tubes, retractors, hot-water supply, and incentive spirometers. The number of items that needed to add to the equipment were 10 for required equipment and 22 for elective equipment. Conclusion: A standardized mandatory list of equipment for laboratory facilities and expenses for practice in 4-year nursing schools needs to be developed.

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A Study on the Level of Health Promotion to Introduce the WHO's Health Promoting Hospitals in Regional Public Hospitals (WHO 건강증진병원 사업 도입을 위한 전국지방의료원의 건강증진병원 환경 평가)

  • Lee, Dong-Won;Song, Jin-Sung;Nam, Eun-Woo
    • Korea Journal of Hospital Management
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    • v.15 no.2
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    • pp.44-60
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    • 2010
  • This research, which is designed to introduce the concept of the WHO's health promoting hospital project to Korea, was conducted in a total of 34 local hospitals across the nation. To evaluate the level of health promotion at hospitals, an evaluation index for health promoting hospital environments was made using the Analytic Hierarchy Process Decision-Making Method, from which a total of 20 questions were developed in the five areas of no-smoking, moderation in drink, exercise, nutrition and rest in Korea. Through this analysis, it was found that local hospitals across the nation were on average excellent in terms of their no-smoking environments, but poor in their rest and moderation in drink environments. A comparison of local public hospital environments by region showed that Busan, Daegu, and South Gyeongsang Province were good, while South Chungcheng Province, Jeju Province and Gwangwon Province were poor. In terms of the number of beds, mid-size local hospitals (200-299 beds) came first. This research revealed that local hospitals across the nation had different health promotion environments according to area and size, and in particular, their environments for rest and moderation in drink turned out to be lacking, which vividly showed that these areas desperately needed to be supplemented in order to introduce the concept of health promotion at hospitals in Korea.

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A study on the relationship between the concentration status of inpatient services and medical charges per case between 2009 and 2011 (입원서비스의 집중화 수준과 진료비 간의 관계 분석: 2009년~2011년)

  • Kwak, Jin-Mi;Lee, Kwang-Soo;Kwon, Hyuk-Jun
    • Knowledge Management Research
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    • v.16 no.1
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    • pp.209-224
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    • 2015
  • Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.