• Korea Journal of Hospital Management
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• v.13 no.2
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• pp.20-35
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• 2008

Though the attending system was first implemented in 2003 to facilitate the efficient utilization of medical resources and specialties, only a few hospitals and physicians are participated in that system. The purpose of this study was to investigate the actual facts which related to operation of attending system and propose a basic information to revitalized of the attending system in Korea. The data were collected between August 1 and October 30, 2005 from 25 hospitals and 42 attending physicians who were in part of the attending system. Medical institutions were unwilling to participate despite the advantages of the attending system with respect to the utilization of medical resources and improvement in the quality of medical services. The primary reason for this was the lack of understanding among physicians about the attending system and the difficulty(lack of time) encountered by the attending physicians in administering care to patients hospitalized in the attending hospitals. Moreover insufficient reimbursement for rendered medical services constituted another important reason. In conclusion, we can state that the establishment of a committee is required to discuss the issues surrounding the attending system and to control the growing disparity between the viewpoints of hospitals and physicians. Regardless, there is a need to develop economical incentives for medical institutes. The attending system served as a useful policy in promoting the medical service system and bringing about an improvement in the management of medical institutes.

• Health Policy and Management
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• v.8 no.2
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• pp.1-24
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• 1998

There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• Journal of Society of Preventive Korean Medicine
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• v.16 no.2
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• pp.83-94
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• 2012

Objectives : This study aimed to investigate the use and patterns of health care resources of local patients and to analyze the health seeking behaviors focusing on shopping around phenomenon. Methods : Questionnaires on the use of health institution were developed and administered to the residents in Yangsan city, Korea. We selected patients who were suffering from any diseases two months and over. Patients' health seeking behaviors were categorized, and the factors for selecting health institutions in each visiting stages were analyzed. Results : 139 local patients participated in the survey, and 130 completed questionnaires were analyzed. We found that there were sixty eight different types of medical utilization paths. The most frequent path was 'western clinics ${\rightarrow}$ Korean medicine hospitals or clinics ${\rightarrow}$ western clinics'. Only 6 patients started at Korean medicine, however, 16 patients(12.3%) finalized their treatment at Korean medicine hospitals or clinics. In most health seeking stages, patients tended to select health resources by their own decisions, and the geographic factor was the key reason to select health resources. Conclusions : Patients had not any stable forms to treat with their diseases, and we observed diversified patterns in the health seeking behaviors of patients, a typical shopping around phenomenon.

• Journal of Korean Public Health Nursing
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• v.27 no.3
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• pp.578-591
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• 2013

Purpose: The purpose of this research was to identify the health behaviors, health status, and utilization patterns of health care institutions for homeless shelter residents as well as to compare these research outcomes between younger and older male homeless shelter residents. Methods: The subjects in this study were 357 homeless shelter residents that were recruited by simple random sampling. Data were collected from August to September 2009. Health behaviors, health status, and utilization patterns of health care institutions were measured using structured questionnaires. Data were analyzed using the Chi square test and Fisher's exact test using SPSS 14.0. Results: Both younger and older male subjects showed unhealthy behaviors, and their health status was lower than that of the Health & Nutrition Examination Survey conducted in 2009. Subjects preferred to utilize national or municipal hospitals as well as pharmacies as opposed to general hospitals, clinics, and public health centers. Conclusion: Differentiated comprehensive health care services and monitoring should be provided to homeless shelter residents based on the needs of each group in order to improve their health status as well as to prevent communicable diseases and complications of chronic diseases.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2007.11a
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• pp.55-55
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• 2007

See Full Text

• Proceedings of the Korean Society of Health Policy and Administration Conference
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• 2005.12a
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• pp.361-362
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• 2005

• Journal of Society of Preventive Korean Medicine
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• v.19 no.3
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• pp.45-55
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• 2015

Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.85-105
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• 1999

The main purpose of this article is to analyze the managerial performance of small and medium-size hospitals that are specialized in certain areas of medical services. Data of 189 hospitals were obtained from the data file of Korea Institute of Health Services Management The items include general characteristics of the hospitals, fianancial reports, and utilization records. Degree of specialization is measured by concentration(Herfindahl) index, and the sample hospitals are accordingly classified into specialized and unspecialized groups, by means of cluster analysis. These groups are compared in terms of various measures of managerial performance, which include several profitability indices such as operating margin, return on assets(ROA), and return on equity(ROE). To examine the relationship between specialization and managerial performance, we estimate the regression model, where the profitability indices are used as the dependent variables and the concentration index as the independent variable, controlling for the hospital characteristics such as size, type and location. Also, we perform 'Du Pont' analysis, to investigate the basic elements that can explain the differences in profitability between specialized and unspecialized hospitals. Major findings are as follows: 1. Managerial performance is better for the specilized hospitals than the unspecilized, in all aspects of profitability(operating margin, ROA, ROE). 2. Regression analysis suggests that there is a positive, statistically significant relationship beween the degree of specialization(i.e. concentration) and hospital profitability. 3. Main reason for the higher profitability of specialized hospitals lies in lower expenses rather than higher revenue. 4. In particular, personnel and material expenses are significantly smaller for the specialized hospitals, and this result seems to stem from the efficiency of operating fewer lines of business.(some kind of 'economies of scale') 5. Specialized hospitals also have fewer employees compared with the unspecialized, especially in administrative departments, which implies their efficient personnel management.

• YAKHAK HOEJI
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• v.58 no.2
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• pp.99-106
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• 2014

This study explores the prescribing pattern of generic drugs and the relationship between socio-demographic factors and the use of generics in South Korea. The analysis was based on claims data of 2011 from Korean National Health Insurance. We examined utilization, costs, and market share of oral preparations by original and generic product. Multiple logistic regression was performed to evaluate the predictive factors of generic use among multi-source medications. Generics accounted for 37~41% of utilization and 34~41% of costs in the insured market of oral preparations. In the generic market, costly generics made up about 58~61%, 56~66% of volume and value, respectively. Other things being equal, institutional factors affected generic use to the largest degree. The odds of having generics were 6 times higher in clinics, 4 times higher in hospitals, and 1.7 times higher in general hospitals than in teaching hospitals. Those in metropolitan or rural area were more likely to prescribe generics than those in the capital area. While generics were frequently prescribed for off-site pharmacy (OR=1.173), the odds of having generics was 0.88 after weighting the data by units prescribed. This study empirically presented the pattern of generic prescribing, confirming the widely accepted view that costly generics were more likely to be utilized in the Korean market. Up to two thirds of the generic market consisted of costly products. The strongest factors affecting generic use were institutional variables.