Kim, Ji-Hyoung;Ha, Ho-Wook;Lee, Hae-Jong;Sohn, Tae-Yong
Korea Journal of Hospital Management
/
v.10
no.3
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pp.45-66
/
2005
The purpose of this study was to analyze related factors affecting profitability on general hospitals(300-499 beds). The data were derived from survey by the Korean Hospital Association on 33 hospitals during 10 years (from 1993 to 2002). Profitability was measured by 3 ratios - net profit to total assets, normal profit to total assets and operating margin to gross revenue - as dependent variables. Independent variables were classified by general factors (ownership, number of bed, period of establishment, region), financial factors (total asset turnover, current ratio, liabilities to total assets, personnel costs per operation profit, material costs per operation profits), productivity index(number of daily patient per nurse), the score of quality assurance activity and the time lag score. Multiple regression model was used in this study. First, Number of bed, region was not statistically significant for profitability. But ownership was affect positively to normal profit to total assets and operating margin to gross revenue. Private hospitals had higher profitability than that of public hospitals Second, the score of quality assurance activity was not statistically significant to profitability. Third, Those hospitals having more daily patient per nurse had significantly higher profitability than the others. Fourth, Those hospitals having higher proportion in total asset turnover had significantly higher profitability than other hospitals. But liabilities to total assets and liquidity ratio had no difference to the profitability. Those hospitals having higher proportion in personnel costs and material costs per operation profits had significantly lower hospital profitability than others.
This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.
Purpose: To investigate the factors influencing health promoting behavior in college students and to provide a basic data for developing an effective health promotion program. Method: The subjects were 711 college students living in Jecheon city and were selected using a convenience sampling method. The instruments used in this study included the Health Promoting Lifestyle Profile developed by Walker et al.(987). Perceived Health Status developed by Lawston et al. (1982). Self-Esteem scale developed by Rosenberg(1965), Self-Efficacy scale developed by Becker et al. (1993), and Health Locus of Control developed by Wallston et a1.(1978). The data were analyzed by descriptive statistics, pearson correlation coefficient, and stepwise multiple regression using SPSS/WIN program. Results: I) The mean score of health promoting behavior was 2.39 point out of 4. In terms of sub-domains of health promoting behavior, self-actualization(2.78) showed the highest mean score, followed by interpersonal support(2.75), stress management(2.38), nutrition(2.11), exercise(2.04), and health responsibility (1.97). 2) The health promoting behavior had significantly positive correlations with self-efficacy, powerful others health locus of control, internal health locus of control, chance health locus of control, and perceived health status. 3) In the relationship between general characteristics and health promoting behavior, health promoting behavior was significantly different by gender(t=2.17, p=.03), and financial status of parents (F=10.79. p= .00). 4) The most powerful predictor of health promoting behavior was self-efficacy. A combination of self-efficacy, self-esteem, powerful others health locus of control, and sex accounted for 40.4% of the total variance in health promoting behavior. Conclusion: The findings of this study showed that health responsibility and exercise were the domains where the college student showed relatively lower scores than other domains, self-efficacy was the most important predictor of health promoting behavior. Therefore, it is suggested that health promoting programs should focus on health responsibility, and exercise. Nursing strategies that can enhance self-efficacy should also be developed in order to promote healthy lifestyles in college students.
The concept of "public health care (public health and medical services)" as discussed in South Korea is used in an unclear sense, with a meaning unlike the terminology used worldwide. The terms "public health care (public health and medical services)" and "health care (health and medical services)" have the same legal definition in Korea. Globally, "public health care (public health and medical services)" refers to medical services provided to the public that are operated as publicly funded resources, but in Korea, this term is confined to limited medical services prescribed by the government. The following considerations regarding "public health care (public health and medical services)" in Korea are proposed: All medical services performed by the state, regional governments, health care institutions, or health care workers to protect and promote the health of the people should be clearly established as "public health care (public health and medical services)" by definition. The financial burden borne by the state through national health insurance should be increased to an appropriate level to clarify the state's responsibility. Improving public health is an urgent priority in Korea, and this goal can be achieved by improving regional public health through systematic relationships between the state and regional governments, establishing a Ministry of Health, and efficiently allocating public health doctors who are important for providing regional medical care in rural and remote areas. It will be possible to actively deal with infectious diseases at the national level through establishment of a Ministry of Disease Control and Prevention.
For the development of Korean health promotion projects, this paper appraised the capacities of health promotion projects and examined the latest international trend of the health promotion field, based on the appraisal of data made by the Ministry of Health and Welfare, 2005 and IUHPE relevant reports. The capacities of Korean health promotion should be strengthened as follows: First, it is urgent to give health education and to use the professionals of it. Secondly, setting approach is required when working on health promotion projects. Thirdly, it is necessary to strengthen the capacities of local communities through the central government's administrative and financial supports for the healthy cities project which is a strategy of general approach to new public health projects. The $21^{st}$ century is an age of new public health that the cause for deaths increasingly is centered on life style. So it is necessary to expand the scope of health education to the field of making the environment of local community healthy beyond the level of individual health education. And further, it is required to develop the curriculum of health and to work out new strategies for health promotion. In conclusion, Korea should train competent human resources in the fields of practice of healthy public policies, of knowledge-based projects, and of health promotion (like health educators). The political direction for it should be to promote various healthy city projects, not only health center-led health promotion projects, and further, to strengthen the capacities of the health promotion projects of local communities.
The purpose of this study was to investigate a plan of middle/high school foodservice systems which could properly provide nutrition for juveniles' health. Questionnaires were developed and distributed to: 245 middle schools with 271 parents, 328 students, 180 teachers, and 345 administrators; 163 high-schools with 223 parents, 466 students, 179 teachers, and 163 administrators in Seoul and Kyunggi province. The results of this study were as followed. For the desirable feeding type as in-school meal plan, 62.2% responded to the current elementary school feeing type:10.3% responded to a lunch-box prepared at home; and 38.0% responded to free dining out type. For a feeding operation type, school administrators, teachers and parents favored the current school feeding systems in elementary schools with proportion of 68.2%, 47.7%, and 87.6% as respectively. Also, 20.3% of school administrators, 22.6% of teachers, and 6.9% of parents preferred contract management. A total of 27.6% of teachers, 9.2% of school administrators, and 3.7% of parents responded to a lunch-box prepared at home. There was a significant difference between the responses for establishing the main body of financial burden to solve the problem of financial burden which could be the most obstacle to bring middle/high school feeding system into operation. For the management of school feeding systems when brought into operation, 88.7% out of 470 responded schools and 89.9% out of 227 responded teachers reported that an expert should manage school feeding systems. For futuristic direction, an effective joint cooking type between schools which may be the way to solve the difficulties in securing the appropriate space and to decrease the financial burden, the problem of transportation for delivering feeding products, low quality of feeding, and sanitation can occur. Therefore, the distance between schools which operate a joint cooking system will affect as a major factor. Furthermore, concrete examination of plans for introduction of various types of school feeding and institutional devices for management system and supervision of operation should become a condition precedent.
This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.
The purpose of this study is to analyze the internal factors that influence the performance of local government hospitals in Korea. Out of 34 Local Government hospitals, 6 hospitals were selected as sample hospitals. Then hospitals were divided into two groups(3 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was Normal Profit to Total Assets. The major findings of this study were as follows : The headcount per 100 bed of the profit-making hospitals was 8.8 persons less than the loss-making hospitals and the ratio of payroll expenses to total revenue 14.7% less. Inpatient bed occupancy ratio of the profit-making hospitals was 92.8%. This result is higher 21.8% than loss-making hospitals.
Illness intrusiveness(illness induced lifestyle disruption) was investigated in 902 patients with arthritis and compared between rheumatoid arthritis(N=439) and osteoarthritis(N=463) patients. Arthritis patients were reported to perceive illness intrusiveness similar to patients with ESRD(end stage renal disease), bipolar disorder and peritoneal dialysis. Especially they were intrusive into health, work, and active recreation domains. And patients with rheumatoid arthritis were significantly more intrusive into activities, especially in diet, financial situation, family relations, other social relations, self-expression/self improvement, religious expression, and community and civic involvement. Differences in treatment regimens and age were hypothesized to account for these differences in illness intrusiveness.
The objectives of this research is to find the factors which determined hospital profitability. The unit of analysis is hospital, and the data is collected from two sources. One source is derived from Ministry of Health and Social Affairs(4 years' data from 134 hospitals), and another source is derived from Sam-II Accounting Co.(1 year's data from 37 hospitals). Hospital profitability, which is dependent variable in our research, is measured with financial ration, such as ROI(reture on investment). The major findings are as follows; 1) The hospital profitability is determined with not hospital type itself but management-incentives associated with hospital type. 2) The maximum profitability is obtained in 775 bed-size. 3) The hospital location isn't a factor to determine profitability 4) The internal control and management, such as account receivables, inventory, fixed assert investment, is major factor to hospital profitability.
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