This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation.
Purposes: We analyzed the profitability determinants of regional public hospitals during the entire period between 2010 and 2020 and the period before and after COVID-19. We intended to provide fundamental data for developing publicness evaluation index and task of establishing and expanding regional public hospitals. Methodology: The financial and non-financial information of the regional public hospitals were used as the main analysis data; The financial data was established by the Center for Public Healthcare Policy of National Medical Center, and the non-financial data by the Health Insurance Review and Assessment Service. T-test and regression analysis were used. Findings: The results can be summarized in two. First, the main determinants of profitability of the regional public hospitals were appeared to be the total asset turnover rate and the labor cost rate. Second, during the COVID-19 pandemic in the regional public hospitals, the number of sickbeds, the number of isolation rooms, the total asset turnover rate and the labor cost rate appeared to be the factor worsening the profitability. Practical Implication: The results of this study suggests that the management of the regional public hospitals is not aiming for the profit making, but it performs the functions as the community healthcare safety net such as controlling infectious diseases.
Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.
Kim, Han-Sung;Kim, Young-Hoon;Woo, Jung-Sik;Lee, Hae-Jong;Yoon, Byoung-Jun;Han, Whiejong;Choi, Young-Jin
Korea Journal of Hospital Management
/
v.17
no.4
/
pp.87-115
/
2012
This research classified hospital specialization strategy types through cluster analysis, analyzed fitness of hospital specialization strategy types for external environment or organizational structure, and examined relation between hospital specialization strategy types and organizational performance. This research surveyed 1,437 hospitals which have more than 30 patient's bed and practice national health service in Korea. Specifically, this research divided into two part : external fit - analysis of relation between external environment and specialization strategy, internal fit-analysis of relation between organizational structure factors and specialization strategy. also, as the organizational performance for achieving specialization strategic purpose, not only the productivity, efficiency, profit but also the medical quality was considered. In case of external fit, many hospitals chose integration type if there are a lot of competitive hospitals and regional population. Particularly, if there are many competitive hospitals, concentration type is chosen. In contrast, if there are many doctors in the region, differentiation type is chosen. In case of internal fit, according to organization type and patient's bed number, hospitals chose different types. If it is a general hospital and has a few bed number, generalization or concentration type is chosen. Tertiary hospital or the hospital with many patient's bed chose differentiation type. According to the number of specialists, if there are a few specialists, generalization or concentration type is chosen. If there are many specialists, differentiation type has high fitness for the hospital. In relation to strategy types and organizational performance, differentiation type has best result. Differentiation type has a good result in 7 items out of 11.
Recently, the needs for marketing activities is increasing of the hospitals, but there are no such measurement for the efficiency and the effectiveness of the marketing activities. Thus, the research aims to suggest the necessity of approach method which can combine the efficiency and the effectiveness of the marketing activities both systematically and comprehensively in line with examining the current status of marketing capability of hospitals in Korea. From the research findings, it is known that, in respect of financial performance, hospitals in Korea should establish the plan and implement accordingly in order increase both the sales revenue and profit ratio in contrast to the sales revenue through strengthening the internal marketing activities rather than the external marketing activities.
Journal of Korean Academy of Nursing Administration
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v.19
no.4
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pp.449-461
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2013
Purpose: The purpose of this study was to explore the relationship between cost and revenue for inpatient nursing activities in general wards. Methods: Data were collected from 12 medical-surgical wards in one general hospital from January 1 to December 31, 2010. The nursing activities were categorized into 2 groups according to nursing service payment type in terms of the Korea health insurance system. Descriptive statistics were used to identify nursing activities and nursing activity costs. Results: Of 140 nursing activities identified as performed in general wards, payment for 69 items was included in nursing management fees. The percentage of each cost for the nursing units was 90% for labor, 4% for materials, and 6% for operating expenses. The cost for medical support nursing service accounted for 38% of costs and nursing management fees, 62%. The average profit and loss was -237,257,000 won. The cost recovery rate for nursing service was only 44%. Conclusion: The results indicate a need to measure the economic value of nursing activities performed in general wards and use it as a basis for establishing an adequate reimbursement system for nursing service.
This study examines nonpatient revenues of hospital in korea. The data source for this study was the 11 national university hospitals over the period 2008-2012. In this study, patient revenues, patient expenses, operating profit, nonpatient revenues, total revenues, ratio of the nonpatient revenues in the total revenues, operating margin, normal profit to gross revenues were analysed by the annual. The analysis of nonpatient revenue differences by management performance, bed size, location was performed. The results were as follows. Nonpatient revenues of national university hospitals were increased during the period 2008-2012. Nonpatient revenues were no significant differences by management performance. Nonpatient revenues in hospitals which are large bed size and located in big city were larger. Based on these results, this study suggests implications to diversify profitability for management performance in hospitals.
This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.
This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.
New system solves scheduling problem in medical services. The existing scheduling system by FCFS is for a hospital but new system expresses the condition of a hospital and the profit of separate system's parties by the automated negotiation. This system expresses user preference time as a priority number and is designed that the schedule is changed according to the priority number with a negotiation strategy for a patient. And a hospital makes a schedule according to the policy. The system supports customer satisfaction in medical services by considering not only equipment efficiency but also the patent waiting time unlike the existing system considering the idle time for a equipment.
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