• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.12-21
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• 2014

Purpose: This study was conducted to examine the factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Method: A cross-sectional survey was conducted through staff and patients in 39 hospitals (34 local province hospitals, and 5 red-cross hospitals) from September to October in 2011. A questionnaire was designed to collect information on job satisfaction, inpatients and outpatients satisfaction. The data of medical profit per bed was collected in 2011 annual financial reports from each 39 hospitals. Finally, data from 5,521 staff, 1,730 in-patients and 1,730 out-patients were analyzed. Multiple logistic regression analysis was performed to determine factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Results: The medical profit was positively correlated with job satisfaction of staff. As the results of multiple logistic regression, the significant variables of medical profit per bed, were communication satisfaction of staff(OR=0.48, 95% CI=0.25-0.91), hospital environment satisfaction of in-patients(OR=1.53, 95% CI=1.05-2.22). Conclusion: The satisfaction of patient and staff were significantly effect to medical profit in public hospitals. The Government and administrators have make an effort to improve satisfaction of staff and patients in public hospitals.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.109-129
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• 2001

The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

• Korea Journal of Hospital Management
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• v.4 no.1
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• pp.41-65
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• 1999

This study was attempted to identify the factors affecting profitability of general hospital in Kyung-In Region. Operating profit to gross revenues and net profit to gross revenues were used as a proxy indicator for profitability of hospitals. The unit of analysis was hospital, and the data were collected 5 years data from 20 hospitals. The major findings are as follows; (1) The average operating profit rate was 1.03% and the net profit rate was -5.00% in twenty hospitals in the Kyung-In Region for the last five years. In terms of maximum surplus, the operating profit rate was 14% and net profit rate was 3.40%. In terms of maximum loss revenue, the operating profit rate was -16.56% and the net profit rate was -22.83%. (2) Since the year 1993, which was the starting year of this study, the operating profits and the net profits consistently decreased. (3) Analyzing the difference in profits among various hospital groups, the tertiary hospital group and the 501-1000 beds group exhibited the highest in operating profit rate. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited the highest in operating profit rate. There is a statistically significant difference in those groups(p<0.05, p<0.01). (4) In the health care delivery system, the profit gain in the secondary hospital was 51.5% and in the tertiary hospital was 72.4%. Based on the number of beds in each hospital group, the highest profit gain was 75.0% in the over 1001 beds group, and 71.4% in the 501-1000 beds group. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited 88.6% surplus. (5) According to the surplus difference based on the analysis of health care utilization, a group with over 31 patients in bed turnover rate, a group with over 96% in bed occupancy rate and group with over 9% in emergency cases to outpatient visits exhibited the highest profit gains. In addition, a group with over 301 patients in daily outpatient visits per 100 beds and group with 11-12 days average length of stay exhibited the highest profit gains. These results are statistically significant(p<0.05, p<0.01). (6) According to a stepwise regression analysis, the variables measuring the bed turnover rate, number of licensed beds, and number of outpatient visits per specialist explain 34.1% of the variation in operating profits. In terms of net profits, the new outpatient visits, the bed turnover rates and the number of general bed variables explain 30.6%. These results are statistically significant(p<0.01).

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.99-110
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• 2010

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.

• Korea Journal of Hospital Management
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• v.10 no.3
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• pp.45-66
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• 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.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.138-155
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• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.71-92
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• 2005

The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.

• Health Policy and Management
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• v.13 no.3
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• pp.129-147
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• 2003

This study is to grasp a trend of profitability classified by characteristics of hospitals and to analyze related factors. Subjects are 145 hospitals which have gotten the standardization audit by Korean Hospital Association during 1998-200l. Profitability was measured in the aspect of operation profit rate with operating margin to gross revenue as proxy variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, competition), financial factors (liabilities to total assets, current ratio, fixed ratio, total asset turnover, inventories turnover), and factors related to patient treatment (average length of stay, bed occupancy rate, new outpatient ratio, admission ratio of outpatients, number of patients per specialist, personnel costs per adjusted inpatient, administrative costs per adjusted inpatient). Hierarchical multiple regression analysis model was used in this study. As a result of hierarchical multiple regression analyzation of operating margin to gross revenue, adjustive $R^2$ of general factors was relatively more powerful. The factors had significant effect on operating margin to gross revenue were ownership(+), number of beds(+), competition(+), current ratio(+), fixed ratio(+), total asset turnover(+), personnel costs per adjusted inpatient(-).

• 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.

• Korea Journal of Hospital Management
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• v.12 no.3
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• pp.47-67
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• 2007

This paper aims at suggesting several ways lo change financial vulnerability and to improve managerial capability of local public hospitals (LPHs) in Korea through the identification of factors affecting profitability. Several findings of the research are as follows: To begin with, LPHs exhibited a statistically significant difference in their profitability from one another, according to tile analyses of their profitable margins from tile general characteristics. It depends on the number of hospitals in the area, the population of the hospital-built area, the number of competing hospitals, the number of staff per 100 beds, the opening of special clinic, the educational function, and the capacity of rooms. However, there was no variable in the managerial characteristics, presenting a significant difference, in contrast with hospitals which have been managed by private companies and made a great amount of profits. Second, according to the analyses of profit differences in behavioral effort-characteristics, a statistically significant difference was revealed upon the basis of the efforts to improve the clinic service, invite special patients, and shorten the period of being hospitalized. Third, the result of analyses about the difference of profitability from medical care and finance is statistically significant in the rate of labor cost, the rate of management cost, bed-occupancy rate, and the period of being hospitalized. Fourth, according to the analyses of the factors influencing the net profit ratio of the entire capital, Adjusted explanatory power(Adjusted $R^2$) was shown up to 65.2%, which is high. To compare the adjusted explanatory power stage by stage, the first stage model applying only two variables such as structural and strategic characteristics exhibited 23.8%, and the second stage model adding financial characteristics showed 51.5%. The explanatory power was much improved up to 65.2% when the third stage model incorporated the outcome of medical care performance. When the return on investment(ROI) was examined by using the multi-variate linear regression analysis at the final model of third stage, it was found that ROI had a positive relationship with the increase rate of patients, labor costs per doctor, and medical care rate of socially protected inpatients. However, it revealed that ROI had a negative relationship with the ratio of labor costs, the number of patients per managerial staff, and occupancy rate of rooms, respectively. The research suggests that in order for LPHs to increase profitability, LPH, should make efforts not only to attract patients to the hospitals without any discrimination of the patients depending on their financial status, but also to develop efficient management methods to reduce labor costs.