• 한국병원경영학회지
• /
• 제8권4호
• /
• pp.149-181
• /
• 2003

It has been asserted that per diem payment system should be introduced, in place of the current fee-for-service system, for payment of the inpatient services of the geriatric hospitals, Based on the assentation, this study aims at calculating costs and profits per inpatient-day of the geriatric hospitals, and thereby at contributing to the managerial improvement from the both sides of the Government and the hospitals. Relevant data of the three months, May to August, 2002 were collected from the five geriatric hospitals, and per inpatient-day costs and profits were calculated for the three disease groups. Major results and conclusions are as follow : Firstly, total costs per insured inpatient-day of the geriatric hospitals are 65, 389 won for dementia (including optimal profit of 3,858 won), 69,730 won for stroke (including optimal profit of 4,117 won), and 70,085 won for other diseases (including optimal profit of 4,134 won). Secondly, the amount of the non-insured costs per inpatient-day occupies 34.5% of the total costs for dementia, 30.3% for stroke, and 30.1% for other diseases. Thirdly, the total amount of the per inpatient-day costs calculated including the optimal profits is, on the average, higher by 12% than the present price level calculated for the current fee-far-service system. This implies that the present price level should rise by 12% when the current fee-far-service payment system be maintained, and Finally, introduction of a sliding-scale payment system should be considered for the inpatient medical management fees for the length of stay over six months or more that are being cut in the claim examination process by the insurance corporation.

• 보건행정학회지
• /
• 제13권3호
• /
• pp.129-147
• /
• 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(-).

• 보건의료산업학회지
• /
• 제4권1호
• /
• pp.99-110
• /
• 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.

• 지식경영연구
• /
• 제16권1호
• /
• pp.209-224
• /
• 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.

• 한국병원경영학회지
• /
• 제6권3호
• /
• pp.109-129
• /
• 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.

• 한국병원경영학회지
• /
• 제10권1호
• /
• pp.71-92
• /
• 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.

• Journal of Preventive Medicine and Public Health
• /
• 제31권3호
• /
• pp.490-502
• /
• 1998

본 연구는 우리 나라 병원도산 예측모형을 도출하기 위한 연구로 1992년에서 1997년 사이 5년간의 전국 병원 경영통계 자료를 이용하여 1995년부터 1997년 사이에 도산한 병원중도산전 3년까지의 연속된 자료가 있는 31개 병원을, 비교군 병원은 도산병원과 유사한 병상규모를 가지고 당기순이익이 발생한 31개 우량병원을 선정하여 단계적 판별분석에 의한 실증연구를 시행하였다. 본 연구의 구체적 연구결과는 다음과 같다. 첫째, 도산전 각 연도별로 도산병원과 우량병원간에 연구변수의 단순 평균치분석 결과, 자본구조 지표인 자기자본비율과 수익성지표인 총자본의료이익을, 의료수익의료이익을, 총자본경상이익을, 의료수익경상이익율, 총자본순이익을 등은 도산 1, 2, 3년전 모두에서 도산병원과 우량병원간에 유의한 차이를 보였다. 자본고정성지표는 도산 1년전에 고정비율이 유의한 차이를 보였고, 유동성지표는 도산 1년전에는 유동비율과 당좌비율이 유의한 차이를 보였고 도산 2년전에는 당좌비율만이 유의한 차이를 보였다. 활동성지표로는 도산 1년전에 총자본회전율과 재고자산회전율이 유의한 차이를 보였고 도산 2년전에는 총자본회전율과 의료미수금회전율이, 도산 3년전에는 의료미수금회전율만이 유의한 차이를 보였다. 생산성지표로는 도산 2년전에 총자본투자효율이, 도산 3년전에는 조정환자1인당 부가가치가 유의한 차이를 보였다. 진료실적지표로는 도산 3년전 일평균재원환자수가 유의한 차이를 보였다. 둘째, 도산 1, 2, 3년전 판별함수는 각각 도산 1년전 Z=($0.0166\times$당좌비율)-($0.1356\times$총자본경상이익을)-($1.545\times$총자본회전을), 도산 2년전 Z=($0.0119\times$당좌비율)-($0.1433\times$총자본의료이익율)-($0.0227\times$총자본투자효율), 도산 3년전 Z=($0.3533\times$총자본순이익율)-($0.1336\times$의료미수금회전율)-($0.04301\times$조정환자1인당부가가치)+($0.000119\times$일평균재원환자수)이었다. 셋째, 도출된 도산 1, 2, 3년전 각 판별함수의 예측력은 77.42%, 79.03%, 82.25% 이었다.

• 한국병원경영학회지
• /
• 제9권1호
• /
• pp.66-94
• /
• 2004

The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

• 디지털융복합연구
• /
• 제17권3호
• /
• pp.261-269
• /
• 2019

본 연구는 우리나라의 종합병원의 경영성과와 지역 의료이용 친화도를 알 수 있는 RI를 과학적인 방법으로 산출하여 지역의료이용량과 병원 경영성과의 인과 관계에 대한 연구결과를 바탕으로 효율적인 경영전략을 제시하는데 그 연구의 의의가 있다. 연구결과를 보면 첫째, 일반적 특성에 따른 지역친화도 차이에서는 도시구분별 병상 수, 경상이익에서 통계적으로 유의한 차이가 나타났다. 둘째, 지역 의료이용의 친화도(RI)와 변수들 간의 상관관계를 살펴보면, 경상수지비율, 외래환자 초진율, 의료수익의료이익률, 100병상 당 1일 평균 외래환자 수, 100병상 당 1일 평균 입원환자 수, 입원환자 1인 1일당 평균진료비와 유의한 상관관계를 나타냈다. 연구결과를 바탕으로 본 연구의 의의를 살펴보면, 첫째 지역 의료이용 지표인 지역 의료이용 친화도를 산출하여 경영성과와의 연관관계와 유의한 영향을 미치는 변수를 규명하였다는 점에서 본 연구의 의의가 있다고 할 수 있다. 둘째로는 도시규모, 병상규모 등 내,외부적 환경요인에 따라 비교분석하였으며, 향후 병원이 지역 의료이용률를 높이기 위한 병원경영 전략의 수립에 기초 자료를 제공하였다고 할 수 있다.