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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
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Journal DOI :
The Korean Society of Health Policy and Administration
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Volume & Issues
Volume 12, Issue 4 - Dec 2002
Volume 12, Issue 3 - Sep 2002
Volume 12, Issue 2 - Jun 2002
Volume 12, Issue 1 - Mar 2002
Selecting the target year
Segmenting Inpatients by Mixture Model and Analytical Hierarchical Process(AHP) Approach In Medical Service
Health Policy and Management, volume 12, issue 2, 2002, Pages 1~22
DOI : 10.4332/KJHPA.2002.12.2.001
Since the early 1980s scholars have applied latent structure and other type of finite mixture models from various academic fields. Although the merits of finite mixture model are well documented, the attempt to apply the mixture model to medical service has been relatively rare. The researchers aim to try to fill this gap by introducing finite mixture model and segmenting inpatients DB from one general hospital. In section 2 finite mixture models are compared with clustering, chi-square analysis, and discriminant analysis based on Wedel and Kamakura(2000)`s segmentation methodology schemata. The mixture model shows the optimal segments number and fuzzy classification for each observation by EM(expectation-maximization algorism). The finite mixture model is to unfix the sample, to Identify the groups, and to estimate the parameters of the density function underlying the observed data within each group. In section 3 and 4 we illustrate results of segmenting 4510 patients data including menial and ratio scales. And then, we show AHP can be identify the attractiveness of each segment, in which the decision maker can select the best target segment.
Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean
Health Policy and Management, volume 12, issue 2, 2002, Pages 23~42
DOI : 10.4332/KJHPA.2002.12.2.023
The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search `patient compliance`, `sick role behavior`, `major clinical disease`, and `intervention` as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients` or others` reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.
Factors Affecting the Financial Structure of Hospitals in Korea
Health Policy and Management, volume 12, issue 2, 2002, Pages 43~75
DOI : 10.4332/KJHPA.2002.12.2.043
This study focuses on the factors that make the financial structure of hospitals in Korea different, and on recommended courses of action that could be very helpful to hospitals in maintaining a sound financial structure. Data used in this study were collected from 132 hospitals with complete general data of present conditions as well as financial statements. They were chosen from the 174 hospitals that passed the standardization audit undertaken by the Korean Hospital Association from 1996 to 2000 for the purpose of accrediting training hospitals. The dependent variable in this study is financial structure. It consists of liabilities as against total assets (total liabilities to total assets, short-term liabilities to total assets, long-term liabilities to total assets, short-term borrowings to total assets, long-term borrowings to total assets). The independent variables are ownership type, hospital type, location, whether or not a representative is a director of the hospital, the possibility of changing a hospital director, bed size, period of establishment, asset structure, profitability, growth, tax shields, business risk, competition. The factors that appear to have the strongest impact on the liabilities to total assets of all the hospitals sampled are ownership type, hospital type, profitability, tax shields, and business risk. It was found that not-for-profit private hospitals and for-profit private hospitals have more liabilities than public hospitals, and tertiary medical institutions have less liabilities than the secondary general hospitals. Moreover, hospitals earning more at the expense of high business risk have a distinct tendency to lower liabilities. Concerning the current ratio, it was found that factors such as ownership type, hospital type, period of establishment, asset structure, and business risk are the more significant variables. The current ratio of public hospitals is higher than that of both not-for-profit private hospitals and for-profit private hospitals, and the current ratio of tertiary medical institutions is higher than that of general hospitals. As business risk is higher in hospitals compared to other businesses, the current ratio becomes higher; this is because it is assumed that for fear of bankruptcy, hospitals lessen liabilities to total assets. On the other hand, as hospitals become older, the fixed assets to total assets become lower. It is remarkable that in hospitals, the factors affecting liabilities to total assets have an opposite regression coefficient sign against factors affecting current ratio. It brings out the same results borne out by the old financial theories and researches, in which a lot of the liabilities of hospitals are considered as the cause of worsening liquidity. Therefore, it is very important for hospitals to maintain a sound financial structure in order to survive using the rational acquisition and maintenance of capital.
Educational Need Assessment for Developing Curriculum for Field Epidemiology Specialist Training Program on Infectious Disease
Health Policy and Management, volume 12, issue 2, 2002, Pages 76~91
DOI : 10.4332/KJHPA.2002.12.2.076
This study aimed to assess the educational need for management of communicable disease prior to developing curriculum for Field Epidemiology Specialist Training Program on Infectious Disease. We sent questionnaires(72 items) to two personnels who were related to communicable disease in each public health center through e-mai and 300 were returned(62.0% of response rate). The subject for education which showed the highest educational need was management(2.31 point), followed by immunization(2.30 point), and the lowest was surveillance(2.10 point). Generally, the educational need was higher in the aspect of attitude or practice than in that of knowledge. The subject which showed the differences in educational need by job titles were immunization(p<0.01), outbreak investigation(p<0.01), and case management and sanitation(p<0.01). There was negative correlation between communicable disease management-working duration and educational need. Considering this result, the curriculum should be focused on strengthening the ability for problem-solving especially in management and immunization.
Self-regulation of a Health Information On the Internet
Health Policy and Management, volume 12, issue 2, 2002, Pages 92~114
DOI : 10.4332/KJHPA.2002.12.2.092
While making a vigorous discussion about self-regulation for exponential growth of harmful health information on the Internet, many countries lave made various efforts to select and circulate high quality health information on the Internet. The purpose of this study Is to review the serf-regulation methods of health information on the Internet and to suggest quality control methods of health information on the Internet suitable for Korea. Self-regulation methods of the health information on the Internet include ‘content rating system(or content selection system)’, ‘codes of conduct or guideline’, ‘internet hot-line’, ‘education for information providers and consumers’. Any self-regulation method should be used with other methods. We can regulate health information on the Internet effectively by using both self-regulation methods and compulsive methods such as law. Also information providers, information consumers, specialists, consumer representatives, scholars, governments officers should take part in doing these efforts and make concern.
An Exploratory Study of Cooperative Relationship and Influencing Factors of Cooperating Performance in Interhospital Cooperative Relationship
Health Policy and Management, volume 12, issue 2, 2002, Pages 115~135
DOI : 10.4332/KJHPA.2002.12.2.115
Many tertiary hospitals have started to establish cooperative relationships with small and medium sized hospitals in Korea. But the performance of the relationship is not satisfactory to both of partners. The relationship and performance of cooperation for small and medium sized hospitals are analyzed according to the framework of inter-organizational cooperation. Data are collected by 4 focal hospital and 34 small and medium sized hospitals through interview and questionnaire. The findings are : a) The cooperation is focused on management area, such as healthcare technology transfer and information sharing, rather than patient referral. b) Patient referral is not yet active in cooperative relationship. But some partner hospitals which is located close and managing internal organization for cooperation show a significant number of referrals. c) The characteristics of high performers are positive attitude about cooperation, and recognition of the relationship as flexible, experiences of cooperation, internal and external management activities.