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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
Editor in Chief :
Volume & Issues
Volume 16, Issue 4 - Dec 2006
Volume 16, Issue 3 - Sep 2006
Volume 16, Issue 2 - Jun 2006
Volume 16, Issue 1 - Mar 2006
Selecting the target year
The Relationship between Hospital Size and the Impact of Market Orientation on Performance in Korea
Lee, Kyun-Jick ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 1~23
DOI : 10.4332/KJHPA.2006.16.4.001
There is general consensus in the research literature that market orientation is related to organizational performance. The study examines this relationship in the Korean hospital industry. One feature of this study is to examine the differences between large and small hospitals in terms of their market orientation, performance and the relationship between these constructs. The other feature is that both market orientation and performance are conceptualized as being multi-dimensional constructs. Hence a structural equations modeling (SEM) technique is used to examine the dimensionality of market orientation and performance and to examine the nature of this relationship. Data for this study are collected using a questionnaire that is mailed to the top marketing-related managers of 1,048 hospitals. Usable responses are obtained from 230 hospitals for a response rate of 21.9%. The SEM results confirm the multi-dimensional nature of both market orientation and performance, and the strong relationships between the constructs. Interestingly, this relationship is found to be much stronger for smaller hospitals than for larger hospitals. For smaller hospitals, this study shows that market orientation has a tremendous influence on performance, with almost 73.9% of the variance in performance being attributed to market orientation.
An Empirical Analysis on Trade-off Theory and Pecking Order Theory for Medical Institutions's Capital Structure
Kim, Jai-Myung ; Ham, U-Sang ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 24~47
DOI : 10.4332/KJHPA.2006.16.4.024
Based on the findings of a study focused on medical institutions(Fama & French, 2002), this study determined possible causality between determinants of capital structure and liability level, while estimating targeted debt ratio. Moreover, it also examined hypotheses about the adjustment of targeted debt ratio and the of fundraising patterns, so that it verified the relative priority of trade-off theory and pecking order theory. First, profitability had positive(+) relationships with liability level, while investment opportunities had negative(-) relationships with liability level. This finding supported pecking order theory, and non-liability tax shield effects had negative(-) relationships with liability level as estimated in both trade-off theory and pecking order theory. Next, this study verified trade-off and pecking order theory at once by means of regression analysis about the variation of liability level in associations with disparity from targeted debt ratio and short-term fluctuation of profit and investment. As a result, it was noted that liability level became mean-reversed to targeted liability ratio but slowly, SO it was difficult to assert that such mean reverse may support trade-off theory. However, the finding that most of short-term fluctuations of profit and investment are absorbed into liabilities supported pecking order theory. On the other hand, it was found that the larger scale of medical institutions is more supportive of pecking order theory in the associations between liability level and profitability and the fundraising patterns than trade-off theory.
Satisfaction with Health Care in North Korea: A Study of North Korean Refugees in China
Kim, Gae-Young ; Chung Woo-Jin ; Lee, Yun-Hwan ; Park, Chong-Yon ; Robinson W. Courtland ; Lee, Myung-Ken ; Lee, Og-Cheol ; Burnham Gilbert M. ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 48~67
DOI : 10.4332/KJHPA.2006.16.4.048
The aim of the study was to examine levels of satisfaction with health care in North Korea and to identify factors associated with it using a convenience sample of North Korean refugees in China. Data from the 2004 Survey of Health Seeking Behavior of North Korean Households conducted by the Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health were used. The study subjects were 273 North Korean refugees whose length of stay in China was less than 3 months. Factor analysis was used to extract factor dimensions from the 12 satisfaction items. Bivariate (t test and ANOVA) and multiple regression analyses were used in examining factors associated with satisfaction with health care use in North Korea Overall, satisfaction level was low (
, score range: 1-5). Of the three-factor dimensions, physician skills scored the highest
, followed by drug availability
and general cleanliness
. In the multiple regression analysis, having a usual source of care was significantly associated with patient satisfaction. Respondents who identified primary care (section) doctors as their usual source of care tended to be less satisfied than those with the city or county hospital as their usual source of care. County residents tended to report a lower degree of satisfaction with general cleanliness than city residents. Among socioeconomic characteristics, the number of household assets positively predicted satisfaction with drug availability. North Korean residents appear to be dissatisfied with their medical care. It may reflect some inadequacies in the North's universal health care system to meet the healthcare needs of its people.
Characteristics of Hospital by Network Type in Korea
Shim, Jae-Sun ; Kwon, Young-Dae ; Chang, Hye-Jung ; Kang, Sung-Wook ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 68~85
DOI : 10.4332/KJHPA.2006.16.4.068
With the competitive environment accelerating in healthcare industry, the hospital network system is considered as one of the strategies for clinical and managerial efficiency. This study was intended to offer a theoretical view on the hospital network system and to analyze the current network status of hospitals in Korea. Specifically, network types were classified based on the criteria modified from previous studies, and were used to describe and compare the scope and intensity of associated activities. The questionnaire survey was conducted with 237 hospitals during the period of December 27 2005 to January 25 2006. Above 90% of tertiary and secondary care hospitals were under the network system, while only 20% of primary care clinics were affiliated. In general, the scope and intensity of network activities was limited. Vertical and/or clinical integration was more common than horizontal and/or managerial integration. Three most frequent types of hospital network systems were clinical-vertical integration (Type A), clinical/managerial-vertical integration(Type B), and clinical/managerial-horizontal /vertical integration (Type C). Such network types differentiated significantly different features of affiliated hospitals and network systems. The affiliation duration to the network system was the only significant factor influencing on the network type. The strategic approach to the network system was emphasized for hospitals to increase the potential advantage of hospital network systems.
Analysis of Experts' Views on Health Care: A Survey
Jung, Young-Ho ; Ko, Suk-Ja ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 86~111
DOI : 10.4332/KJHPA.2006.16.4.086
Either ways of understanding health care as a commodity or public work are at opposite ends of health care spectrum. These two rival conceptions reflected by viewpoint(ideology) would lead to different directions in policy-making for health care reform. The purpose of this study is to access the value differences of experts' policy views about health care issues by analyzing the extent of consensus among experts in the field of health care. Using primary data obtained through a mail survey of 558 experts in the field of health care, we analyzed the differences of experts' opinions about characteristics of health care market, policy issues and values Gdeology). The study represents from 50-50 split analysis, entropy index, and factor analysis that the wide spread disagreements over health policy, which is a major barriers to effective policy-making, could be caused by the ideological perception differences among experts. This implies that, if values play an important role in policy-making, we should identify the differences in value and seek ways to balance among the diverse values such as efficiency, equity, freedom, and security. For this, the policy issues debated on differences in values should be reconciled for narrowing gaps of experts' perceptions through various ways.
Development of Performance Indicators in Public Health Center Based Home Healthcare
Chang, Hyun-Sook ; Lee, Tae-Bum ; Nam, So-Young ; Chin, Young-Ran ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 112~127
DOI : 10.4332/KJHPA.2006.16.4.112
The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.
Characteristics of non-emergent patients at emergency departments
Chung, Seol-Hee ; Yoon, Han-Deok ; Na, Baeg-Ju ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 128~146
DOI : 10.4332/KJHPA.2006.16.4.128
The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients.
and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.
The Effect of Drug Vintage on Mortality : Economic Effect of New Drug
Jung, Kee-Taig ; Kim, Jeong-Yoon ; Lichtenberg, Frank ;
Health Policy and Management, volume 16, issue 4, 2006, Pages 147~168
DOI : 10.4332/KJHPA.2006.16.4.147
Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.