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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Health Policy and Management
Journal Basic Information
Journal DOI :
The Korean Society of Health Policy and Administration
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Volume & Issues
Volume 9, Issue 4 - Dec 1999
Volume 9, Issue 3 - Sep 1999
Volume 9, Issue 2 - Jun 1999
Volume 9, Issue 1 - Mar 1999
Selecting the target year
Empirical Analysis of 3 Statistical Models of Hospital Bankruptcy in Korea
Health Policy and Management, volume 9, issue 2, 1999, Pages 1~20
This study was conducted to investigate the predictors of hospital bankruptcy in Korea and to examine the predictive power for 3 types of statistical models of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 30 bankrupt and 30 profitable hospitals in 1. 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the predictive power of statistical models of hospital bankruptcy were compared. The major findings are as follows. 1. Nine out of 21 indicators - fixed ratio, quick ratio, operating profit to total assets, operating profit to gross revenue, normal profit to total assets,normal profit to gross revenue, net profit to gross revenue, inventories turnrounds, and added value per adjusted patient - were found to be significantly predictitive variables in Logit and Probit models. 2. The predicdtive power of discriminant model of hospital bankruptcy in 1. 2, and 3 years before bankruptcy were 85.4, 79.0, and 83.8% respectively. With regard to the predictive power of the Logit model of hospital bankruptcy, they were 82.3, 75.8, and 80.6% respectively, and of the Probit model. 87.1. 80.6, and 88.7% respectively. 3. The predictive power of the Probit model of hospital bankruptcy is better than the other two predictive models.
A Study on Physician Performance Measures for Financial Compensation in Academic Medical Centers
Health Policy and Management, volume 9, issue 2, 1999, Pages 21~39
An increasing number of hospitals are seeking for new or mixed compensation strategies to improve the productivity of their medical staff in the struggle to provide high quality medical services at low costs amid the economic hardship. To motivate physicians toward the right direction, it is necessary to effectively evaluate their performance that provides a basis for compensation. However, productivity has been historically difficult to measure, particularly for physicians in academic medical centers who are expected to engage in research, education, and patient care simultaneously. The objectives of this study were to define performance measures of physicians and clinical departments in academic medical centers. to examine correlations between the measures. and to investigate factors affecting the measures. The performance data of 212 faculty physicians in 17 clinical departments in two university teaching hospitals affiliated to one medical school during the fiscal year 1994 was used for analyses. Patient care revenue, net profit. and adjusted number of patients were defined to measure the performance in patient care. and number of articles published in academic journals and research grant were defined for research activities. Both individual physicians' performance measures and per physician measures of clinical departments were analyzed. All measures defined to evaluate individual physicians' performance were positively related to each other. Clinical department and rank of faculty position were statistically significant predictors of revenue. and hospital. clinical department. and rank were significant predictors of net profit. journal publication. and research grant. Patient care measures defined to evaluate clinical departments were related to each other. so were research measures. and no significant correlations were found between patient care measures and research measures. Also found were large differences in department. ranks when clinical departments were evaluated by absolute per physician performance measures and evaluated by annual rate of changes in performance measures. These findings suggest that departmental performance measures opposed to individual performance measures are relatively free from problems of factors affecting the performance measures that are not in control of clinical departments or individual physicians. Results from the correlation analysis of departmental performance measures indicates that measures of research performance should be included in the evaluation to promote research activities in academic medical centers.
Comparative Analysis of Health Service Utilization Patterns in Rural Region
Health Policy and Management, volume 9, issue 2, 1999, Pages 40~54
The purpose of this study is to compare the health service utilization patterns between up and myun and to find the determinants of utilization. For this purpose. this study used different versions of utilization rates. such as crude utilization rates. utilization rates adjusted for population composition. and age-sex adjusted utilization rates. Data used in this analysis were the Community Health Interview Survey which was conducted by interviewing 741 households from August 31 to September 11, 1998 in HongCheon-Gun. KangWon-Do. The major findings of the analysis are summarized as follows: 1. There was a statistically significant difference in the level of health service utilization between up and myun. Depending upon the unit of analysis employed (those who were interviewed vs those who were sick). the difference between up and myun was reversed. 2. Determinants of health service utilization are analyzed using logistic regression. The result showed that predisposing factor influenced health service utilization in rural areas, while the enabling factor didn't.
The Local Council Members' Attitudes to the Health Policy
Health Policy and Management, volume 9, issue 2, 1999, Pages 55~76
In order to understand the local council members' attitudes to the health policy, we conducted mail surveys using self-administered questionaire for 2 months(February and March. 1995). The study subjects were 2.312 local council members in Korea, but only about 11% among whom. 257 persons, responded to 2 times mail survey. This response rate revealed that the local council members was not interested in health care fields. The main results were as follows; The respondents thought that the economic and income development was most important among 15 regional policy agendas and the health care was the 5th or 7th important agenda. They. who had more health needs of and poor access to health care, tended to think that the health care was more important. They considered lobbying to and persuading the civil servants as the best method to tackle the local health care policy agenda. The respondents, who had poor access to health care facilities. tended to set the highest priority for the expansion of public and private health care resources. They expected that the election of local governor would activate the public health program more than thought that the program was implemented more actively than other region. The main opinion of respondents was that the central government had to take over planning and financing for the public health program, and the basic local government had to implment the program and budgeting. The majority of respondents agreed the private dominant medical care delivery system and nation-wide uniformed financing mechanism. Over 60% of them suggested that they were ready to suffer environmental pollution inducing health hazards for the purpose of regional economic and income development. About 75% of them favour the campaign for antismoking regardless of reducing local government's revenue from sale tax.
An Analysis on Decision-making Process Regarding the Use of Medical Service According to Lifestyle
Health Policy and Management, volume 9, issue 2, 1999, Pages 77~94
The purpose of this study is to establish strategy by subdividing consumer market according to the lifestyle which influences the use of medical facilities. The subject of this study were 700 adults who were over 20 years of age and residing in Suwon and its vicinity. To collect data trained staff conducted person-to-person interviews with the assistance of structured questionnaires. The questionnaires cover the areas of life style pattern study. the characteristics of demographic sociology, decision-making process related to the use of medical service. The influencing factors were analyzed and as a result total 18 factors were singled out. Cluster analysis was performed to differentiate similar responses. Each group was named as 'health-unconcern type' 'passive health-concern type' 'regular health-concern type' and 'active health-concern type' according to the characteristics. Each group showed statistically significant difference in the characteristics of demographic sociology. Decision-making process regarding the use of medical service according to lifestyle was analyzed. As a result following items showed significant difference:whether the information was utilized, what was the criteria in selecting medical facilities for serious illness or complicated examination. who was the decision maker in selection medical facilities, and with whom one discussed in selecting medical facilities. The result of this study has its limitation in that it can not be applied directly to market subdivision. However, this will help medical facilities understand customers' lifestyle. which will eventually provide medical facilities with marketing tools in establishing effective PR strategy. In order to apply the lifestyle as a marketing tool of medical facilities, following tasks are to be carried out: the development of the questionnaire which can better analyze consumers' lifestyle related to the use of medical service. the examination of precise characteristics of subdivided market according to lifestyle. and the continuing study on the relationship between lifestyle and the process in selecting medical facilities.
A Study on Experience of the Indemnity Request from Patiences and Indemnity Paid of Malpractice
Health Policy and Management, volume 9, issue 2, 1999, Pages 95~117
The purposes of the study was to analysis the factors on the physicians' indemnity experience and indemnity on malpractice. Data was collected from mail interview for the physicians from August, to October in 1996. Questions were asked to the physician who selected with random sample(n=8.338) about the opinion of malpractice insurance. experience that he(she) have requested the indemnity from patience. context of experienced indemnity and demographic characteristics of physician and patience. Response rate is 37.5%(n=3,124). This study was analyzed in two levels' the first. influential factors on whether physician has experience of indemnity and the second. influential factors of indemnity among physicians who had experienced the indemnity. The major findings were as follows : 1. Logistic regression on whether physicians had experience of indemnity request was conducted. And it indicated that statistically meaningful variables of model 1 (about all physicians) were department of surgery, physicians who have intention of insurance fee, physician age and income, physicians who owned the hospitals and statistically meaningful variables of model 11 (about physicians who owned the hospital) were department of surgery and internal treatment. 2. Multiple regression on the influential factors on indemnity was conducted. And it showed that statistically meaningful variables in model 1 were method of malpractice quarrel(physician association), whether physician had malpractice, whether suit succeeded, physician age, average practice time and income and whether physician owned the hospital and statistically meaningful variables of model 11 were whether physician had malpractice, number of outpatient, number of beds. As the conclusion, the thesis was examined about the variables related with experience of indemnity and cost of malpractice. But in order to prevent malpractice and promote medical quality, the reasonable system to solve a malpractice have to settle and cost estimation on malpractice is essential. Therefore an advanced research is progressed with methodology to decide the indemnity bases.
Variations on Drug Utilization between the Types of Hospital in Some Frequent Diseases
Health Policy and Management, volume 9, issue 2, 1999, Pages 118~138
This study presents the variations on drug utilization for outpatients' URI, gastritis. and hypertension by the type of hospital- tertiary hospital. general hospital. hospital. clinic. It investigated drug expenses. daily drug expenses. days of medication. the highest price of the drugs used. and the number of the different drugs used for each disease and type of hospital. This study also performed analysis to see how much the variations of variables related to drug use affect the variations of drug expenses. The dependent variable was drug expenses and the independent variables were days of medication. the average price of the drugs used. and the number of the different drugs used. Analysis of the drug utilization was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Patients with secondary diseases were excluded. In this study. 379 patients with URI, 386 patients with gastritis. 1.257 patients with hypertension were included. It was founded that there were large variation on drug utilization between the types of hospital for same diseases. Days of medication were longest in tertiary hospitals and shortest in hospitals or clinics. Clinics showed the lowest daily drug expenses in all of the diseases investigated. Daily drug expenses were highest in general hospitals or hospitals. which also tended to use drugs of higher price than other types of hospital. General hospitals and hospitals had larger variations in daily drug expenses and the highest price of drugs. It suggested that drug might be utilized overly in general hospitals and hospitals and some other factors might influence on drug utilization in these hospitals. It was found that the variations of drug expenses were affected by the variations of drug price and days of medication rather than the number of the different drugs. Then the strategy to reduce the variations of drug utilization and to improve the quality of drug utilization should focus on the drug price and days of medication. Further study is needed to assess the quality as well as the variation of drug utilization and to show the factors which affect them.
Primary Care Physicians and Residency Training Programs in Korea
Health Policy and Management, volume 9, issue 2, 1999, Pages 139~156
Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.
Nurse's Image:Perceived by Students of Elementary, Middle and High Schools in Taegru, Korea
Health Policy and Management, volume 9, issue 2, 1999, Pages 157~173
The purpose of this study was to investigate the image of nurse perceived by students of elementary. middle and high schools in Taegu. Korea. Also the details for establishing the image were analyzed. The subjects of this study were 1.119 students from elementary. middle and high schools in Taegu. Data were collected from July 1. to July 16. 1998 and analyzed with Frequency. X 2-test. t-test. ANOVA. and Stepwise Multiple Regression in SPSS 7.5. The results of this study were as follows; (1) There was a significant difference in the nurse's image among the three groups(F= 168.42. p= .000). and the elementary students had the most positive image among the groups. (2) There was a significant difference in the nurse's image between male andfemale students. and the male students had more positive image(t=3.20. p = .001) than female students. (3) The experiences of hospitalization. books. and mass media affected on establishing the image of nurse, and experienced students had more positive image than those who was not. (4) 22.3% of the nurse's image was explained by the educational years. (5) The students who could distinguish between nurses and nurse aids, who had a nurse in their family, and who had experiences of nurse by TV had more positive image than those who had not. The students who had experiences of family member's hospitalization had more negative image than those who had not.