Purposes: This study aims to analyze the patterns of inventory turnover and inventory holding periods in Korean hospitals and to empirically investigate the association between these inventory management indicators and hospitals' operating profit margins. Methodology: We constructed a panel dataset comprising 2,177 observations from 301 hospitals nationwide for the period 2016-2023. To control for unobserved hospital-specific characteristics, we employed a random-effects model with hospital-level random intercepts, estimated using restricted maximum likelihood. The key independent variables were inventory turnover and inventory holding period. Control variables included the number of beds, hospital type, region, asset structure, and labor cost ratio, among other financial characteristics. Findings: A one-unit increase in inventory turnover was associated with a 0.006 percentage-point increase in operating margin (β=0.006, p<0.05). A one-day increase in inventory holding period was associated with a 0.130 percentage-point decrease in operating margin (β=-0.130, p<0.001). In extended models, the effects of inventory management variables remained stable even after controlling for additional financial ratios. Practical Implications: Inventory management efficiency emerged as a significant determinant in improving hospital financial performance. In particular, reducing inventory holding periods represents one of the strategic levers for enhancing hospital profitability.

연구목적: 2016년부터 2024년까지 한국 상급종합병원과 종합병원의 비용구조 및 수익성 변화를 종단적으로 분석하고, 병원군(상급종합/종합) 및 지역(수도권/비수도권)에 따른 이질성을 규명하고자 한다. 연구방법: 의료기관 회계공시 시스템(HASPA)에 2016-2024년 9년간 연속 제출한 253개 병원(상급종합 47개, 종합 206개, 총 2,277 hospital-year)의 균형패널 자료를 구축하였다. 의료수익 대비 비용 비율(가중평균), 12개 비용항목의 연평균성장률(CAGR), 그리고 비용 CAGR과 의료수익 CAGR의 격차(CAGR gap) 및 병원 단위 1,000회 부트스트랩 95% 신뢰구간을 산출하였다. 연구결과: 의료원가율은 2016년 96.7%에서 2024년 104.7%로 8.0%p 상승하였고, 의료이익률은 +3.3%에서 -4.7%로 전환되었다. 수도권 종합병원은 2019년에 가장 먼저 의료원가율 100%를 돌파한 반면, 수도권 상급종합병원은 2024년에 처음 이 역치를 넘었다. 의료수익 CAGR 5.17%에 대하여, 복리후생비(+2.42%p), 퇴직급여(+2.26%p), 제수당(+2.13%p), 약품비(+1.88%p), 인건비 총합(+1.60%p), 급여(+1.51%p), 지급수수료(+1.26%p), 전기수도료(+1.12%p), 재료비 총합(+0.97%p) 순으로 수익 성장을 통계적으로 유의하게 상회하였다. 반면 관리운영비 총합과 외주용역비의 CAGR gap은 통계적으로 유의하지 않았다. 함의: 한국 병원의 구조적 수익성 악화는 인건비 관련 간접비 복합체(특히 복리후생비, 퇴직급여, 제수당)와 약품비를 포함한 재료비에 의해 주도되며, 관리운영비 총합의 과도한 증가에 의한 것은 아니다. 이는 수가 조정 및 인력 정책이 이 두 축을 구분하여 접근할 때 재정적 효과가 클 것임을 시사한다.

Purposes: This study examined the association between referral center use and outpatient medical costs among new and first-visit outpatients at a tertiary hospital, paying particular attention to whether cost differences were concentrated in diagnostic testing components. Methodology: Administrative and clinical data were analyzed for 16,447 new and first-visit adult outpatients who visited a tertiary hospital in Seoul between January 1 and January 31, 2023. The main independent variable was referral center use. Outcomes included total medical costs, general diagnostic test fees, imaging test fees, and non-test medical costs. Generalized linear models with gamma and Tweedie distributions and logarithmic links were used to estimate adjusted predicted means after controlling for age, sex, residential region, clinical department, cancer status, and Charlson Comorbidity Index category. Oaxaca-Blinder decomposition was used to assess the extent to which observable patient and clinical characteristics explained the total cost difference. Findings: Referral center users accounted for 4,553 patients, or 27.7 percent of the study population. Their unadjusted mean total medical costs were higher than those of non-users, at 175,195 versus 127,702 Korean won. After adjustment, referral center use was associated with 30.8 percent higher total medical costs but 5.2 percent lower non-test medical costs. In the adjusted predicted mean analysis, general diagnostic test fees were 42.8 percent higher and imaging test fees were 73.2 percent higher among users. Observable patient and clinical characteristics explained 6.7 percent of the total cost difference. Practical Implications: Higher total medical costs among referral center users should be interpreted alongside consideration of unmeasured clinical severity, care complexity, and tertiary-level evaluation needs. The findings suggest the need to strengthen the pre-referral sharing of test and imaging information, use prior diagnostic results, manage potentially duplicative testing, and reinforce back-referral coordination.

Purposes: This study aimed to analyze the impact of psychological violence experienced by hospital administrative staff from patients and caregivers on turnover intention and organizational commitment and to verify the mediating effect of organizational commitment in this relationship. Methodology: An online questionnaire survey was conducted with 120 hospital administrative employees from healthcare institutions across Korea. The questionnaire included measures of psychological violence, organizational commitment, and turnover intention. Data were analyzed using SPSS, including reliability analysis, descriptive statistics, correlation analysis, and multiple regression analysis. Findings: Higher levels of psychological violence were significantly associated with increased turnover intention. Psychological violence was also found to significantly decrease organizational commitment. Organizational commitment partially mediated the relationship between psychological violence and turnover intention. Practical Implications: The findings provide empirical evidence of the detrimental impact of psychological violence on job attitudes and behaviors among hospital administrative staff. The study highlights the need for organizational strategies to protect employees from psychological violence and enhance organizational commitment, offering practical insights for human resource management and policy development in healthcare settings.

Purposes: This study qualitatively explored the workplace human rights experiences of non-regular employees in general hospitals, aiming to gain an in-depth understanding of their perception and interpretation of human rights within their work environments. Based on these findings, we propose approaches for improving human rights management at both departmental and institutional levels. Methodology: Semi-structured interviews were conducted with 11 non-regular employees working in general hospitals who were recruited through internal online and offline announcements. The data were analyzed through open coding, focusing on three primary domains: working conditions, human resource management, and intra-departmental interpersonal relationships. From this analysis, key themes and categories were identified. Findings: The findings indicate that participants perceived unstable employment conditions, limited information access, unequal resource distribution, non-transparent evaluation processes, social exclusion within departments, and workplace harassment as human rights violations. Conversely, equitable welfare benefits, appropriate task assignments, adherence to labor standards, work performance recognition, respectful communication, and supportive collegial relationships were regarded as indicators of human rights protection. These results demonstrate that non-regular employees interpret human rights not only in terms of formal systems and material conditions, but also through everyday interactions and organizational culture. Practical Implications: This study highlights the need for fair working conditions, transparent evaluation mechanisms, clearly defined contractual arrangements, and a culture of mutual respect to ensure effective human rights management for non-regular workers in hospital settings. The findings offer empirical evidence to inform policy development and institutional strategies aimed at safeguarding the rights of non-regular employees in general hospitals.

Purposes: This study aimed to elucidate the socio-psychological mechanism of nursing assistants whose occupational calling affects organizational commitment, by examining the mediation effect of positive psychological capital and the moderation effect of social support on the relationship. Methodology: A sample of 301 nursing assistants working in healthcare organizations in Seoul was recruited. Participants completed a questionnaire including items measuring occupational calling, psychological capital, social support, and organizational commitment. Data were analyzed by using SPSS 27.0 with Hayes' PROCESS Macro. Findings: Occupational calling was positively associated with organizational commitment, and psychological capital mediated this relationship. Moreover, social support moderated the relationship between occupational calling and psychological capital, more strongly strengthening the relationship when it is high, compared to when it is low. Practical Implications: In terms of practical implications, our findings indicate that healthcare organizations should select nursing assistants with a high level of occupational calling, which enhances their psychological capital and organizational commitment. Moreover, healthcare organizations should provide social support, such as mentoring programs or team-based support systems for nursing assistants, to improve their organizational commitment.

Purposes: This study aimed to classify learners' subjective perceptions of automated error detection and feedback in virtual reality (VR)-based nursing practice using Q methodology and to identify the learning characteristics associated with each perception type. The study sought to provide evidence to inform the design of effective VR-based practice environments and feedback strategies in nursing education. Methodology: A Q methodological approach was used with learners who participated in VR-based nursing practice and career exploration programs. Statements describing experiences with automated error detection and feedback were collected through written interviews and a review of previous studies. After refinement and validity review, 34 statements were selected for the Q sample. Participants sorted the statements into a forced quasi-normal distribution using a 9-point scale. The sorted data were analyzed using factor analysis with the PC-QUANL program. Findings: Five perception types regarding automated error detection and feedback in VR-based nursing practice were identified. Type I emphasized the importance of immediate instructor feedback for learning and performance improvement. Type II highlighted limitations of automated feedback compared with real clinical practice. Type III viewed VR practice as a means of indirectly understanding nursing tasks and procedures. Types IV and V perceived automated feedback as supporting repeated practice, learning confidence, self-monitoring, and self-directed learning. Practical Implications: This study provides a structured understanding of learner experiences with automated error detection and feedback in VR-based nursing practice. The results offer foundational evidence for tailoring VR practice designs and feedback systems to learner characteristics, thereby enhancing the effectiveness of nursing practice education.

연구배경: 치주질환은 전신 염증 반응을 유발해 심혈관 예후를 악화시키는 것으로 알려져 있다. 그러나 주요 심혈관 수술 또는 시술 환자에서 수술 전 예방적 구강관리가 퇴원 후 재입원에 미치는 영향을 평가한 대규모 인구 기반 연구는 부족하다. 연구목적: 수술 전 예방적 치석제거술과 퇴원 후 모든 원인 및 심혈관 원인 재입원 위험의 관련성을 평가하였다. 연구방법: 건강보험심사평가원(HIRA) 청구자료를 이용하여 2024년 심혈관 수술 또는 시술을 받은 성인 환자 코호트를 구축하였다. Kaplan-Meier 분석과 log-rank 검정을 시행하였고, 역확률가중법(IPTW)과 다변량 Cox 회귀모형으로 위험비를 산출하였다. 연구결과: 총 78,431명(치석제거군 5,012명, 미치석제거군 73,419명)이 포함되었다. IPTW 및 다변량 보정 후 치석제거군은 모든 원인 재입원(aHR=0.962, 95% CI=0.949-0.975)과 경쟁위험 분석(aHR=0.937, 95% CI=0.925-0.950)에서 모두 위험이 낮았다(P<0.001). 심혈관 원인 재입원도 Cox (aHR=0.914; 95% CI=0.897-0.932)와 경쟁위험 분석(aHR=0.861; 95% CI=0.846-0.877)에서 모두 유의하게 감소하였다(P<0.001). 이러한 연관성은 대부분의 하위군에서 일관되었으며, 만성신장질환, 만성폐쇄성폐질환, 심근경색 병력 환자에서 더욱 뚜렷하였다. 연구결론: 수술 전 예방적 치석제거술은 주요 심혈관 수술 또는 시술 환자의 모든 원인 및 심혈관 원인 재입원 위험 감소와 관련이 있었다. 이는 의과-치과 협진과 수술 전 예방적 구강관리 확대를 뒷받침하는 근거를 제공한다.