• The Journal of Asian Finance, Economics and Business
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• 제9권4호
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• pp.315-324
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• 2022

The goal of this study is to understand better the relationship between hospital bed occupancy rate and cost rigidity as a proxy for the degree of hospital bed congestion, as well as the relationship between the risk of changes in hospital bed occupancy rate and congestion cost, targeting public hospitals. As public hospitals for analysis, we selected hospital projects from the Public Enterprises Survey Reports published by the Department of Public Enterprises, Ministry of Finance, and obtained unbalanced panel data consisting of 1,505 hospitals and 15 years, totaling 12,595 hospitals and years. The analysis revealed that the risk of changes in the bed occupancy rate increases the degree of cost rigidity and leads to a decrease in the variable cost ratio; furthermore, an increase in the bed occupancy rate decreases the degree of cost rigidity and leads to an increase in the variable cost ratio. These findings suggest that although public hospitals are taking managerial actions to avoid congestion costs, congestion costs resulting from higher bed occupancy rates have not been eliminated. The regression analysis results show that even if congestion costs arise as the occupancy rate increases, they are covered by the increase in revenue associated with the increase in the occupancy rate.

• 한국병원경영학회지
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• 제15권4호
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• pp.43-62
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• 2010

This study provides an evidence on the determinants of the profitability of university hospital by analyzing university hospital-level data set of hospital performance during the year 2007 (32 university hospitals in total). For the study, a multiple regression model is employed in which profitability index obtained from the DEA computations, operating margin to total asset and gross revenue are used as the dependent variables, and a number of hospital operating characteristics are chosen as the independent variables such as ownership type, location, bed size, period of establishment, bed occupancy rate, admission ratio of outpatients, patients per medical specialist, personnel cost per patient, liabilities to total assets, current ratio, fixed ratio, total asset turnover, medical assistance rate and public indicator. First, the results indicate that the bed occupancy rate and liabilities to total assets are positively and significantly associated with operating margin to total asset. Second, number of beds, the bed occupancy rate and number of patients per medical specialist are positively and significantly associated with operating margin to gross revenue. Third, the bed occupancy rate, number of patients per medical specialist, liabilities to total assets, total asset turnover are positively and significantly associated with profitability index revealed from DEA.

• 보건의료산업학회지
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• 제3권2호
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• pp.1-15
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• 2009

The purpose of this study is to analyze the internal factors that influence the performance of local government hospitals in Korea. There are 34 hospitals in korea as of 2008. Among these hospitals 5 are profit-making and the other loss-making in terms of profitability. Data was collected by Institute of local government hospital union. The major findings of this study was as follows : Firstly, 7 hospitals are high level, over than 100% of fixed ratio. But that result was better than the other study 5 years ago. Secondly, 29 hospitals are bellow 85% of bed occupancy rate. There are a number of hospitals didn't use the facilities and the personnel cost in total costs are high. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are personnel cost(-), liability to total assets(-), average length of stay(-), outpatient visits to inpatient days(-). In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and to increase bed occupancy rate.

• 한국병원경영학회지
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• 제14권2호
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• pp.1-20
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• 2009

The purpose of this study is to find the determinant variables to make profitability in regional public hospitals. The data come from financial statements and annual reports of 34 regional public hospitals for five years (from year 2003 to year 2007). The T or F-test and hierarchical multiple regression analysis are used. The dependant variables are the profitability indicators, ordinary income to total asset and operating margin to gross revenue, and the independent variables are general characteristics, diagnosis and treatment patterns, financial and public benefits. The findings of this study are summarized as follows. First, Variables affecting the profitability indexes revealed from DEA results is the bed occupancy rate, number of hospitalized patients to outpatients, ratio of first medical examination for outpatients, number of daily patients per medical specialist, labor cost per patient and managerial expenses per patient. Second, the ordinary income to total asset representing the asset usage performance is affected by the average hospitalized days, bed occupancy rate, labor cost per patient and ratio of patients with medical insurance coverage. Third, the operating martin to gross revenue obtained from the actual operations of hospitals has its significance with the bed occupancy rate, number of hospitalized patients to outpatients, managerial expenses per patient and public benefit indicator. This study has some restriction not to use pannel data analysis, although it used data for five years. Accordingly, various additional studies should be done to supplement such problems.

• Journal of Hospice and Palliative Care
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• 제13권3호
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• pp.143-152
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• 2010

목적: 본 연구는 호스피스 완화의료 기관 조사와 통계청 자료를 이용하여 호스피스 완화의료 기관 현황과 장애요인, 그에 따른 활성화 방안을 조사하고 분석하여 향후 정책수립을 위한 기초자료를 제공하고자 실시되었다. 방법: 현황조사를 위해 국내 호스피스 완화의료 관련 단체 및 기관을 통해 호스피스 완화의료 제공 기관을 선정 하여 2009년 2월에서 3월까지 설문을 시행하였으며 설문내용은 기관의 일반현황, 대상자, 서비스 제공인력, 시설, 재정, 활성화 방안으로 구성되었다. 또한 필요병상수 및 병상충족률 산출을 위해 통계청의 지역별 인구수 자료를 이용하였다. 결과: 전체 53개 호스피스 완화의료 기관 가운데 42개 기관이 종합병원 이상으로 총 설문대상 기관 중 의원급 기관은 6개였다. 전체 53개 기관 중 18.8%의 기관이 수도권 지역에 분포하고 있었다. 전반적인 호스피스 완화의료 병상충족률은 21.9%로 낮은 것으로 나타났으며 4개 광역시도의 경우 호스피스 완화의료 전용병상이 없는 것으로 보고되었다. 2008년 호스피스 완화의료기관의 사망자는 전체 암사망자의 6.3%에 불과했다. 기관의 재정 관련한 설문에서 86%의 시설이 재정이 부족하다고 답변하였으며 그 외 인력수급 장애요인 및 시설기준 미충족의 원인으로도 재정 부족을 원인으로 꼽은 기관이 과반수를 넘는 것으로 나타났다. 호스피스 완화의료 활성화를 위한 정부의 지원으로 가장 필요한 부분으로 재정지원이었으며(71.2%), 기부문화 활성화 방안으로 기부금 전액 세금 공제(43.1%), 공익재단 설립(23.5%) 등으로 나타났다. 결론: 본 연구는 이처럼 기관의 현황 자료조사 및 설문조사를 통해 국내의 호스피스 완화의료 이용률 및 병상충족률이 낮은 문제점, 지역별 병상충족률 편차가 큰 문제점 등을 파악하였으며 호스피스 완화의료의 장애요인으로 재정부족, 인력수급 장애, 인식부족 등을 파악하였다. 또한 이를 위해 호스피스 완화의료 기관의 재정마련 방안이 필수적이며 인식 부족에 대한 개선 노력도 동시에 이루어질 필요가 있을 것으로 결론지었다. 이 중 재정 부족에 대한 방안으로는 정부의 재정 지원과 기부금 전액 세금공제와 공익재단 설립이 검토해 볼 만한 대안으로 제시할 수 있겠다.

• 한국병원경영학회지
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• 제9권2호
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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• pp.51-65
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• 1996

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.

• 한국병원경영학회지
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• 제4권1호
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• pp.41-65
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• 1999

This study was attempted to identify the factors affecting profitability of general hospital in Kyung-In Region. Operating profit to gross revenues and net profit to gross revenues were used as a proxy indicator for profitability of hospitals. The unit of analysis was hospital, and the data were collected 5 years data from 20 hospitals. The major findings are as follows; (1) The average operating profit rate was 1.03% and the net profit rate was -5.00% in twenty hospitals in the Kyung-In Region for the last five years. In terms of maximum surplus, the operating profit rate was 14% and net profit rate was 3.40%. In terms of maximum loss revenue, the operating profit rate was -16.56% and the net profit rate was -22.83%. (2) Since the year 1993, which was the starting year of this study, the operating profits and the net profits consistently decreased. (3) Analyzing the difference in profits among various hospital groups, the tertiary hospital group and the 501-1000 beds group exhibited the highest in operating profit rate. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited the highest in operating profit rate. There is a statistically significant difference in those groups(p<0.05, p<0.01). (4) In the health care delivery system, the profit gain in the secondary hospital was 51.5% and in the tertiary hospital was 72.4%. Based on the number of beds in each hospital group, the highest profit gain was 75.0% in the over 1001 beds group, and 71.4% in the 501-1000 beds group. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited 88.6% surplus. (5) According to the surplus difference based on the analysis of health care utilization, a group with over 31 patients in bed turnover rate, a group with over 96% in bed occupancy rate and group with over 9% in emergency cases to outpatient visits exhibited the highest profit gains. In addition, a group with over 301 patients in daily outpatient visits per 100 beds and group with 11-12 days average length of stay exhibited the highest profit gains. These results are statistically significant(p<0.05, p<0.01). (6) According to a stepwise regression analysis, the variables measuring the bed turnover rate, number of licensed beds, and number of outpatient visits per specialist explain 34.1% of the variation in operating profits. In terms of net profits, the new outpatient visits, the bed turnover rates and the number of general bed variables explain 30.6%. These results are statistically significant(p<0.01).

• 보건행정학회지
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• 제14권2호
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• pp.1-16
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• 2004

The study purpose was to find which factors affect selection of hospital network types. This study used the 1998 American Hospital Association Annual Survey Database from Health Forum. Among these U.S. hospitals, the researcher selected hospitals located in Metropolitan Statistical Areas. Therefore the final observation cases for analysis are 1,971 Metropolitan Statistical Area hospitals in the United States. To identify significant variables influencing hospital network types, the study used proportional odds logistics regression model on population size, Health Maintenance Organization penetration rate, and market competition rate of area including a hospital, types of hospital ownership, hospital bed size, proportion of Medicare patients and Medicaid patients in total hospital patients, and occupancy rate. Contrary to conventional wisdom, selection of hospital network types was influenced by population size of area which a hospital located, types of ownership, hospital bed size, and proportion of medicare patients rather than Health Maintenance Organization penetration. Population size 1,000,000-2,499,999 had the highest probability of selecting type IV (clinical-vertical integration) from an independent hospital, and a religious group owned hospitals and for-profit owned hospitals had the highest probability of selecting Type IV (clinical-vertical integration) from an independent hospital. A bed size had positive relation on selecting Type IV (clinical-vertical integration) from an independent hospital. Unlikely general belief that the selecting types of hospital network was determined by the change of health insurance policy such as Health Maintenance Organizations and Preferred Provider Organizations, the types of hospital network were influenced by community characteristics such as population size, and hospital characteristics.

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