Earticle

Objectives : Medical service specialization could have positive effects on their profits and medical service quality. This study was to examine the relationship between medical service specializations and operational performance in hospitals. Methods : We used the National Inpatient Sample data provided by the Health Insurance Review and Assessment Service from 2010 to 2013. The hospital operational performance was determined by measuring the specialization level of the hospital based on DRGs. Results : The information theory index was 2.38 in 2010, 2.38 in 2011, 2.37 in 2012, and 2.37 in 2013. A multiple regression model was constructed which showed that if the specialization level becomes higher, it decreases the length of stay per case with an increase in medical expense. Conclusions : Differentiation and concentrated medical service specialization strategy have had a positive effect on the operational performance of hospitals.

Objectives : The aim of this study was to investigate whether there is a difference in the factors affecting the financial performance and profitability before and after the specialty hospital designation and thereby identifying the differentiated significance of the financial performance of specialty hospitals. Methods : Based on the year 2011, the analysis period was divided into the pre-specialty hospital designation (2007–2010) and post-specialty hospital designation (2011–2014), and the data were pooled according to the respective analysis period and analyzed by descriptive statistics and regression analysis. Results : The difference in the financial factors that affected the financial performance and profitability before and after the specialty hospital designation was discovered, and a financial performance factor different from prior studies was found. Conclusions : This study identified improved outcomes in financial performance due to the specialty hospital designation and the factors that affect profitability in terms of the finance of specialty hospitals.

Objectives : This study applied the research model of Bontis (1998), which has been used to investigate everything from business corporations to hospitals in Korea, examined its generalizability and attempted to verify which factors of the intellectual capital affects organizational performance, represented by indicators for the clinical and financial performance of hospitals. Methods : Primary data for the study were collected from 91 general hospitals through self-administered questionnaires, and secondary data on clinical and financial performance of hospitals were collected form existing statistics. Collected data were analyzed with SPSS 11.5 (ver.) and AMOS 18.0 (ver.). Results : It was found that only human capital and customer capital had indirect effects on hospital performance. It was also revealed that structural capital had a direct effect on clinical performance, and an indirect effect on financial performance. Conclusions : This result means that there is a need to individually consider both the clinical performance and financial performance when measuring the organizational performance of a hospital, and it also shows that positive improvement in the clinical performance can contribute to the improvement of the financial performance through this process.

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

Objectives : The aim of this study was to identify the effects of nursing performance and innovative behavior on the self-leadership of geriatric hospital nurses. Methods : The participants in this study were 206 nurses working in geriatric hospitals in Busan, Ulsan and Yangsan City. Data were collected from October to November, 2015. A structured questionnaire was used for the data collection, and the data were analyzed with the SPSS/WIN program. Results : Nursing performance and innovative behavior positively correlated with self-leadership. The most significant predictors of self-leadership were nursing performance and innovative behavior. Conclusions : These findings suggest that nursing performance and innovative behavior were linked to self-leadership. The results of this study can be used to help develop self-leadership programs.

Objectives : This study was to test the influencing effects of calling, work value, and organizational commitment on turnover intention in hospital nurses. Methods : Two-hundred sixty hospital nurses were recruited in B city, South Korea. They were asked to complete a questionnaire, and 251 data sets were included in the multiple regression analysis. Results : Subjects had more extrinsic work value rather than intrinsic and a low calling level. There were significant correlations among transcendent summons, purpose/meaningfulness, pro-social intentions, intrinsic work value, and organizational commitment. Influencing factors of turnover intention were purpose/meaningfulness (t=-2.170, p=.031) and organizational commitment (t=-7.824, p<.001). The model was statistically significant explaining 27.8% of the variance (F=47.550, p<.001). Conclusions : Nurses showed a weak sense of calling and their work value leaned towards the extrinsic domain. Therefore, nurse managers should support a plan that enhances the calling and intrinsic work value of nurses to get them to commit to their organization and subsequently, reduce the turnover rate.

Objectives : The purpose of this study is to suggest an efficient human-resources direction for the management of dental hygienists, the study analyzes the influential relationship between superior's coaching leadership as perceived by dental hygienists and their on the job satisfaction, and proves the moderating effects of leader trust and of followership in the process. Methods : To test the empirical model, data were collected by survey using structural self-administered questionnaires that were distributed to 300 dental hygienists working at dental clinics in the Busan, Ulsan, Gyeongnam, and Gyeonggi areas, from 27 March to 10 April, 2015, 286 cases were used in final analysis. Results : Coaching leadership is found to have a significant influence on job satisfaction. Trust in a leader showed a significant main moderating effect on job satisfaction, on the other hand, followership showed a significant main effect, but no significant moderating effect, on job satisfaction. Conclusions : The results of this study imply that leadership factors such as coaching leadership and leader trust are crucial for improving the job satisfaction of dental hygienists, therefore, a program for enhancing the leadership skills of dental managers is needed in dental health organizations.

Objectives : The purpose of this study was to identify the determinants of the long-term influence of violence on hospital nurses. Methods : Three-hundred hospital nurses were recruited in B city, South Korea. They were asked to complete a questionnaire, and 282 data- sets were included in the multiple regression analysis. Results : Subjects experienced more episodes of verbal violence than that of physical threats or physical violence. Assailants tended to be patients and their caretakers rather than internal customers. Nurses who had religion, worked in a surgical ward, and a 3-6 year career perceived a high level of violent experiences compared to their counterparts. The determinants of the long-term influence of violence were physical violence (t=-2.705, p=.007), emotion-focused coping (t=3.049, p=.003), and emotional response (t=3.611, p<.001). The model was statistically significant explaining 13.0% of the variance (F=14.981, p<.001). Conclusions : Nurse managers should help nurses who are victims of hospital violence by teaching them not to depend on emotion-focused coping and by alleviating their emotional response to violence.

Objectives : The purpose of this study was to explore diverse factors of patients with periodontal diseases, make comprehensive and pluralistic assessment of relevant factors, construct a hypothetical model, including direct and indirect paths, and test goodness-of-fit of the model. Methods : TRaw data were used from the sixth Korea National Health and Nutrition Examination Survey for the first and second years which was conducted from January 2013 to December 2014. Excluding current patients with cancer which could severely affect the quality of life among patients with periodontal diseases who were between 40 and 64 years of age, a total of 1,555 patients were included and finally analyzed in this study. Results : Among the factors affecting the quality of life, health perception had total effects through direct effects and functions had indirect and total effects through the channel of health perception. Conclusions : In oral health programs for the middle-aged, it is necessary to have preventive interventions in oral health; in particular, it is necessary to provide intervention programs that can improve health perception and relieve functional restrictions.

Objectives : This study investigated the prevalence of unmet health care needs among Korean adults and related factors. Methods : The study participants were adults over the age of 20 mental health experience from the Korea Health Panel in 2012(n=4,730). Statistical analysis methods used in this study were the χ²-test, Logistic Regression Analysis and other basic statistics such frequency-and percentage using SPSS version 22.0. Results : ①Significant variables of stress: Factors were age, economic activity, subjective health status, and activity limitation. ②Significant variables of depression: Factors were age, income class(low) and activity limitation. ③Significant variables of suicidal impulse: Factors were age, chronic diseases, income class, and activity limitation. Conclusions : Stress, depression, and suicidal impulse can be unmet medical factors; therefore improvement measures and mental health counseling programs in response to suicide impulses, should be developed. Thus there is a need for a health sciences approach.

Objectives : Using several waves of the Panel Study of Worker’s Compensation Insurance(PSWCI), this study analyzed the effect of work hours on health and lifestyle of Korean workers in a sample from the 2013~2014 year (The first survey was completed in August-October 2013; the second survey was completed in August-October 2014). Methods : The research subjects were 1,312 men from among employees who responded to a 2013 PSWCI panel report. Statistical analyses were done with SAS version 9.3 (SAS Institute Inc., Cary, NC, USA). Results : According to the results of the analysis, the male subjects had differences in economic activity and health conditions based on the length of working hours. There was a significant relationship among working hours and life satisfaction, and the correlation coefficients were statistically significant. The results show that workplace conditions has a direct positive effect on life satisfaction as we anticipated in the hypothesis. Conclusions : Management should focus on the factors identified in this study when developing employment interventions programs to improve the the promotion of healthy lifestyles for adults over the age of 40.

Objectives : The aim of this study was to validated the effectiveness of the information gap in work and daliy life satisfaction. Additionally, this study attempted to verify the mediating effect of self-esteem. Methods : The study examined 327 students who participated in a study on the PSWCI 1st Wave by KCOMWEL. Data were analyzed through descriptive statistics using the reliability test in SPSS 22.0 Ver. Moreover, hypothesis testing was analyzed with covariance based on structure equation modeling (CB-SEM) using Amos 21.0 Ver. Results : The low information gap has a positive effect on satisfaction with work and daily life. Additionally, self–esteem also has a positive effect on each satisfaction measure. However, self-esteem does not have a mediating effect between information gap and each satisfaction measure. Conclusions : The results of the study found the factor of effect on effect factor on beneficiary's satisfaction of industrial accident compensation insurance. Therefore, new ways need to be found that reduce the information gap and increase self-esteem.

Objectives : The purpose of this study was to evaluate the effect of critical thinking disposition and self-esteem to self-leadership in nursing students. Methods : In this study, 273 data was collected from nursing students of K-university in South Korea from Sep. 2015 to Nov. 2015, and the collected data was analyzed using SPSS 22.0 Statistics Program. Results : The results showed that both of critical thinking disposition and self-efficacy according to school year are significant to self-esteem. It was found that critical thinking disposition, self-esteem and self-leadership has a positive correlation. Critical thinking disposition and self-esteem were predictors of self-leadership with 46% of influence. Conclusions : The nursing training program needs to be developed to promote critical thinking and self-esteem in the nursing curriculum, so that the nursing students can demonstrate the ability as a nursing leader in the various fields of clinical practice and health care.