Earticle

Objectives : The purpose of this study was to analyze factors affecting the performance of public hospitals in South Korea. Methods : We collected management performance data from 2013 to 2015 from income statements, balance sheets, and annual reports from 32 local public hospitals. The dependent variable used was profitability, which included operating margin, return on assets and net profit to gross revenues. The independent variables were general characteristics, liquidity, stability, and activity. Results : Patient revenues, total assets, and total capital had increased steadily but patient expenses had increased to a greater extent. Operating profit, and net profit were consistently in deficits and the management status of local public hospitals had recently been in difficulty. The debt ratio, quick ratio, ratio of fixed liability and fixed assets turnover rate have a significant positive(+) effect on performance in the years 2013-2015. Conclusions : We suggest management strategies for these hospitals based on the results analyzed.

Objectives : This study investigated the effects of psychological ownership on job attitude markers (job satisfaction and affective commitment) of employees in general hospitals. Methods : Data were collected using self-administered questionnaire completed by employees in two hospitals in Seoul and Gyeonggi-do province, from May 21 to 26, 2014. Job attitude markers were measured by job satisfaction and affective commitment. We analyzed 300 cases using SPSS 21.0. Results : Psychological ownership of hospital employees had a significant effect on the job satisfaction and affective commitment. Psychological ownership explained a total of 20.5% and 9.9% of the variance in job satisfaction and affective commitment while controlling for gender, age, marital status, work position and work experience. Conclusions : Psychological ownership of hospital employees is a useful factor and key to recruiting and conducting training program for them, thus enhancing job attitudes.

Objectives : This study analyzed the trends of patient costs in 7diagnosis-related groups(DRG) since July 2013 when the government made it mandatory for all hospitals and clinics. Methods : Data were collected from the 7DRG score chart published by the Ministry of Health and Welfare(MoHW) from July 2013 to January 2017. The average value of the weekday relative value scale was multiplied by unit price, referred to as‘- “patient costs by disease group”-’ and they were analyzed by time series. Results : Patient costs had increased among all patients with a comprehensive disease. Small and medium-sized hospitals (hospitals and clinics) showed a slight increase in patient costs. Conclusions : Enforcement of the Korean diagnosis-related groups has led to management crisis in small and medium-sized hospitals and deterioration medical service quality. To solve this problem, The weekday relative value scale of small and medium-sized hospitals should be increased significantly.

Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

Objectives : The purpose of this study was to identify the prevalence of malnutrition and to explore its association with socioeconomic and social support factors among Korean elderly in the community. Methods : The study sample was a weighted population of 10,160 elderly who participated in the 2014 Korean Elderly Living Conditions and Welfare Survey. Multiple logistic regression analyses were performed to assess the association socioeconomic and social support factors have with malnutrition. Results : Of the Korean elderly 18.6% were at risk of malnutrition. Being uneducated (OR=1.40) and having a lower household income (OR=1.97) were significantly associated with malnutrition even after adjusting for other socio-demographic and health-related covariates. Elderly who lived alone (OR=1.86) and who had poor relationships with their children (OR=1.97) were at much higher risk of malnutrition than their counterparts. Their having poor relationships with acquaintances and poor social participation were also associated with malnutrition. Conclusions : Socioeconomic and social support resources are important factors in the nutritional status of the elderly.

Objectives : This study was a methodological study to verify the validity and reliability of the translated and modified Older Patients in Acute Care Survey-US (OPACS) tool, which was originally developed by Dikken and his colleagues. Methods : The OPACS was translated into Korean, and the content validity, composition validity, and reliability were verified using 348 nurses working for hospitals with over 200 beds and located in C city, B city, and K province. Results : The analysis showed that the Korean version of the OPACS had of eleven questions in the practice experience section and twelve in the general opinion section for older patients in the acute phase. Cronbach’s αs were 0.84 for practice experience and 0.81 for general opinion. Conclusions : The study showed that the OPACS could measure the practice and opinion of Korean nurses who cared for elderly patients in the acute phase. The significance of the study was that it provided baseline data information regarding the performance and opinion of these nurses for nursing managers to improve the nursing environment.

Objectives : The purpose of this study was to investigate the effects of gambling environment factors (being around gambling, gambling ad access) and irrational gambling belief on the gambling behaviors of college students who experienced sports gambling. Methods : Study participants were 240 college students with sports gambling experience. Data were collected through self-report questionnaires and analyzed with SPSS 18.0. Results : Being around gambling and sports gambling ad access have a statistically significant effect on irrational gambling beliefs, which have statistically significant statistical effects on gambling addiction. Self-regulation did not show statistically significant regulatory effects between irrational gambling beliefs and gambling addiction. Conclusions : It is necessary to take a proactive approach to minimize the negative effects of sports betting and to be aware of the rapidly changing sports gambling environment factors.

Objectives : To determine the relationship between of subjective recognition of social class and mental health. Method: The participants were adults with mental health experience over the age of 20 from the Korea Health Panel in 2013 (n=5,126). Methods : Data were analyzed using SPSS Statistics 22.0 The chi-square test and logistic regression analysis used to verify the relationship between subjective recognition of social class and mental health. Results : Lower subjective recognition of social class was associated with experience of depression and suicidal ideation. Other factors associated with depression experience were subjective health status, gender, age, marital status, type of medical care, disability, subjective health status, current smoking and frequency of drinking. Experience of suicidal ideation was, by contrast, associated with subjective health status, age, marital status, economic activity, private insurance, subjective health status and frequency of drinking. Conclusions : Health policies and institutions must be established to optimize health and preventive medicine approaches, especially or mental health as well as the provision of services.

Objectives : To review a Tanzanian medical engineering education program and determine improvement measures for the Official Development Assistance (ODA) healthcare projects. Methods : A consultation of the Tanzanian medical engineering education program funded by the National Research Foundation of Korea (NRFK) was reviewed. An on site survey, an environmental analysis, and in-depth interviews were performed. Results : Survey results highlighted a lack of medical device education and the low operating rate of medical equipment. The need to establish educational program was thus confirmed. The expansion of healthcare facilities appeared to be limited within the current medical management system. A master coursework plan for Tanzania medical engineering was developed. Conclusions : The needs of medical engineering education were recognized. A plan and curriculum were developed. The medical engineering education program should be planned and budgeted prior to the ODA healthcare program.