노인케어시설의 정책개발을 위한 국제비교연구

김기훈 ( Key Hoon Kim ) 한국보건행정학회 1998 보건행정학회지 Vol.8 No.1

종합전문요양기관에 입원한 뇌졸중환자의 진료비 분석

김기훈 ( Key Hoon Kim ),박재용 ( Jae Yong Park ),한창현 ( Chang Hyun Han ) 한국병원경영학회 2009 병원경영학회지 Vol.14 No.4

This study was conducted to present strategies for efficient use of older people`s medical expense and efficient management of hospital beds 삭제by analyzing factors which influenced medical charge of inpatients with stroke and medical charge of each medical treatment. The subjects was 1,070 inpatients with stroke in Academic hospital. The result of this study can be summarized as follows. In the case of cerebral hemorrhage, the rate of female was higher than that of male. In the case of cerebral infarction, the rate of male was higher than that of female. With increase of age, patients with cerebral hemorrhage decreased and patients with cerebral infarction increased. Medical charge for cerebral hemorrhage was 12,600,000 won, while that for cerebral infarction was 572,000 won. The medical charge with surgery was four times of that with non-surgery. The total medical charge for inpatients with stroke was 6,860,000 won. The patient payed 2,240,000 won(32.6%) and National Health Insurance Corporation payed 4,620,000 won(67.3%). Among charges of specific medical treatments, operation and treatment charge was highest(27.7%) in the case of cerebral hemorrhage, while examination charge was highest(32.2%)in the case of cerebral infarction. This study will provide basic information for efficient use of Medical Charge for Inpatients with Stroke.

재원일별 진료비 발생양상과 재원일수의 결정요인

김영훈 ( Young Hoon Kim ),문재우 ( Jae Woo Moon ),김기훈 ( Key Hoon Kim ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.2

Stroke is a high-risk disease. The future of the medical environment is that the proportion of elderly population is increasing, the average life expectancy is being increased, while the fatal rate of stroke will be low. These situation will due to the financial burden on medical insurance. The most important factor that affects on the medical costs of stroke patients is the length of stay. In this study the mean length of hospital for stroke stay was 21.81days(37.97days for intracerebral hemorrhage, 18.89 days for cerebral infarction). The payment per case of stroke was 6.86 million won(12.6 million won for intracerebral hemorrhage, 5.72 million won for cerebral infarction). The payment per case of intracerebral hemorrhage was 2.2 times more than that of cerebral infarction. The payment in the day of hospitalization was the highest and until the second day medical costs was high. After the third day medical costs tended to decline, after that seemed to show an almost constant level. The length of hospital stay was found to be the most important determinant of inpatient charges for stroke. Accordingly rational management of the length of stay will be beneficial to health care consumers, providers, states.

사례연구 : 병원의 아웃소싱과 조직유효성의 관계에 관한 연구

김영훈 ( Young Hoon Kim ),오수진 ( Su Jin Oh ),김한성 ( Han Sung Kim ),김기훈 ( Key Hoon Kim ),김효정 ( Hyo Jeong Kim ) 한국병원경영학회 2013 병원경영학회지 Vol.18 No.3

The purpose of this study is to make managerial information regarding outsourcing more concrete by identifying and evaluating how outsourcing as an useful strategic tool for hospitals influences organizational effectiveness. The survey was performed to 311 general hospitals and tertiary hospitals, and 63 questionnaires were recovered and analyzed. As the result of measuring organizational effectiveness after introduction of outsourcing, non-financial performance(3.34) was higher than financial performance(3.25) and satisfaction(3.08). According to the characteristics of organizational structure, financial performance showed statistically significant difference when categorizing the hospitals. It was higher in the general hospitals than in the tertiary hospitals. In addition, the hospitals that outsource the logistic and patient affairs parts have higher financial performances than non-financial ones. Especially, there was statistically significant difference depending on the sub-parts of the logistics, which means the hospitals outsourcing the logistic part have higher financial performance than the hospitals without outsourcing the logistics.

Gini 계수와 Lorenz 곡선에 의한 지역별 병상분포 양상 분석

안병기 ( Byeung Ki An ),박재용 ( Key Hoon Kim ),김기훈 ( Jae Yong Park ) 한국병원경영학회 2011 병원경영학회지 Vol.16 No.3

In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.

사례연구 : DACUM 법에 의한 병원행정사 직무분석

유형식 ( Hyeong Sik Yoo ),김영훈 ( Young Hoon Kim ),김기훈 ( Key Hoon Kim ) 한국병원경영학회 2011 병원경영학회지 Vol.16 No.1

The purpose of this study was to analyze of hospital administrator based on the DACUM(Developing A Curriculum) method. The contents of this study were to extract the duties, tasks consisting of job of hospital administrator and to investigate levels of importance, difficulty, frequency and entry level on each task, and to make out a job model of hospital administrator. A DACUM committee was composed to analyze job of hospital administrator and the committee members were total 9, a facilitator, 7 hospital administrator and a recorder. The major findings of this study were as the followings; first, duties in job of hospital administrator were total 13, which were organization of hospital administration affairs, health insurance review & assessment, general affairs, personnel management, hospital planning & management, medical quality improvement, hospital financial affairs, logistics management, facilities management, computerized system management, education & study supports, medical consultation cooperation, public relations . And total tasks in job of hospital administrator were 97. Second, the tasks which were important, difficult, frequent and essential in entry step of occupation were receiving medical fees , managing inpatient & outpatient, reviewing & assessmenting medical fees, charging for medical service, labor-management relations, managing hospital accounts, settling hospital accounts, purchasing logistics, managing logistics, managing hospital information system, managing hospital database. Third, a job model of hospital administrator was constructed based on the results of DACUM job analysis.

병원 간호등급에 따른 간호수행 정도

윤순길 ( Soon Gil Yun ),박재용 ( Jae Yong Park ),김기훈 ( Key Hoon Kim ),한창현 ( Chang Hyun Han ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.3

As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses` awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses` performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses` awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses` job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.

직무분석을 통한 병원관리분야의 교육과정 모형 개발

김기훈,유형식 慶北專門大學 2003 慶北專門大學 論文集 Vol.22 No.-

The purpose of this study is to design curriculum model in hospital management. To accomplish this purpose in this study, the job analysis of Y Hospital and investigation of qualifications related health administration have done. Major findings of the study were summarized as follows : 1. Design of curriculum must be included the division of hospital administration, medical record management, health information and basic medicine. 2. Design of curriculum must be considered the outcome of job analysis and items related qualifications at the same time. 3. Design of curriculum must reflected the need of related industry.

영주시 지역의료보험조합 가입자의 의료이용행태 및 진료비 분석

김기훈,유형식,최만규 慶北專門大學 1998 慶北專門大學 論文集 Vol.17 No.-

In order to identify the medical care utilization rate of other health service district of the insureds, Young-ju City's the Regional Medical insurance data were used for analyzing major variables. The results of analysis are as follows : Of the medical care utilization rates, inpatient rate by age was the highest at the age group between 20 and 30, and outpatient rate for dental treatment was significantly high at the age group between 10(16.6%) and 20(14.2%) among all age groups. Also the higher age group showed higher avarge medical cost per case, especially in case of population above 50. In the comparison of care utilization rate by medical institute, impatient rate indicated 15.9% in a general hospital, 7% in a hospital and a dental hospital. This study revealed that there was meaningful difference in the utilization rate among health service districts. The utilization rate was very high in Taegu·Kyungpook in case of a outpatient rate(98.7%), and was more or less high in Seoul in case of a inpatient rate(10.8%).

綜合病院의 經營成果 測定을 爲한 模型開發

金基勳 경북전문대학교 1990 慶北專門大學 論文集 Vol.9 No.-

It is important to understand management status and to measure the management performance for improving hospital management. For the purpose of achieving these gols, there is a need to have sufficient data, Specialist with expertise as well as much time and endeavors. For meeting these limitations, I found that it is necessary to develop a simple model to forecast comprehensively present management status and future management performances. This study is conducted to develop a simple model for measuring management performances in order that we can use it is supporting decision makers to establish management policy as the means of decision-making. For the objective of this study, collected the information on financial management of 25 sample hospital among all hospitals with 250-300 beds. These collected data were analyzed by multiple regression using SPSS program package. The results of the analysis, the measuring model of hospital management performance, were as follows : Y=-40.316+0.1602X_(1)-0.0004X_(2)+0.3122X_(3)+0.2704X_(4)-0.0390X_(5)+0.2121X_(6)+0.1083X_(7) Y:Returns rate X_(1):Rate of adjusted auerage daily census per bed X_(2):Material cost of adjusted average daily census per capita X_(3):Additional valne of adjusted averaged daily census per capita X_(4):Turnover rate of uncellected amount X_(5):Dependence rate of others capital X_(6):Turnover rate of stock asset X_(7):Weighted medical benefit