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한국병원경영학회> 한국병원경영학회지> Kano모델과 Timko 모델을 이용한 의료소비자의 병원선택요인에 관한 연구

KCI등재

Kano모델과 Timko 모델을 이용한 의료소비자의 병원선택요인에 관한 연구

A Study on Medical Consumers ’ Hospital Selection Factors Using Kano Model and Timko Model

김수정 ( Sujung Kim ) , 김준용 ( Junyong Kim ) , 김준배 ( Junbae Kim )
  • : 한국병원경영학회
  • : 한국병원경영학회지 23권4호
  • : 연속간행물
  • : 2018년 12월
  • : 40-52(13pages)
한국병원경영학회지

DOI


목차

Ⅰ. 서론
Ⅱ. 이론적 배경
Ⅲ. 연구 방법
Ⅳ. 연구 결과
Ⅴ. 고찰 및 결론
참고문헌

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초록 보기

The purpose of this study is to identify medical consumers’ hospital selection factors in response to the rapidly changing environment of medical industry. For that purpose this study classified consumers’ hospital selection factors into three categories such that human factors including expertise, reliability, empathy; system factor including, convenience, differentiation, efficiency; and facility factor including tangibility, accessibility, and location, based on the previous studies and the results of a preliminary survey of the patients of a small private hospital. The nine factors were further divided into 23 more specific attributes. Then, an online survey was conducted to measure the perceptions of the 23 attributes by the medical consumers over the age of 20.
The analysis of the survey data using Kano model and Timko model indicated that 14 of the 23 attributes were classified as attractive factors, eight attributes were or classified as, one-dimensional factors, and one attribute, doctors’ educational background, was classified as indifference factor. Of the 14 attractive factors, “unique and differentiated services related to medical treatment” and “distance from home to hospital” had the highest customer satisfaction coefficients. Of the eight one-dimensional factors, “kind treatment,” “providing adequate explanations,” “accuracy of diagnosis, ” and “cleanness of facilities” had the highest customer satisfaction coefficients as well as the highest dissatisfaction coefficients. The findings indicate that these six attributes are the most basic and most impactful attributes that hospitals must manage strategically to improve their service quality and attract more medical consumers to their hospitals.

UCI(KEPA)

I410-ECN-0102-2019-300-001124829

간행물정보

  • : 사회과학분야  > 경영학
  • : KCI등재
  • :
  • : 계간
  • : 1226-6299
  • :
  • : 학술지
  • : 연속간행물
  • : 1996-2022
  • : 651


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저자 : 전희원 ( Huiwon Jeon ) , 홍민정 ( Minjung Hong ) , 정재연 ( Jaeyeon Jeong ) , 김예순 ( Yesoon Kim ) , 이창우 ( Changwoo Lee ) , 이해종 ( Haejong Lee ) , 신의철 ( Eulchul Shin )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 1-10 (10 pages)

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Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program.
Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant.
Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

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2의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인

저자 : 김지은 ( Ji Eun Kim ) , 함명일 ( Myung-il Hahm ) , 이혜원 ( Hyewon Lee ) , 김선정 ( Sun Jung Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 11-19 (9 pages)

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Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision.
Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA).
Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination.
Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

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3가감지급사업 실행 후 급성기 출혈성 뇌졸중의 원내 사망률 변화 분석

저자 : 설진주 ( Jin-ju Seol ) , 유기봉 ( Ki-bong Yoo ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 20-30 (11 pages)

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Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke.
Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data.
Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful.
Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

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4노인 환자 및 보호자에 의한 입원서비스 결정 여부가 재원일수와 진료비에 미치는 영향

저자 : 손예리 ( Yehrhee Son ) , 김규나 ( Kyuna Kim ) , 서영준 ( Youngjoon Seo )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 31-42 (12 pages)

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Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family.
Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis.
Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense.
Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family.

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5회피가능한 사망에 미치는 지역 영향요인 분석: 2010~2019

저자 : 이현지 ( Hyun-ji Lee ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 27권 1호 발행 연도 : 2022 페이지 : pp. 43-57 (15 pages)

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Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region.
Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate.
Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect.
Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

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발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 1-14 (14 pages)

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Purpose : Customers with loyalty are very important to hospitals for sustainable growth in their medical market. Individuals with loyalty are likely to visit same hospital repeatedly when they need medical services. This study was to identify factors associated with selection of specialty hospitals among customers with loyalty.
Methods : The subjects of this study were 735 inpatients in 22 specialty hospitals in 6 designated fields(joints, spine, colorectal-anal, obstetrics and gynecology, ophthalmology, otolaryngology). Customer types classified as customers with high loyalty, neutral customers, and customers with low loyalty according to net promoter score(NPS). Factor analysis was conducted to classify 22 hospital selection factors into some similar properties. Logistic regression analysis was conducted to confirm the selection factors related to loyal customers.
Findings : Most of specialty hospitals received high NPS of 8 points or higher in all the designated fields. Five factors associated with selection of specialty hospital are (1) hospital facilities and convenience, (2) trust in doctor and hospital, (3) rapidness of treatment, (4) hospital awareness, and (5) accessibility. As a result of logistic regression analysis, selection factors related to loyal customers were 'hospital facilities and convenience', 'trust in doctor and hospital' and 'rapidness of treatment'. Differences in the degree of importance of three selection factors by customer types appeared for each designated field.
Practical Implications : This study confirms the high level of patient experience among inpatients of specialty hospitals. Factors associated with selection of hospital among inpatients with loyalty are 'facilities and convenience of hospitals', 'trust of doctor and hospital' and 'rapidness of treatment'. This study will be meaningful as basic data to systematically enhance the roles and functions of the health care system and to provide securing competitiveness according to designated fields in the management aspect of specialty hospitals.

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2치료재료 별도산정 기준 개선을 위한 델파이 및 계층분석과정 조사

저자 : 노진원 ( Jin-won Noh ) , 이예진 ( Yejin Lee ) , 장석용 ( Suk Yong Jang ) , 김미경 ( Mi Kyung Kim ) , 조경희 ( Kyoung Hee Cho ) , 김재현 ( Jae-hyun Kim ) , 유기봉 ( Ki-bong Yoo )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 15-25 (11 pages)

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Purposes: The objectives of this study present the direction of the criteria for the separately reimbursement of therapeutic medical device.
Methodology: We summarized expertsʼ opinion using Delphi survey and Analytic Hierarchy Process(AHP). 48 experts were gathered from Medical Insurance Review Nurses Association, medical device industry, academy and association, Medical Device Expert Evaluation Committee. Descriptive statistics, consistency index, content validity ratio were analyzed.
Findings: Clinical utility, patient safety, infection control, cost-homogeneity, cost-effectiveness showed high feasibility and importance, but market contribution and functional utility showed low feasibility and importance in a relative sense. The results of functional utility differed between clinical and non-clinical experts. Measurability was low across the whole area. Among the criteria for the separately reimbursement of therapeutic medical device. Patient safety/infection control and clinical utility showed the highest relative importance values, analyzed using AHP.
Practical Implications: Patient safety and infection control are needed to be considered as one of Value Assessment Criteria. It is important to find out how to improve the measurability of therapeutic medical device.

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저자 : 황상원 ( Sang Won Hwang )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 26-39 (14 pages)

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Purposes: The purpose of this study is to analyze the issue of interest in patient medical service of small and medium hospitals using big data.
Methods: The method of this study was implemented by data mining and social network using SNS big data. The analysis tool were extracted key keywords and analyzed correlation by using Textom, Ucinet6 and NetDraw program.
Findings: In the results of frequency, the network-centered and closeness centrality analysis, It was shown that the government center is interested in the major explanations and evaluations of the technology, information, security, safety, cost and problems of small and medium hospitals, coping with infections, and actual involvement in bank settlement. And, were extracted care for disabilities such as pediatrics, dentistry, obstetrics and gynecology, dementia, nursing, the elderly, and rehabilitation.
Practical Implications: Future studies will be more useful if analyzed the needs of customers for medical services in the metropolitan area and provinces may be different in the small and medium hospitals to be studied, further classification studies.

KCI등재

4Kano모델과 Timko 모델을 이용한 의료소비자의 병원선택요인에 관한 연구

저자 : 김수정 ( Sujung Kim ) , 김준용 ( Junyong Kim ) , 김준배 ( Junbae Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 40-52 (13 pages)

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The purpose of this study is to identify medical consumers' hospital selection factors in response to the rapidly changing environment of medical industry. For that purpose this study classified consumers' hospital selection factors into three categories such that human factors including expertise, reliability, empathy; system factor including, convenience, differentiation, efficiency; and facility factor including tangibility, accessibility, and location, based on the previous studies and the results of a preliminary survey of the patients of a small private hospital. The nine factors were further divided into 23 more specific attributes. Then, an online survey was conducted to measure the perceptions of the 23 attributes by the medical consumers over the age of 20.
The analysis of the survey data using Kano model and Timko model indicated that 14 of the 23 attributes were classified as attractive factors, eight attributes were or classified as, one-dimensional factors, and one attribute, doctors' educational background, was classified as indifference factor. Of the 14 attractive factors, “unique and differentiated services related to medical treatment” and “distance from home to hospital” had the highest customer satisfaction coefficients. Of the eight one-dimensional factors, “kind treatment,” “providing adequate explanations,” “accuracy of diagnosis, ” and “cleanness of facilities” had the highest customer satisfaction coefficients as well as the highest dissatisfaction coefficients. The findings indicate that these six attributes are the most basic and most impactful attributes that hospitals must manage strategically to improve their service quality and attract more medical consumers to their hospitals.

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5듀퐁 분석을 통한 한국 병원계의 경영 현황 분석

저자 : 노진원 ( Jin-won Noh ) , 이해종 ( Haejong Lee ) , 차선정 ( Sunjung Cha ) , 이예진 ( Yejin Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 53-64 (12 pages)

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Purposes: The hospitals needs to generate a minimum profit, in order to perform its own role such as providing high-quality medical services. The demand for hospital management is increasing, as the social demands are diversified and the financial transparency is emphasized. The purpose of this study is to compare hospitals management based on Dupont Identity, by various hospital classification.
Methodology: This study is based on '2016 Statistics for Hospital Management' provided by the Korea Health Industry Development Institute. The hospitals were classified according to the scope of care, the type of establishment, the location, and the number of beds. We analyzed the general and financial characteristics of over 337 hospitals using the method of Dupont Identity.
Findings: Net profit margin (PM) has the biggest impact on return of equity (ROE). By the number of beds, general hospital with 160-299 beds have the highest return on equity (ROE). By location, hospitals in local municipalities have higher return on equity than hospitals in urban municipalities. According to the type of establishment, public hospitals have lower business performance, and although they invest more than private hospitals.
Practical Implications: This study can inspire interest and provide understanding in hospital management and financial structure, by analyzing through an intuitive indicator named Dupont identity. It is possible to provide basic data for hospital management methods for each financial elements, in order to increase the profitability of hospitals.

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Purposes: The purpose of this study was to analyze the relationship between empowerment, job satisfaction and organizational commitment of the general hospital administrative staff working for customer interaction department.
Methodology: For this purpose, this study sampled 260 administrative staff working for the general hospitals in Seoul and Gyeonggi-do. A total of 260 questionnaires were distributed to them, and 229 ones responded to the survey, which had been conducted from Mar. 9, through Mar. 30, 2018. 211 responses were used for the final analysis. The data collected were processed using the SPSS 18.0K for descriptive statistics, T-test, ANOVA and regression analysis.
Findings: The results of this study can be summed up as follows. The empowerment of the subjects scored 3.73 on average on the 5-point scale. To be specific, the sub-factor 'meaning' scored the highest or 4.01, while the sub-factor 'impact' was lowest. Subjects' job satisfaction scored 3.37 and their organizational commitment scored 3.54 both on the 5-point scales.
Practical Implications: Meaning and self determination of empowerment positively related to subjects' job satisfaction and organizational commitment, and particularly, meaning of empowerment was more strongly related. Hence, it is required of the general hospitals to operate a customized competence build-up program and educational courses on a continual basis. Besides, it would also be important to create a working environment wherein the administrative staff can demonstrate their deliberation, autonomy and independent services.

KCI등재

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저자 : 이진용 ( Jin Yong Lee ) , 김현주 ( Hyun Joo Kim ) , 은상준 ( Sang Jun Eun )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 23권 4호 발행 연도 : 2018 페이지 : pp. 81-86 (6 pages)

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Purposes: The purpose of this study is to argue that the taxation system for non-for-profit medical institution in Korea should be revised and that the basic direction should be to expand tax exemption like the US.
Methods: We analyzed the US context of taxation policy for non-for-profit medical institutions and compared the US and Korean situation.
Findings: In the United States, for-profit or non-for-profit medical institutions eternities are the most important criteria for hospital classification. Basically, full tax-exemption has been applied for non-for-profit medical institutions. The reason why many hospitals maintain their status as non-for-profit are following. First, the American society places great importance on the social responsibility and role of non-for-profit hospitals. Second, maintaining the status of non-for profit medical institutions is financially beneficial while maintaining good social reputation. The most powerful financial incentives are tax deductions and tax deductions for donations.
Practical Implications: How will the taxation system for medical institutions in Korea be reformed in the future? First, if Korean government do not allow for-profit medical institutions, Korean government should consider implementing a full tax exemption system suitable for non-profit medical institutions like the US. Second, there are many variation in taxation for non-for-profit medical institution according to their legal positions. Therefore, current taxation system should be revised. Third, the reorganization of such taxation system should be in a direction that can finally encourage community benefit activities of medical institutions of nonprofit hospitals.

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