This study examines public hospitals and their performance in order to determine improvement measures for the management of public hospitals so that public medical services can be improved and new medical services created. In this study, public hospitals in Korea and other countries are analyzed regarding their current operation and management, and existing research is also reviewed to develop ways for improving the management efficiency of public hospitals.
Public hospitals are part of the nation’s health welfare system and are either directly run by the government or receive support from the government, and they are operated in the form of governmental intervention in the medical market, with an aim to achieve social equity. Korea’s public hospitals have unclear functions within the nation’s public medical system, with insufficient management and coordination capabilities. Combined with the state-level issues of rigid human resource management and budgeting, public hospitals generally have a number of issues in terms of inefficient management and operation.
The purpose of public hospitals in Korea is to provide general medical services to local residents, and to provide patient care for specific diseases, as well as medical services for low-income individual. Public hospitals account for a significant proportion of the medical system with 8.8 percent of medical institutes and 15.5 percent of beds. However, public hospitals are concentrated in urban areas and operate with small budgets. When compared with public hospitals in the US and Japan, Korean public hospitals lack in terms of the number of institutes, beds, and budget. The national health insurance system ensures financing equity in the public healthcare system, but objectives are not being accomplished because of issues of communication between medical service providers and patients, and lack of skilled medical professionals in rural and coastal areas.
Concerning resource investment, Korean public hospitals are evaluated to be fair in terms of convenience of facilities and the distribution of medical equipment. However, since many hospitals are located in inconvenient areas, hospitals have difficulties in securing medical professionals. Also, there are objectivity issues concerning hospital operation and management because of performance-oriented evaluation of individual staff or union resistance. Moreover, public hospitals tend to have no or mediocre strategic plans or management innovation strategies. The effectiveness of cooperation with other medical institutes is estimated to be very low, and public hospitals don’t have sufficient specialized personnel for information utilization other than in the area of medical care. In regards to business management, public hospitals’ capital increase rates are relatively higher than that of industry and manufacturing, and growth rates of capital turnover ratio and the volume of inpatients and outpatients are maintained at high levels, but the growth rate of equity capital is low. Current safety ratios are maintained at fair levels, and activity and productivity ratios are also showing positive performance.
However, the gap between public hospitals and private medical institutes is significant in terms of performance, such as net profit growth and patient treatment. Public hospitals lag behind in terms of number of outpatients per number of beds, number of hospitalized patients, and number of medical aid beneficiaries treated. Public hospitals fare better in terms of bed utilization rate and average revisit rates and this is because general patients prefer private hospitals and patients are concerned about medical costs.
This analysis indicates that in order to improve management efficiency of public hospitals, first, management innovation strategies and management efficiency improvement strategies should be established according to the objectives of the hospital. Public medical service does have limitations in profit generation, but efficient organizational management is required, such as management by objectives centering on autonomous business management systems, and human resource management based on leadership responsibility. Second, understanding on healthcare and medical services should be improved, considering state responsibility and social efficiency. Medical incentives for vulnerable populations should be expanded. Third, as the medical environment changes, growth strategies must be established and implemented so that public hospitals can compete against private institutes through differentiation and niche strategy.
- 병원폐기물 관리현황과 정책과제(Effective management of public hospitals in Korea)
병원폐기물 관리현황과 정책과제(Effective management of public hospitals in Korea)
서울 : 한국보건사회연구원
|Series Title; No||정책 / 1997-01|
|Subject Country||South Korea(Asia and Pacific)|
|Subject||Social Development < Health|