우리나라 3차진료기관의 구조적인 특성과 병원사망률의 관계

손태용,유승흠,Sohn, Tae-Yong,Yu, Seung-Hum 대한예방의학회 1996 예방의학회지 Vol.29 No.2

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

병원직원의 노동조합몰입에 영향을 미치는 결정요인분석

손태용 ( Tae Yong Sohn ) 한국병원경영학회 2007 병원경영학회지 Vol.12 No.1

The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of general hospital organization management. The subjects of this study were 428 employees in 8 Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from November 10 to November 30, 2006 through survey questionnaires. The main results of this study were as follows: 1. The commitment level of the subjects according to their characteristics was higher in older employees than the younger ones, large family to support than small family to support and those who had higher positions in labor union. 2. The commitment level of the subjects according to the Job and role related variables were higher those who had higher satisfaction level to their job, role conflict in all hospitals. 3. The commitment level of the subjects according to union related variables, variables jointly controlled by union and employer was statistically significant positive correlation. 4. The results of multiple regression analysis shows that formal and informal socialization, satisfaction with the labor union`s were all found as important antecedents of labor union commitment. 5. The results of AMOS shows that structure characteristics of hospital, Job and manager satisfaction, socialization were statistically significant labor union satisfaction. The satisfaction level of labor union was statistically significant labor union commitment. To summarize study results, the level of commitment in labor union depends on job satisfaction, managers` attitudes, union satisfaction factors, their colleagues attitudes toward union. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as formal and informal socialization is important determinant in union commitment, hospital managers should have countermeasures to enhance the colleague attitude and job satisfaction level of hospital employees. Moreover, as managerial factors of the principal of hospital influence union commitment directly, the attitudes of hospital managers toward union and transparency of hospital management should be improved.

대학병원과 종합병원 직원의 부서간 갈등수준 비교분석

손태용(Tae Yong Sohn) 한국병원경영학회 2000 병원경영학회지 Vol.5 No.1

The purpose of this study is to promote the efficiency of the management of the controls organization in the university hospitals and general hospitals by evaluating the factors underlying organizational conflict. The subject population included 351 hospital workers randomly selected from two general hospitals of less than 200 beds and two university hospitals over 500 beds in Seoul area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors between the departments. The results are as follows : 1. Those in high job position group demonstrated significantly higher level of conflict between departments. Those working in the general hospitals, who were older and had long-term tenure at current working hospital had higher level of conflict between the departments. 2. Concerning the involvement of conflicting factor and the level of conflict in the employees` there was statistically significant positive correlation between reliability and job-related and intradepartmental level of conflict in university hospitals. There was a significant positive correlation between interdepartmental conflicting factors of mutual dependence, difference in goal/orientation and interdepartmental level of conflict. 3. In the university hospitals, among the interdepartmental factors, mutual dependence and difference in goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals, job position was a significant factor which sowed that those in high position such as section chief or above, compared to those in general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in medical are department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess. In the university hospitals setting efforts to reexaminitation of the organizational structure and efficiency conveyance of information and efforts to resolve conflict among young workers with lower level of education is need. This study has its own merit in comparing empirically the conflict among hospitals workers in the university hospitals and general hospitals. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

병원 종합 물류시스템 운영에 대한 관련직원들의 인식

이광용 ( Kwang Yong Lee ),유승흠 ( Seoung Hum Yu ),손태용 ( Tae Yong Sohn ) 한국병원경영학회 1999 병원경영학회지 Vol.4 No.2

The purpose of this study is to identify influencing factors for successful introduction, implementation and management of HMRPS through assessment of the employees attitude toward HMRPS in technical, administrative, and organization behavioral areas. Data were collected from 157 HMRPS employee members' self-reporting questionnaire in three university hospitals in the city of Seoul and Kyonggi Province from November 5 to November 10, 1997. Relevant literature on industry company MPR system theory was reviewed to develop the theoretical framework. The results were as follows : The employee's recognition of tangible benefit were more significantly influenced success than intangible benefit for successful operation relating the HMRPS. Concerning the employee's recognition of the successful HMRPS and the factor of influenced success was significantly positive correlation between tangible and intangible benefits and success factor in technical, administrative, and organizational behavior area. This study showed that major factor affecting the employee's recognition of tangible and intangible benefit for successful HMRPS. For tangible benefits : Success factors in the technical areas were quality of the data and information, efficiency of inventory management and rescheduling of operation plan. Success factors in the administrative areas were : role of top management. Success factors in the organization behavioral areas were ; simplicity of the HMRPS, human resistance to change. For intangible benefits : Success factors in the organization behavioral areas were ; user involvement, simplicity of HMRPS, human resistance to change. Furthermore as the exact evaluation of successful factors of HMRPS implement is needed, research for the development of systemic variables of physical distribution system control, methods, capacity of system, duration and other environment in many of 30 hospitals or more, and for the empirical study for HMRPS.

의과대학 졸업 10년 후 활동의사의 출신대학별 근무지역과 지역별 출신대학 분포

유승흠,손태용,오현주,Yu, Seung-Hum,Sohn, Tae-Yong,Oh, Hyohn-Joo 대한예방의학회 1996 Journal of Preventive Medicine and Public Health Vol.29 No.3

The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.

입,퇴원 수속창구 중앙화와 분산화에 따른 이용자의 만족도와 재이용 의사

함태훈 ( Tae Hoon Ham ),이경우 ( Kyung Woo Lee ),손태용 ( Tae Yong Sohn ),유승흠 ( Seung Hum Yu ) 한국병원경영학회 2009 병원경영학회지 Vol.14 No.4

The purpose of this study is to design strategic hospital service based on each hospital`s features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

백내장 환자의 병원선택기준에 관한 연구 -서울시내 안과전문병원과 대학병원을 중심으로-

김용란 ( Yong Ran Kim ),하호욱 ( Ho Wook Ha ),손태용 ( Tae Yong Sohn ) 한국병원경영학회 2000 병원경영학회지 Vol.5 No.2

병원 구성원들의 직종별 조직몰입의 영향요인에 관한 연구

방용주 ( Yong Joo Bang ),하호욱 ( Ho Wook Ha ),손태용 ( Tae Yong Sohn ) 한국병원경영학회 2002 병원경영학회지 Vol.7 No.4

The purpose of this study was to analyze the characteristics of socio-demographic, organizational culture, organizational conflict and organizational commitment, and to examine the interrelation of influential factors in the organizational commitment. The data for this study were collected through a self-administrated survey with a structured questionnaire to 1,027 subjects from several medical doctor staff members, nursing staff members, administration staff members, pharmacist, and technical expert of eleven hospitals. The data were collected by self-reporting questionnaire from July 29 to September 7, 2002. In this analysis frequency test, t-test, ANOVA, multiple regression were used. The main results of this research is as following; 1. According to socio-demographic characteristics the respondents` level of the organizational commitment was higher in a administration staff members than others, for males than females, and for employees aged more than forty, as working for longer time, and as higher level of the working position. 2. According to the organizational culture characteristics the progressive culture, affiliative culture, and task-focused culture among many types of organizational culture were moderately and positively correlated with the level of the organizational commitment while the hierarchical culture was negatively correlated. 3. According to the organizational conflict characteristics as the respondents who got less conflict experience in the organization, their level of the organizational commitment was higher. And, technical conflict experiences were expressed greater than herarchical confhct experiences. 4. According to the job satisfaction Characteristics as his or her satisfaction that is about the promotion, working itself, salary, and fellowship in the organizational was higher, the level of the organizational commitment was higher. The most important factor of the satisfactions was the fellowship among the respondents while the level of job satisfaction for the promotion and salary was average. 5. Overall, according to the result of Multiple Regression as older age and longer working hours, the level of the organizational commitment was higher and as a higher level of the satisfaction for the promotion, working itself, salary, and fellowship in the organization, it caused more effective factors for the organizational commitment. 6. According to the result of Multiple Regression for the doctor staff members in special hospitals rather than general hospitals the hierarchical culture and task focused culture was positively correlated with the satisfaction of working itself while hierarchical conflict factors in the organizational conflict characteristics was negatively correlated with the organizational commitment. For the nursing staff members the affiliative culture and the job satisfaction for the promotion, working itself, salary, and fellowship were positively correlated with the organizational commitment. For the administration staff members as the job satisfaction for the fellowship was positively correlated with the organizational commitment. For medical and pharmacy staff members as more working experience, correlation with the organizational commitment was positive. Besides, as he or she has a high perception of the affiliative culture, it caused statistically more effective factors for the organizational commitment. For the slull and technicians, male worker expressed greater organizational commitment in the organization than female worker. And also older age along with higher education also showed higher organizational commitment. Moreover, the job satisfaction for the fellowship was positively correlated with the organizational commitment. This study identified the major effective factors of the organizational commitment and analyzed the differences among the job category. In that respect, it is significant for the study to be able to provide a reference for managing hospital

기준병상수와 상급병상수의 적정규모에 관한 연구

백승준,유승흠,손태용,Back, Seung-Joon,Yu, Seung-Hum,Sohn, Tae-Yong 한국병원경영학회 2001 병원경영학회지 Vol.25 No.3

The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

농약사용과 암발생과의 관계

설재웅,이상욱,손태용,지선하,남정모,오희철,Sull, Jae-Woong,Yi, Sang-Wook,Sohn, Tae-Yong,Jee, Sun-Ha,Nam, Chung-Mo,Ohrr, Hee-Chul 대한예방의학회 2002 예방의학회지 Vol.35 No.1

Objective : Few studies have examined the relationship between the risk of cancer and exposure to pesticides in Korea or in other East Asian that have until recently used chlorophenoxy herbicides. The aim of this study was to evaluate the relationship between the exposure to pesticides and cancer incidence. Methods : We conducted a prospective cohort study with a follow-up period of 13 years (1985-1998). The subjects included 2,687 male and 3,589 female Kangwha Island residents, Koreans aged fifty-five or more as of March 1985, who received a personal health interview and completed a health examination survey. A Cox proportional hazards models were used to estimate relative risks(RR). Results : At baseline, the mean age of the study participants in 1985 was 66.4 for males and 67.1 for females. During the 13 years follow-up, a total of 300 incidents of cancer in males and 140 in females developed. In males, the total cancer incidence in the highest group was RR, 1.4 (95%. CI=1.0-1.9), p for trend=0.041, for digestive organ cancer Incidence in the highest group, RR, 1.5 (95% CI=1.0-2.3), p for trend=0.057, for stomach cancer, incidence in the highest group, RR, 1.6 (95% CI=0.9-2.8), p for trend=0.094, for gallbladder cancer incidence in the highest group, RR, 9.1 (95% CI=1.1-77.0), p for trend=0.014 were elevated according to the higher frequency of pesticide use per year. In particular, the risk of gallbladder cancer was very high. Although not significant, the risk of liver cancer was higher than in the non-exposed group (in the highest group, RR, 2.0(95% CI=0.7-5.9)). In females, although not significant, breast cancer incidence in the highest exposure group was higher than in the non-exposed group (in the highest group, RR, 4.7 (95% CI=0.5-27.9)). Conclusions : This study demonstrates that Korean farmers who use pesticides, particularly males, have a significantly higher total cancer incidence, particularly from digestive organ cancers such as, stomach, gallbladder, and liver cancer. In particular, the risk of gallbladder cancer was very high.