산재보험 진폐증 장기 입원환자의 의료이용 특성

윤경일,Youn, Kyung-Il 보건의료산업학회 2016 보건의료산업학회지 Vol.10 No.1

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

병원의 서비스개선 우선순위 설정을 위한 IPA 적용

윤경일 ( Youn Kyung Il ) 한국병원경영학회 2009 병원경영학회지 Vol.14 No.2

The importance-performance analysis (IPA) is a widely used analytical technique that produces a priority of managerial attention for the customer satisfaction. This study attempted to compare various different approaches of IPA such as direct and indirect measurement of importance, and traditional four quadrants grid model and diagonal grid model of IPA. Data on 17 inpatient service quality attributes were collected from 234 inpatients of a general hospital. Eight IPA grids were produced to compare the result of each model. Based on the study results the strength and weakness of each model were discussed, and a set of recommendations for practical application of the IPA in hospital settings was suggested.

의약분업 이후 병원 약제부서의 업무내용 및 인력구조 변화 분석

윤경일 ( Kyung Il Youn ),류시원 ( See Won Ryu ) 한국병원경영학회 2002 병원경영학회지 Vol.7 No.2

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

의료서비스 접점직원의 교환관계, 직무태도, 서비스 행동의 구조적 관계

윤경일 ( Youn Kyung-il ),주기중 ( Ju Ki-jung ) 한국고객만족경영학회 2015 고객만족경영연구 Vol.17 No.3

서비스 접점에서 접점직원은 조직을 대표하여 고객과 접촉하기 때문에 이들이 고객을 향한 서비스행동은 고객이 지각하는 서비스 품질 뿐만 아니라 조직의 성과에 까지 영향을 미치게 된다. 본 연구에서는 서비스 접점직원이 관여하게 되는 네 가지 교환관계(조직지원, 상사-부하 교환관계, 고객-직원교환관계, 직무적합성)에 대해 논의하고, 이들 교환변수가 접점직원의 태도와 서비스 행동에 미치는 영향을 구조방정식모형을 통해 실증적으로 검정하였다. 그 결과 조직지원, 고객-직원 교환관계, 직무적합성은 접점직원의 직무만족에 긍정적인 영향을 주고 있으며, 접점직원의 직무만족은 조직몰입에, 조직몰입은 서비스 행동에 긍정적인 영향을 준다는 것을 확인하였다. 본 연구는 지금까지 조직지원, 상사-부하 교환관계 중심으로 연구되어왔던 교환관계를 고객과 직무의 차원으로 확대하였다는 점에서 의의가 있다. 따라서 실무적으로도 고객-직원 교환관계와 직무적합성이 접점직원의 직무만족에 영향을 주어 조직몰입과 서비스 행동으로 이어진다는 점을 고려한 서비스 접점직원의 관리가 필요하다는 것을 시사하고 있다. Since employees in service encounters represent the organization and interact with customers, their service behavior toward customers affects both service quality perceived by customers as well as organizational performance. The purpose of this research is to discuss four exchange relationships (organizational support; leader-member exchange; customer-member exchange; job fitness) involving service encounter employees and to empirically analyze how those four variables influence employees` attitude and their service behaviors. The results show that three of the variables―except leader-member exchange―have positive effects on job satisfaction, organizational commitment, and service behavior. This research contributes to extending previous research focusing on organizational support and leader-member exchange to customer-member exchange and job fitness. Practically, this study suggests that service encounter employees may need to be managed in light of the finding that customer-member exchange and job fitness affect job satisfaction of these employees, which in turn impacts organizational commitment and service behavior.

종합병원 진료과의 구조적 복잡성과 기술적 숙련도가 치료결과에 미치는 영향

윤경일 ( Kyung Il Youn ) 한국보건정보통계학회(구 한국보건통계학회) 2016 보건정보통계학회지 Vol.41 No.2

Objectives: The purpose of this study is to analyze the effects of structural complexity and technical proficiency on treatment outcome of the clinical departments in general hospitals and to verify the conceptual independency of the two variables. Methods: Discharge summary data of 4,528 cerebrovascular diseases patients who underwent surgery during a month period between 2008 and 2011 were analyzed. The analytic model included the independent variables such as surgery volume and number of disease diagnosis in a neurosurgery department. The dependent variables were length of stay and mortality rate. Hierarchical logistic regression and poisson regression model were applied to test the hypothesis. Results: Results showed a high level of complexity departments have a low length of stay and mortality. Also, a high level technical proficiency had a significant negative relationship with the length of stay and mortality rate. In addition, a conceptual independency between the two variables was verified. Conclusions: The studies that intend to analyze surgery volume and mortality rate relationship should consider structural complexity as well as technical proficiency for more rigorous study design.

병원서비스 속성이 환자만족도에 미치는 영향의 비대칭성과 중요도

윤경일(Kyung Il Youn),강인호(In Ho Kang) 한국호텔외식관광경영학회 2009 호텔경영학연구 Vol.18 No.3

The Importance-Performance Analysis (IPA) is a widely used analytical technique that produces a priority of managerial attention for optimizing the customer satisfaction. However, its validity as an analytical tool has been challenged in the perspective of Kano`s three factor theory that argues an asymmetric relationship between service attributes and overall customer satisfaction. The authors investigate the asymmetric nature of the relationship between the concepts in hospital setting. Data on 17 inpatient service quality attributes were collected from 234 inpatients in a general hospital. The data are analyzed using regression analysis adopting dummy variables that classify the sample based on the performance level of each attributes perceived by patients. The results confirm that there exist attributes` asymmetric effects on satisfaction. The results identify the structural factor, work process factor and doctor service as basic factor, nurse service as excitement factor, and administrative service as performance factor. Based on the results this study suggests several items that should be considered in applying the IPA in hospital strategic priority setting.

간호 인력 확보수준 및 구성이 병원 내 사망률에 미치는 영향의 병원 특성별 비교

윤경일 ( Youn Kyung-il ) 한국보건정보통계학회(구 한국보건통계학회) 2017 보건정보통계학회지 Vol.42 No.1

Objectives: The characteristics of nursing workforce is critically important in achieving quality care in a hospital. However, current hospital industry environment does not allow ample investment in human resource. Therefore, hospital management has to come up with effective ways of investment in nursing resources. This study was conducted with the purpose of providing basic information needed for effective nurse staffing decision in hospitals. The impacts of nurse staffing level in terms of quality and quantity on health outcome were analyzed. Methods: Nurse staffing level and in-hospital mortality data of 3,451 hospitals nationwide were analyzed using multiple regression models. Dependent variable of the model was in-hospital mortality and independent variables included number of patient per nurse and percentage of nurse aid in nursing staff. As the control variables, patients characteristics and hospital organizational characteristics were included in the model. Results: Number of patients per nurse and proportion of nurse aides in nursing staff showed significant positive effects on in-hospital mortality. The effects were stronger in the hospital group that had relatively lower nurse staffing level. The positive relationship between staffing level and mortality rate was stronger in the hospitals that had higher severity level. Conclusions: Health policy should focus on improving minimum standard of nurse staffing level. Also, hospitals should lay nursing staff investment priority on the nursing units that serve high severity patients.

성격적 특성과 사회인지적 요인이 병원 근무 간호사의 지식공유행동에 미치는 영향

윤경일 ( Kyung Il Youn ),이원재 ( Won Jae Lee ) 한국병원경영학회 2006 병원경영학회지 Vol.11 No.4

This study investigates the antecedents of knowledge sharing behavior focusing on the individual level factors in an assumption that the behavior is initiated from the individual level decisions. A hypothesis that the relation between personality trait and behavior is mediated by the social-cognitive constructs contained in the Theory of Planned Behavior (TPB) is tested. For the study, we suggest a TPB extended model that extends original TPB model by including conscientiousness facet of FFM(Five Factor Model). This study uses a cross-sectional design. Data were collected from a self-reported survey on 197 nurses in a tertiary hospital. The results showes a significant positive relationship between the conscientiousness facet of FFM and knowledge sharing behavior. In the TPB extended model, the conscientiousness facet has significant direct effects on all the constructs of original TPB model. Of the TPB exogenous constructs, the social norm construct alone has a significant effect on intention and the perceived behavioral has a direct significant effect on the knowledge sharing behavior. These results confirm the importance of conscientiousness in predicting knowledge sharing behavior and clarify the characteristics of knowledge sharing behavior as a contextual, job oriented behavior in a workplace. We conclude that personality trait as conceptualized in the FFM needs to be integrated into TPB model in explaining the knowledge sharing behavior. Based on these results theoretical and practical implications are discussed.

판매사원의 성격적 특성, 동기요인, 고객지향성 및 업무성과 간의 관계

윤경일(Youn, Kyung-il),안봉근(An, Bong-Geun) 계명대학교 산학연구소 2007 經營經濟 Vol.40 No.1

This study analyses the predisposing factors of salesperson’s consumer oriented behavior and its effects on the job performance. As the predisposing factors, we studied the personality traits and motivation factors. For the study, a survey on sales persons was conducted and 227 responses were analysed. Structural Equation Modeling was applied to test the hypotheses. The results indicated that the openness and conscientiousness of personality traits positively affected the level of customer orientation. However, the effect of extraversion traits on customer orientation was not significant. Of the motivational factors, the intrinsic motivation factor positively affected the level of customer orientation. Based on the results theoretical and practical implications were discussed.

주요 상병 별 환자의 의료기관 선택성향 분석

윤경일 ( Kyung Il Youn ),도세록 ( Sei Rok Doh ) 한국병원경영학회 2007 병원경영학회지 Vol.12 No.4

The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.