한 종합병원의 진료실적 및 재무성과에 관한 연구 : 전국민의료보험 실시 전·후의 변화비교

Abstract

[영문]

[한글]

전국민의료보험을 실시한지 3년이 지난 시점에서 병원의 환자진료실적과 운영에 어떠한

변화가 있었는지를 보기 위하여 서울시 동대문구에 있는 한 종합병원을 대상으로 환자진

료실적과 운영을 조사분석하여 다음과 같은 결과를 얻었다.

1. 환자 진료실적은 전국민의료보험 실시 이후 계속 증가되었다. 산재, 자동차보험, 의

료보호 환자의 구성비는 비슷하였다.

2. 과별 외래 및 입원환자의 구성비는 전국민의료보험 실시 전·후하여 변화가 없었다.

3. 입원환자의 지역별 환자구성비는 전국민의료보험 실시 전이나 후에 큰 변동이 없었

으나, 보험실시 후 경기도 구리시와 동대문구 환자가 2-3% 증가되었을 뿐이고, 특히 도봉

구 환자가 감소되었다.

4. 입원 및 외래 수입은 보험실시 이후에 계속 증가 되었다. 진료재료비와 인건비는 계

속 증가 되었으나, 일반관리비는 크게 상승하지 않았다. 이익금은 변화가 없었다.

5. 직원 1인당 외래환자수는 보험실시후 감소되었으며 직원 1인당 입원환자수는 증가

되었다. 전문의 1인당 환자수는 입원의 경우 보험실시후 감소되었고, 외래도 감소되었다.

6. 직원 1인당 수익은 증가되었고 인건비도 증가되었다.

7. 총자본 순이익율 수익성은 보험실시후 감소되었으며 단기지급능력은 전국민의료보험

실히후 높아졌고 부채비율은 호전되었다.

8. 총자본회전율은 전국민의료보험실히후 감소되었고 의료수익율은 보험실시후 감소 되

었으며, 총자본율은 증가되었다.

이상의 연구결과를 종합하여 보면 전국민의료보험실시후 환자수의 증가와 재정의 안정

화를 가져왔으나 진료재료비와 인건비의 지출증가로 인해 운영이익은 감소되었고, 진료과

별 환자구성은 큰 변화가 없었으나 입원환자구성은 점차 인근주민화 되었다. 따라서 내부

관리 측면에서 부적절한 비용을 절감하여 수익성을 제고해야 할 것이고, 환자수 증대를

위하여 진료의 전무화와, 지역 내의 병원 및 의원과의 환자의뢰체게의 구축이 필요하다.

Comparison of management performance in a general hospital before and after the

universal health insurance in Korea

Taek Gyeom Kim

Graduate School of Health Science and management Yonsei University

(Directed by Professor Seung Hum Yu, M.D.,Ph.D.,Dr.P.H.)

In order to find out what changes have been brought about in to the medical

services for both outpatients and inpatients, and management performance after

three years of enforcement of the universal health insurance the patients and

statistics management performance wererevewed and analyzed, in a 410beds general

hospital which is located in Dongdaemun-gu, Seoul. major findings are as follows:

1) The number of impatients as well as outpatients have been gradually increased

since the enforcement of universal health insurance. The percentage of the patients

of the workers compensation insurance, automobile liability insurance, has been

same.

2) No change has occured in the distribution of outpatients and inpatients for

each clinical department before and after the enforcement of universal health

insurance.

3) No change has occured in the distribution of inpatients by area before and

after the enforcement of universal health insurance. The patients from Gyeong Gi Do

Guri-city, Dongdaemum-gu(included Jungnang-gu) have only increased by percent and

the patients from Dobong-gu have decreased.

4) The revenue for both inpatients and outpatients has gradually increased ever

since the enforcement of universal health insurance. Expenses for material and

personnel expenses have also gradually increased while no management expenses

significantly increased. In the meantime, no change shows in gains of before and

after enforcement of universal health insurance.

5) In a review of the earning and personnel expense per employee, the earning has

been increasing, however the personnel expenses are also increasing.

6) Regarding profitability in consideration of the earning rate of total

capital(R.O.I), it had decreased right after the enforcement of universal health

insurance. However, the margin of profitability has been recovered.

7) Rearding the ability of short term payment, it was heightened since the

enforcement of universal health insurance and even the rate of liabilities has

improved.

8) Regarding the revolving rate of total capital, it has decreased in comparison

to what it was before the enforcement of universal health insurance.

9) Regarding the increasing rate of revenue, it decreased for a while, but since

then has increased. Also, regardng the increasing rate of total capital, it has

increased after its initial decrease, NO significant change shows in the increasing

rate of the number of patients.

In the overall results, even though the increase of the number of patients and

financial stabilization has been brought about since the enforcement of universal

health insurance, no operational profit has been brought in due to the increase in

both the material expenses of medical care and personnel expenses.

No change shows in the distribution of inpatients for each clinical department.

Inapatients are mostly from the near area.

In a final suggestion, it is considered that in the aspect of internal management

in the future, profitability should be lifted by means of reducing improper

expenses.

It is recommended that this hospital pursue a better relationship with the small

hospitals and clinics in the area to enhance speciality care for patients which

they examine.