보건학과/석사[한글]
1970年代에 들어 우리나라의 급속한 經濟成長과 醫療需要의 急增에 따라 醫療分野에도 커다란 變化가 계속되어 왔다. 기존의 많은 病院들이 점차 규모를 擴大시켜 施設과 裝備를 現代化하고 있으며 또한 現代化된 病院들이 날로 新設되고 있다. 이러한 추세로 새로
운 自動化裝備나 高價의 裝備에 대한 投資는 병원내 전체 投資中 점차 커다란 比重을 차지하게 되었다.
이러한 高價醫療裝備를 이용하여 迅速하고 正確한 診斷을 통해서 診斷의 質을 向上시켜 왔지만, 너무 高價인데다 追加的인 附帶施設과 高度로 訓練된 人力을 必要로 하게 되어 이들은 醫療費 上昇의 중요한 원인의 하나로 作用하였고 많은 경우에 있어서 병원財政을 한층 어렵게 하고 있다.
그러므로 이러한 裝備投資의 意思決定을 위한 적절한 方針이 미리 마련되어 있어야 할 필요성이 절실한 것이다.
그런데 아직 많은 病院들은 高度技術의 새로운 高價裝備에 대하여 投資를 해야 할 것인지에 대한 重大한 意思決定을 하는데 도움을 주는 具體的인 情報를 충분히 갖고 있지 못한 것이다.
이에 연구자는, 數種의 自動血球計算機를 選定해서 病院裝備投資時 意思決定에 필요한 情報를 募集分析하였다.
1단계 분석에서는 250병상 규모의 병원과 그 병원의 자동혈구계산기(SP2 모델)를 분석모델로 선정하고 그에 대한 收益性과 損益分岐點을 算出하였다.
會計年度內 SP2모델의 운용으로 發生된 收益과 費用은 각각 55,402,872원과 60,046,071원이었으며, 4,673,199원의 損失을 냈다. 그리고 損益分岐點은 60,060,031원이었다.
같은 조건에서 500병상규모의 신축병원으로 移轉을 가정했을 경우에는, 損益分岐點은 79,941,147원으로 증가하게 되며, 28.2%의 純利益率과 31,281,567원의 利益을 낸다.
2단계 분석에서는 100병상, 200병상, 400병상, 600병상, 800병상, 1,200병상 규모의 6個 병원과 미화 12,500달러의 Z모델, 22,000달러의 S5모델, 50,000달러의 SST모델, 90,000달러의 SP2모델, 105,000달러의 SP4모델의 5종류의 자동혈구계산기를 분석모델로 선정해
서 각 병원과 혈구계산기를 서로 交叉하여 組合을 만들고, 各 組合의 收益性을 산출하였다.
20%이상의 純利益을 기준으로 한 장비선정에서 100-200 병상에 Z모델, 200-400병상에 S5나 SST모델, 600-800병상에 SP2 모델, 800병상이상에 SP4모델이 適正하였다.
그리고 모델선정時 최종적인 의사결정을 위해서는, 收益性 외에도 診療, 敎育, 硏究와 같은 병원의 機能的 側面까지도 충분히 고려되어야 하겠다.
Hospital Size and Adequate Blood Cell Counter
-A Profitability Analysis-
Kyung-Jin Cho
Department of Public Health, Graduate School of Health,
Science and Management Yonsei University
(Directed by Prof. Il Soon Kim, M.D.)
Since the 1970 the hospital industry in Korea has been expanding rapidly along
with the rapid economic growth and the increasing medical care demend. Many of the
existing hospitals have expanded their sizes and modernized their facilities and
equipments, and many new modern hospitals have been constructed. New automated,
sophisticated and costly equipments have occupied the large portion of the
investment Put into the hospital industry.
Nobody denies that such costly equipment improves the quality of medical care
through fast and accurate diagnosis. The sophisticated equipment, however, is very
costly and requires additional facilities and highly trained manpower and has
become one of the most important cost-pushing factors leading to financial
difficulties of many hospitals. It is strongly felt that some guidelines should be
developed to make a decision for the investment. The hospitals, however, do not
have enough information to make an important decision on the investment of new,
costly and sophisticated equipments.
This study was conducted to provide a set of information derived from
profitability analysis and break-even analysis for the decision of the investment
of hospital to those equipments.
The automatic blood cell counter of various types were selected and the study was
performed by two-step analysis.
On the first step, a 250-bed hospital and SP 2 blood cell counter model was
selected for the analysis and then profitability and break- even point of the cell
counter were calculated.
The revenue and cast occured by the operation of SP 2 model were ₩55,402,872 and
₩60,046,071 respectively. with loss of ₩4,643.199 during the year. The break-even
point was ₩60,060.031. For the 500-bed hospital under the same circumstance, the
break-even paint shifts to ₩79,941.147 with net profit of ₩31,281,567 as 28.2%
net profit ratio.
On the second step, six hospitals of different sizes (100-bed, 200-bed, 400-bed,
600-bed, 800-bed, and 1,200-bed) and five different types of cell counters of
different prices (Z model: US12.500.S5model:US22.000, SST model:US50,000,SP2model:US90,000, SP4 model:US105,000)werechosenasanalyticalmodels.Theprofitabilitiesofthecross−matchedcombinationamonghospitalsandcellcounterswerealsocalculated.Theadequatemodelsfordifferenthospitalsinsizewhichshowthenetprofitratiomorethan20600−800beds:SP2model,800bedsupward:SP4model.However,tomakeafinaldecision,thefunctionalobjectivesofthehospitalsuchasqualityofmedicalcare,educationandresearchcomponentsotherthanprofitabilityshouldfullybeconsidered.[영문]Sincethe1970thehospitalindustryinKoreahasbeenexpandingrapidlyalongwiththerapideconomicgrowthandtheincreasingmedicalcaredemend.Manyoftheexistinghospitalshaveexpandedtheirsizesandmodernizedtheirfacilitiesandequipments,andmanynewmodernhospitalshavebeenconstructed.Newautomated,sophisticatedandcostlyequipmentshaveoccupiedthelargeportionoftheinvestmentPutintothehospitalindustry.Nobodydeniesthatsuchcostlyequipmentimprovesthequalityofmedicalcarethroughfastandaccuratediagnosis.Thesophisticatedequipment,however,isverycostlyandrequiresadditionalfacilitiesandhighlytrainedmanpowerandhasbecomeoneofthemostimportantcost−pushingfactorsleadingtofinancialdifficultiesofmanyhospitals.Itisstronglyfeltthatsomeguidelinesshouldbedevelopedtomakeadecisionfortheinvestment.Thehospitals,however,donothaveenoughinformationtomakeanimportantdecisionontheinvestmentofnew,costlyandsophisticatedequipments.Thisstudywasconductedtoprovideasetofinformationderivedfromprofitabilityanalysisandbreak−evenanalysisforthedecisionoftheinvestmentofhospitaltothoseequipments.Theautomaticbloodcellcounterofvarioustypeswereselectedandthestudywasperformedbytwo−stepanalysis.Onthefirststep,a250−bedhospitalandSP2bloodcellcountermodelwasselectedfortheanalysisandthenprofitabilityandbreak−evenpointofthecellcounterwerecalculated.TherevenueandcastoccuredbytheoperationofSP2modelwere₩55,402,872and₩60,046,071respectively.withlossof₩4,643.199duringtheyear.Thebreak−evenpointwas₩60,060.031.Forthe500−bedhospitalunderthesamecircumstance,thebreak−evenpaintshiftsto₩79,941.147withnetprofitof₩31,281,567as28.2Onthesecondstep,sixhospitalsofdifferentsizes(100−bed,200−bed,400−bed,600−bed,800−bed,and1,200−bed)andfivedifferenttypesofcellcountersofdifferentprices(Zmodel:US12.500. S5 model:US22.000,SSTmodel:US50,000, SP2
model:US90,000,SP4model:US105,000) were chosen as analytical models. The profitabilities of the cross-matched combination among hospitals and cell counters were also calculated.
The adequate models for different hospitals in size which show the net profit ratio more than 20% were 100-200 beds:Z model, 200-400 beds:S5 or SST models, 600-800 beds: SP2 model, 800 beds upward: SP4 model.
However, to make a final decision, the functional objectives of the hospital such as quality of medical care, education and research components other than profitability should fully be considered.restrictio