본 연구의 목적은 국내 종합병원급 이상 의료기관의 경영효율성을 결정하는 특성요인을 재무구조 요인과 의료기관 고유 특성 요인으로 구분하여 검증하고자 하는데 있다. 국내 종합병원(상급종합병원 포함)의 2016년부터 2019년 기간 동안의 자료를 대상으로 DEA를 활용하여 의료기관의 경영효율성을 측정하고, 경영효율성 결정요인을 분석하였다. Charnes et al.(1978)이 제시한 CCR모형을 활용 하여 경영효율성을 측정하였으며, 투입요소로는 인건비, 유형자산(의료장비) 그리고 총자본을 산출요소로는 매출액(의료수익)을 고려하 여 경영효율성을 측정하였다. 실증분석 결과를 요약하면 다음과 같다. 첫째, 의료기관의 재무구조가 경영효율성에 미치는 영향을 검증한 결과 병상의 수가 많고, 재무구조가 건전한 병원, 수익률이 좋은 병원, 국가보조금 지원을 많이 받고 연구비 투자 비중 및 의료수익 비중이 높은 병원들이 상대적으로 경영효율성이 높은 것으로 나타났으며, 부채비율의 경우 의료기관의 경영효율성에 유의한 영향을 미치지 않는 것으로 나타났다. 둘째, 의료기관의 고유 특성 요인이 경영효율성에 미치는 영향을 검증한 결과 수도권 소재 병원과 상급종 합병원들이 상대적으로 경영효율성이 높게 나타난 반면, 국ㆍ공립에 해당하는 병원들이 상대적으로 경영효율성이 낮은 것으로 나타났 다. 본 연구의 결과는 우리나라 의료산업의 핵심이라고 할 수 있는 종합병원 이상급 의료기관을 대상으로 경영관리 측면에서의 경영효 율성 결정요인에 대하여 다각도의 검증을 진행함으로써, 의료기관의 지속가능한 성장에 필요한 핵심요소들을 제시하였을 뿐만 아니라, 경영전략 수립 및 경쟁력 확보방안 마련에 대한 시사점을 제공하였다는 점에서 그 의의가 있다.
The purpose of this study is to empirically analyze the characteristic factors that determine the management efficiency of medical institutions above the high-level general hospitals in Korea by dividing them into financial structural factors and unique characteristic factors. Medical industry of Korea faced an era of fierce competition due to the increased expectations for medical care and the rapid expansion of medical services against the backdrop of increased civic awareness and income levels. In addition, the entry into a super-aged society, increase in national income, and health insurance with enhanced protection are increasing the possibility of developing new markets in the medical industry. Unlike these opportunity factors, various threat factors are also inherent. For example, there is a number of changes that increase the uncertainty of the business environment, such as consumers’ desire for diversified and advanced medical services, the acceptance of for-profit hospitals, the entry of foreign hospitals, and the introduction of private insurance. The growth of the medical industry is fundamentally determined by the competitiveness of individual hospitals. In other words, the competitiveness of a medical institution is determined by the degree of effort to improve the inefficiency of its management activities, because an increase in inefficiency in the operation process increases costs, which leads to a decrease in competitiveness. From this point of view, the purpose of this study is to measure the management efficiency of medical institutions and to analyze the determinants to provide evidence for establishing future strategies for strengthening the competitiveness of individual medical institutions and the overall medical industry of Korea. In particular, the management efficiency of medical institutions was analyzed in connection with financial structure factors and the unique and diverse characteristics of medical institutions. This point is meaningful in that it provides direction to the management decision-making of medical institutions to respond to stakeholders who demand the establishment of a rapid and safe response system for the country or local community after the covid-19 pandemic and the reinforcement of safety in the overall society. Based on data from medical institutions above the high-level general hospitals in Korea from 2016 to 2019, the management efficiency of medical institutions was measured using DEA and the determinants of management efficiency were analyzed. The CCR model suggested by Charnes et al.(1978) was applied to the measurement of management efficiency. Labor cost, tangible assets(medical equipment), and total capital were used as input factors, and sales as output factors(revenues in hospital) for efficiency measurement. The results of the empirical analysis are summarized as follows. First, as a result of verifying the impact of the financial structure of medical institutions on management efficiency, hospitals with a large number of beds, hospitals with high returns, and hospitals with high research investment and medical returns have relatively high management efficiency. The leverage ratio did not significantly affect the management efficiency of medical institutions. Second, as a result of examining the effect of unique characteristics of medical institutions on management efficiency, hospitals located in the metropolitan area and high-level general hospitals showed relatively high management efficiency. On the other hand, national and public hospitals showed relatively low management efficiency. The results of this study are significant in that conducted in-depth research on management efficiency determinants in terms of business management, presented key factors necessary for sustainable growth of medical institutions, and provided implications for establishing management strategies and securing competitiveness. However, it is a limitation of this study that a measurement model other than the CCR model could not be applied to measure management efficiency. In addition, There are also limitations that have not been addressed in the fact that the selection of input and output factors based on a clear theoretical basis was not made due to limitations in sample and variable measurement, and the discriminatory responses due to the different purposes of establishment of public and private medical institutions were investigated within the scope of this study. It is hoped that these contents can be further verified through future follow-up studies.