Institutional Analysis on Organizational Changes of Korean Medicine Hospitals

Park Minjung; Lim Buoungmook; Cha Wungseok; You Myoungsoon; Minjung, Park; Buoungmook, Lim; Wungseok, Cha; Myoungsoon, You

doi:10.13048/jkm.14014

JKM > Volume 35(1); 2014 > Article

Minjung, Buoungmook, Wungseok, and Myoungsoon: Institutional Analysis on Organizational Changes of Korean Medicine Hospitals

Original Article

The Journal of Korean Oriental Medicine 2014; 35(1): 145-156.

Published online: March 30, 2014

DOI: https://doi.org/10.13048/jkm.14014

Institutional Analysis on Organizational Changes of Korean Medicine Hospitals

Park Minjung¹, Lim Buoungmook², Cha Wungseok³, You Myoungsoon^{, 1}

¹Graduate School of Public Health, Seoul National University, Seoul, Korea

²School of Korean Medicine, Pusan National University, Pusan, Korea

³Department of Medical History, College of Korean Medicine, Kyung Hee University, Seoul, Korea

Correspondence to: 유명순(You Myoungsoon) 서울 관악구 신림동 서울대학교 보건대학원 221동 422 호, Tel: +82-2-880-2774, E-mail: msyou@snu.ac.kr

Received February 22, 2014 Revised March 18, 2014 Accepted March 21, 2014

Abstract

Objectives

Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector.

Methods:

On the basis of Scott and his colleagues’ identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed.

Results:

First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status (1971∼1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy (1987∼2001), and the reinforcement of specialization and competition (2002∼present).

Conclusions:

Results suggested that: (1) changes in institutional environments had a heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases (e.g. cerebrovascular disease).

Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.

Keywords: Korean medicine, Korean medicine hospital, Institutionalism

Fig. 1

The foundation of KM hospitals by ownership

* Data: Korea Oriental Medical Hospital Association, 1999.

Reconstitution from Yoon17

Fig. 2

The quantitative expansion of Korean medicine hospitals

* Data: National Health Insurance Statistical Yearbook

Fig. 3

Medical professions in KM Korean medicine hospitals

* Data: National Health Insurance Statistical Yearbook

Fig. 4

Increase of Evidence-based researches about Korean medicine

* Searched by (Korea AND (traditional medicine OR oriental medicine) AND evidence)

Fig. 5

The number of newspaper articles about herbal medicine safety and quality

* Data from Chosun-ilbo archive

Fig. 6

The visit days of cerebrovascular diseases inpatient care

* Data from Health Insurance Review and Assessment service

KM: Korean medicine

LC: Long-term care

Table 1

The Institutional Changes surrounding Korean Medicine Hospitals

Institutional environment of Healthcare sector1)
	professional dominance (1952–1976)	government involvement (1977–1999)	coexistence of competing institutional logics (2000-current)

Korean Medicine Hospitals
	The foundation of Korean medicine hospitals to consolidate the legal status (1971–1986)	A rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987–2001)	Reinforcement of specialization and competition (2002∼current)
Logics	Need for establishing educational system of Korean medicine	Increasing accessibility to Korean medicine services(expansion of hospital beds)	Specialization and competition Efficiency&Safety (rationalization for hospital beds)
Actors	The Association of Korean Medicine (AKOM) Colleges of Korean medicine	Korean government The Korean Medical Hospital Association (KOMHA)	Associations of Medical Specialties for Korean medicine Professional executives
Governance	Licensing system Organized service delivery	Government involvement in service delivery Entrepreneurialism	Evidence-based medicine Management practice
Examples of policies	Permission for Korean medicine hospitals in medical law(’73)	National health insurance for Korean medicine(’87) Board system of Korean medicine specialist(’00)	Supporting policy for the foundation of long-term care hospitals(’02) Permission for cooperative practice between Western medicine and Korean medicine(’09) Introduction of Specialized hospitals (’11)

참고문헌

1. Kim SJ, kwon SM, You MS. An Institutional and Ecologial Analysis of the Healthcare Environment in Korea: Focus on Institutional Logics, Actors, and Governance structures. Korean Journal of Health Policy & Adminiatration. 2011; 21:3. 457–92.

2. DiMaggio PJ, Powell WW. The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields. American Sociological Review. 1983; 48:2. 147–60.

3. Hannan MT, Freeman J. POPULATION ECOLOGY OF ORGANIZATIONS. American Journal of Sociology. 1977; 82:5. 929–64.

4. D’Aunno T, Sutton RI, Price RH. Isomorphism and external support in conflicting institutional environments: A study of drug abuse treatment units. Academy of Management Journal. 1991; 34:3. 636–61.

5. Scott WR. Organizations : rational, natural, and open systems. 5th ed. New Jersey: Prentice Hall;2003. p. 1–430.

6. Scott WR. The Adolescence of Institutional Theory. Administrative Science Quarterly. 1987; 32:4. 493–511.

7. Cho BH. The Sociology of diseases and medicine. Seoul: Jipmoondang;2006. p. 1–639.

8. Scott WR. Institutional change and healthcare organizations : from professional dominance to managed care. Chicago: University of Chicago Press;2000. p. 1–427.

9. Lee HJ, Sung HJ, Cho BH. An analysis of the status Change of Korean Oriental Medicine. Journal of Korea Institute of Oriental Medicine. 1999; 5:1. 133–9.

10. Yi GM. A Study on the General Public Understanding and Utilization of Korean Traditional Medicine in Colonial Period. Korean J Med Hist. 2006; 15:2. 227–36.

11. Shin DW. Traditional Medicine under Japanese Rule after 1930s. J Kor Med History. 2003; 12:2. 110–28.

12. Korean Oriental Medical Association. The 40-Year History of the Korean Oriental Medical Association. 1989.

13. Jung WY. The 100 years’ history of Korean medicine. J Kor Med History. 1999; 8:2. 169–86.

14. Korean Institute of Oriental Medicine. The Reestablishment of the history of Korean Medicine. Seoul: Korean Institute of Oriental Medicine;1995.

15. Association of Korean Medicine. 1898–2011 The history of Korean medicine association. 2012.

16. committee Hc. the 30 years’ history of Kyunghee hopsipital. 2012

17. Yoon JS. A Study on the Management Strategies of the Small Oriental Medical Hospitals [dissertation]. Seoul: Kyung Hee University;2000.

18. Cho BH. The State Control of Medicine and Medical Profession. Journal of Korean Sociological Association. 1990; 24:1. 1131–53.

19. Reston J. Now, About My Operation in Peking. New York Times. 1971; Jul. 26.

20. You WG. A Study on Utilization Pattern and Determinants of Oriental Medical Services, in Health policy & administration. Seoul National University;2002.

21. Lee HJ. Comparative Study of the National Policies for Korean Oriental Medicine and Traditional Chinese Medicine. Korean J. Oriental Physiology & Pathology. 2008; 22:5. 1132–9.

22. Department of Health and Welfare. Korea Health Industry Development Institution, Health Technology Research Planning Evaluation Board, 2002 giude of Korean medicine Remedies Research & Development ed. Department of Health and Welfare. 2002

23. Department of Health and Welfare. The Introduction of traditional medicine policy, Department of Health and Welfare, Editor. 1999

24. Kang BJ, Chae BJ, Kwon DH, Kim PT, Kim JS. Survey on the Understanding of Modern vs. Oriental Medicine in Korea. J Korean Society of Biological Therapies in Psychiatry. 1999; 5:2. 158–66.

25. Nam JJ, Choi JS, Kim JH, Moon SS. National Health and Nutrition Examination Survey In-depth and Related analysis. Department of Health and Welfare, Korea Institute for Health and Social Affairs. 2000; 1–399.

26. Kwon SS, Oh CD, Yang SY, Lee HH, Kang HC, Jung ES. Basic Survey on the Patients’ cognition and satisfaction with Western and Oriental Medicine. The Journal of the Korean Academy of Family Medicine. 1992; 13:11. 891–900.

27. Nah YS. Study on the attributes of Patients admitted to western and oriental medical hospitals of Kyung-Hee university medical center [dissertation]. Seoul: Kyung Hee University;1990.

28. Go SK, Jeun HN, Park DJ, Min JH, Kim JH. New role of oriental hospital in the aging society, Health Insurance Review and Assessment Service. 2005.

29. Do YK. analysis of hospital bed policies in Korea : Focused on the comparison between U.S., Japan, and Korea, in Graduate School of Public Health, Seoul Nationtl University2003.

30. Korea Institute of Oriental Medicine. Comparative Research on Traditional medicine Policy in Korea and Asian 3 Countries, Korea Institute of Oriental Medicine. 1997.

31. Lee JY, Park EK, Yoon JY, Song SH. Report on the Operating Status of Long-tern Care Hospitals, Department of Health and Welfare, Health Insurance Review and Assessment. 2007.

32. Chung KH, Cho BS. A study on the field survey of domestic long-term hospitals facilities. JOURNAL OF THE ARCHITECTURAL INSTITUTE OF KOREA Planning &Design. 2003; 19:9. 3–11.

33. Kim DY. Establishment of policy for Korean medicine in long-term care. Akomnews. 2007; Nov. 19.

34. Han DW, Lim BM. The Role of Public Health in Korean Medicine for Aging Society, Department of Health and Welfare. 2005.