This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are... This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to satisfaction with the accreditation program and hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. For the study, according to the overall process regarding accreditation from accreditation preparation process to the situation of the hospitals after accreditation, a survey tool was developed with major issues, the tool went through specialists' reviews, and the survey was done for 189 acute care hospitals that acquired accreditation from 2010 to February, 2014. Among them, 98 hospitals answered, so question response rate was 51.9%, and they were used for the final analysis. For understanding recognition of hospitals about accreditation motives, support within the hospitals and survey process, the participating hospitals were categorized by types and analyzed. As a result, the motive of ‘acquisition of national policy participation requirements' among external motives was the biggest in tertiary general hospitals and clinics. And general hospitals had the biggest motive of ‘PR of hospital and improvement of image'(p<0.01). In addition, ‘reliability about accreditation survey process' among survey process was the highest in clinic(p<0.05), ‘professionalism of surveyor’ was also evaluated highest by clinics in all the items(p<0.01). The factors that affect satisfaction with the accreditation program were categorized into system acceptance factor, recommendation intention and satisfaction factor, and analyzed. The hospitals that had 2~4 employees in charge of medical quality management had higher system acceptance than those with only 1 employee. The system acceptance was higher as hospitals had bigger internal motives, as CEO's will was bigger, as suitability of survey process was higher, and as professionalism of surveyors was higher(p<0.05). Furthermore, the recommendation intention and satisfaction was higher as CEO’s will was bigger, as suitability of survey process was higher, and as professionalism of surveyors was higher(p<0.05). As a result of analyzing the factors that affected accreditation program satisfaction with the system acceptance and recommendation intention combined, as hospitals’internal motives were bigger, as CEO's will was bigger, as suitability of survey process was higher, and as professionalism of surveyors was higher, the accreditation program satisfaction was higher(p<0.05). As a result of analyzing the factors of hospital culture change, process improvement, quality improvement and patient satisfaction to investigate the factors that affect hospital management performances, the hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have. In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<0.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<0.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<0.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<0.05). The above result indicates that to improve the effect of the accreditation program, the principal agent of the policy needs to enhance rationality of the system process and improve understanding of hospitals through PR about the purpose of the system. On the other hand, hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director’s interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances. Meanwhile, it is important to improve the job satisfaction of the staff in charge of accreditation program by reducing the unnecessary document work in the application process in order to secure the stable establishment of the accreditation program and increase the participation rate of the hospitals.
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