• Title/Summary/Keyword: 온라인 등록 시스템

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Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.335-373
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    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

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Impacts of Entrepreneurship and Market Orientation of Business Incubator CEO's on business performance: Focusing on Moderating effects of utilization level of BI Supporting Services (창업보육센터 입주기업 CEO의 기업가정신 및 시장지향성이 경영성과에 미치는 영향: 창업기업의 지원서비스 활용정도 조절효과를 중심으로)

  • Kim, Seong Il;Lee, Woo Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.5
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    • pp.1-13
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    • 2016
  • This study aims to observe the impacts of entrepreneurship and market orientation of Seoul's business incubator (BI) CEO's on business performance, as well as investigate the moderating effects of BI supporting services. The main objectives of this study are as follows: first, to observe how the entrepreneurship of CEO's affects business performance; second, to observe how CEO's market orientation as a cultural factor attributes to business performance; third, to verify whether the utilization level of BI supporting services shows moderating effects between entrepreneurship and business performance, and finally to verify whether the utilization level of BI supporting services shows moderating effects between market orientation and business performance. Business incubators in Seoul registered with the Business Incubator Association were surveyed both online and offline to receive 127 responses out of 320 circulations. By filtering out insincere reponses, 117 were used for statistical analysis. Our results assert that the utilization level of physical BI supporting services does indeed strengthen the relation between initiative and financial performance. Also, it is interesting to note that the utilization level of physical BI supporting services supports the relation between risk sensitivity and financial performance. While risk sensitivity on its own shows no positive effect on business performance, a suitable utilization level of BI supporting services is likely to strengthen the connection. In addition, the utilization level of both physical and non-physical supporting services shows a moderating effect between initiative and non-financial performance. Based on the results above, risk-taking business incubator CEOs with initiative are likely to yield better financial performance in terms of increasing sales, if provided with various physical supporting services such as sufficient educational facilities including communal spaces and conference rooms.

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A Study on the Impact Factors of Contents Diffusion in Youtube using Integrated Content Network Analysis (일반영향요인과 댓글기반 콘텐츠 네트워크 분석을 통합한 유튜브(Youtube)상의 콘텐츠 확산 영향요인 연구)

  • Park, Byung Eun;Lim, Gyoo Gun
    • Journal of Intelligence and Information Systems
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    • v.21 no.3
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    • pp.19-36
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    • 2015
  • Social media is an emerging issue in content services and in current business environment. YouTube is the most representative social media service in the world. YouTube is different from other conventional content services in its open user participation and contents creation methods. To promote a content in YouTube, it is important to understand the diffusion phenomena of contents and the network structural characteristics. Most previous studies analyzed impact factors of contents diffusion from the view point of general behavioral factors. Currently some researchers use network structure factors. However, these two approaches have been used separately. However this study tries to analyze the general impact factors on the view count and content based network structures all together. In addition, when building a content based network, this study forms the network structure by analyzing user comments on 22,370 contents of YouTube not based on the individual user based network. From this study, we re-proved statistically the causal relations between view count and not only general factors but also network factors. Moreover by analyzing this integrated research model, we found that these factors affect the view count of YouTube according to the following order; Uploader Followers, Video Age, Betweenness Centrality, Comments, Closeness Centrality, Clustering Coefficient and Rating. However Degree Centrality and Eigenvector Centrality affect the view count negatively. From this research some strategic points for the utilizing of contents diffusion are as followings. First, it is needed to manage general factors such as the number of uploader followers or subscribers, the video age, the number of comments, average rating points, and etc. The impact of average rating points is not so much important as we thought before. However, it is needed to increase the number of uploader followers strategically and sustain the contents in the service as long as possible. Second, we need to pay attention to the impacts of betweenness centrality and closeness centrality among other network factors. Users seems to search the related subject or similar contents after watching a content. It is needed to shorten the distance between other popular contents in the service. Namely, this study showed that it is beneficial for increasing view counts by decreasing the number of search attempts and increasing similarity with many other contents. This is consistent with the result of the clustering coefficient impact analysis. Third, it is important to notice the negative impact of degree centrality and eigenvector centrality on the view count. If the number of connections with other contents is too much increased it means there are many similar contents and eventually it might distribute the view counts. Moreover, too high eigenvector centrality means that there are connections with popular contents around the content, and it might lose the view count because of the impact of the popular contents. It would be better to avoid connections with too powerful popular contents. From this study we analyzed the phenomenon and verified diffusion factors of Youtube contents by using an integrated model consisting of general factors and network structure factors. From the viewpoints of social contribution, this study might provide useful information to music or movie industry or other contents vendors for their effective contents services. This research provides basic schemes that can be applied strategically in online contents marketing. One of the limitations of this study is that this study formed a contents based network for the network structure analysis. It might be an indirect method to see the content network structure. We can use more various methods to establish direct content network. Further researches include more detailed researches like an analysis according to the types of contents or domains or characteristics of the contents or users, and etc.