• Title/Summary/Keyword: 환경 편익

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The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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Optimization Process Models of Gas Combined Cycle CHP Using Renewable Energy Hybrid System in Industrial Complex (산업단지 내 CHP Hybrid System 최적화 모델에 관한 연구)

  • Oh, Kwang Min;Kim, Lae Hyun
    • Journal of Energy Engineering
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    • v.28 no.3
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    • pp.65-79
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    • 2019
  • The study attempted to estimate the optimal facility capacity by combining renewable energy sources that can be connected with gas CHP in industrial complexes. In particular, we reviewed industrial complexes subject to energy use plan from 2013 to 2016. Although the regional designation was excluded, Sejong industrial complex, which has a fuel usage of 38 thousand TOE annually and a high heat density of $92.6Gcal/km^2{\cdot}h$, was selected for research. And we analyzed the optimal operation model of CHP Hybrid System linking fuel cell and photovoltaic power generation using HOMER Pro, a renewable energy hybrid system economic analysis program. In addition, in order to improve the reliability of the research by analyzing not only the heat demand but also the heat demand patterns for the dominant sectors in the thermal energy, the main supply energy source of CHP, the economic benefits were added to compare the relative benefits. As a result, the total indirect heat demand of Sejong industrial complex under construction was 378,282 Gcal per year, of which paper industry accounted for 77.7%, which is 293,754 Gcal per year. For the entire industrial complex indirect heat demand, a single CHP has an optimal capacity of 30,000 kW. In this case, CHP shares 275,707 Gcal and 72.8% of heat production, while peak load boiler PLB shares 103,240 Gcal and 27.2%. In the CHP, fuel cell, and photovoltaic combinations, the optimum capacity is 30,000 kW, 5,000 kW, and 1,980 kW, respectively. At this time, CHP shared 275,940 Gcal, 72.8%, fuel cell 12,390 Gcal, 3.3%, and PLB 90,620 Gcal, 23.9%. The CHP capacity was not reduced because an uneconomical alternative was found that required excessive operation of the PLB for insufficient heat production resulting from the CHP capacity reduction. On the other hand, in terms of indirect heat demand for the paper industry, which is the dominant industry, the optimal capacity of CHP, fuel cell, and photovoltaic combination is 25,000 kW, 5,000 kW, and 2,000 kW. The heat production was analyzed to be CHP 225,053 Gcal, 76.5%, fuel cell 11,215 Gcal, 3.8%, PLB 58,012 Gcal, 19.7%. However, the economic analysis results of the current electricity market and gas market confirm that the return on investment is impossible. However, we confirmed that the CHP Hybrid System, which combines CHP, fuel cell, and solar power, can improve management conditions of about KRW 9.3 billion annually for a single CHP system.

Building Participatory Digital Archives for Documenting Localities (로컬리티 기록화를 위한 참여형 아카이브 구축에 관한 연구)

  • Seol, Moon-Won
    • The Korean Journal of Archival Studies
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    • no.32
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    • pp.3-44
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    • 2012
  • The purpose of the study is to explore the strategies to build participatory digital archives for documenting localities. Following the introduction of the chapter one, the chapter two deals with categorizing participation types of persons and organizations for documenting localities, analysing characteristics and benefits of each type, and listing up the requirements of participatory archives based on literature reviews. The chapter three focuses on the analyses of digital archives especially based on the participation of organizations such as collecting institutions and community archives in USA, Canada and UK. The cases of participatory archives are divided into two types; i) digital archives based on archival collections of institutions such as libraries, archives, and museums, ii) digital archives mainly based on various community archives. Online Archives California(OAC) and Calisphere of University of California, MemoryBC of British Columbia of Canada, and People's Collection Wales of UK as the first type cases, and Connecting Histories of Birmingham, 'Community Archives Wales(CAW), Cambridgeshire Community Archive Network(CCAN), Norfolk Community Archives Network(NORCAN) as the second type cases are selected for comparative analyses. All these cases can be considered as archival portals since they cover collections from various organizations. This study then evaluates how these digital archives fulfill the requirements of participatory archives such as : i) integrated search of archives that are to be distributed, ii) participation of individuals and organizations, and iii) providing broader contextual information and representation of context as well as contents of archives. Lastly the final chapter suggests the implications for building participatory archives in Korean local areas based on following aspects : host organizations and implementation strategy, networks of collection institutions and community archives, preserving and reorganizing contextual information, selection and appraisal, and participation of records users and creators.

Trends of Study and Classification of Reference on Occupational Health Management in Korea after Liberation (해방 이후 우리나라 산업보건관리에 관한 문헌분류 및 연구동향)

  • Ha, Eun-Hee;Park, Hye-Sook;Kim, Young-Bok;Song, Hyun-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.809-844
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    • 1995
  • The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (1) Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows ; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3 parts, that is , occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was sightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of Occupational Medicine(18.2%), Several Kinds of Medical Colloge Journal(17.0%), The Korean Journal Occupational Health(15.1%), The Korean Journal of Preventive Medicine(15.1%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(18.2%), occupational organization 3(9.1%) and occupational health delivery system 1 (3.0%). Of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was 185(71.1%), followed by women worker, white coiler workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (1) Study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.

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