• Title/Summary/Keyword: Advance ratio

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Analysis of utilization and profit for CT and MRI after implementation of insurance coverage for CT (CT 보험급여 전후의 CT 및 MRI검사의 이용량과 수익성 변화)

  • Suh, Chong-Rock;Yu, Seung-Hum;Chun, Ki-Hong;Nam, Chung-Mo
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.1-21
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    • 1997
  • In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

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Growth and Nutrients Uptake as Affected by Ammonium sulfate and Urea in the Paddy Rice (황산암모니아 및 요소의 시용이 수도의 생육과 양분 흡수에 미치는 영향)

  • ;Eun-Woong Lee
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.28 no.4
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    • pp.391-418
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    • 1983
  • Urea and ammonium sulfate without and with sulfur group, respectively, were compared with respect to their nutritive effects on the rice plants, Suweon 264 and Jinheung, under the nursery trial on the protected upland and lowland seedbed, the pot trials with their various combination ratios and with added sodium sulfate to urea and the trials on the paddy fields which have undergone urea and ammonium sulfate application for many years. The rice seedlings fertilized with ammonium sulfate surpassed those with urea in growth performance and nutrients absorption of the rice seedlings at nursery period. Such stimulating effect of ammonium sulfate on the growth and nutrients uptake was more remarkable under the upland nursery than under the lowland one. The pot trial with the various combination ratios of urea and ammonium sulfate revealed that the chlorophyll content in leaf blade increased with the increment of sulfate ratio in the combination and the sole application of urea caused the chlorosis of leaf which was more conspicuous in Suweon 264 than in Jinheung. Fertilized with the same active ingradient amount of nitrogen, the rice plants supplied with ammonium sulfate surpassed those with urea in the chlorophyll content consistently under the nursery, the pot and the paddy field trials. The photosynthesis of flag leaf at heading stage increased with the combination rate of ammonium sulfate in the pot trial. The sulfur applicated as supplementary element of nitrogen in the nursery, the pot and the field trials were observed to be in positive relationship to the nitrogen and potassium content, but to be in negative correlation to the calcium content. The sulfur content in the rice plants was higher at early growth stage and decreased with the advance in growth stage. The nitrogen content also showed a similiar tendency to the sulfur content, and the N/S ratio was higher at early growth stage than at later one. The N/S ratio was negatively correlated with the chlorophyll content. In the field experiment, ammonium sulfate surpassed urea in the number of productive tiller, dry matter production and unhulled rice yields, but much stimulating effect of ammonium sulfate on the grain production was shown to be less effective than that on the straw production. The nitrogen and major nutrients content in the rice straw at harvest were higher in the paddy field with long-term ammonium sulfate application than in that with long-term urea application, suggesting that the former might have greater potentiality in nutrients supply than the latter.

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Evaluation of Grassland Grade by Grassland Vegetation Ratio (초지식생비율에 의한 초지등급평가 연구)

  • Lee, Bae Hun;Kim, Ji Yung;Park, Hyung Soo;Sung, Kyung Il;Kim, Byong Wan
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.40 no.1
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    • pp.29-36
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    • 2020
  • This study was conducted to suggest the new grassland grade system on evaluating the grassland status. The grassland status has been evaluated based on the forage yield (good, fair and poor) by municipal authorities. The grassland grades by current system were 19 good, 11 fair and 11 poor among the 41 grassland farms from 6 provinces. This evaluation result differed greatly from the result of actual measurement of forage yields which showed all poor. The big difference was resulted from failing the reflection of the various characteristics, such as different seasonal growth and harvest frequency. Furthermore, the lack of consistent examining date and method added the inaccuracy of current grassland grade system. The new grassland grade system based on the grassland vegetation ratio (grass, weed and bare soil) was initially designed into 6-grade system (1st; 100~80%, 2nd; 79~60%, 3rd; 59~40%, 4th; 39~20%; 5th; 19~1% and 6th; 0% on the basis of grasses proportion), but later was changed into 4-grade system (1st, 2nd, 3rd, and 4th grades are 70% or more, 50% or more, 50% or less, and 0% of forage proportion, respectively) after reflecting the opinion of grassland farms and municipal authorities. Re-evaluation on the grassland status using the 4-grade system resulted in the total 80% consisted of 2nd, 3rd and 4th grade which means most grasslands needs the partial reseeding or the rehabilitation of entire grassland. Pictures and schematic diagrams depicting the 4-grade system were presented to improve the objectivity of evaluation. The optimal time for assessing grassland status is fall when plant height 20~30 cm. Conclusively, the 4-grade system is an efficient method for all non-professionals including grassland farms or municipal authorities in assessing the grassland status. To apply this system to the field, the institutional arrangements such as amendment of grassland act should take place in advance.

Analysis of Land Use Characteristics Using GIS DB - A Case Study of Busan Metropolitan City in Korea - (GIS DB를 이용한 토지이용 특성 분석 - 부산광역시 건물 높이 시뮬레이션을 중심으로 -)

  • Min-Kyoung CHUN;Tae-Kyung BAEK
    • Journal of the Korean Association of Geographic Information Studies
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    • v.26 no.3
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    • pp.52-64
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    • 2023
  • As cities continue to develop rapidly, overcrowding, pollution, and urban sanitation problems arise, and the need to separate conflicting uses is emerging. From this perspective, there is no disagreement that urban land use should be planned. Therefore, all activities in land space must be predicted in advance and planned so that land use can be rationally established. This study used the constructed data to compare and analyze the use distribution characteristics of residential, commercial, and industrial areas in Busan Metropolitan City to identify the building area status, total floor area, and floor area ratio by use zone in districts and counties in Busan Metropolitan City. As a result, it was found that the residential area accounted for the largest proportion of the area by use zone at 51%, and that the residential area accounted for the largest proportion at 63% of the total floor area by use zone. And the analysis was conducted using a specialization coefficient that can identify regional characteristics based on land use composition ratio. Because it is difficult to determine the trend of the entire region just by counting the absolute value of the area, the area composition ratio was calculated and compared. Looking at the residential facilities among the specialization coefficients by use area, it is above 1.0 except for Gijang-gun, Sasang-gu, Saha-gu, and Jung-gu. Commercial facilities are over 1.0 except for Gijang-gun, Gangseo-gu, Nam-gu, Sasang-gu, and Saha-gu. Looking at industrial facilities, you can see that the industrial complex distribution area is Gangseo-gu (2.5), Gijang-gun (1.22), Sasang-gu (2.06), and Saha-gu (1.64). In addition, it was found that business facilities and educational welfare facilities were evenly distributed. Land use analysis was conducted through simulation of the current status of building heights according to each elevation in each use area and the height of buildings in each use area. In general, areas over 80m account for more than 43% of Busan City, showing that the distribution of use areas is designated in areas with high altitude due to the influence of topographical conditions.

The Characteristic of Laws on the Kind of Urban Green Spaces and the Legal Requirements for the Green Spaces of Urban Habitat in China (중국의 도시녹지 종류와 도시거주구 녹지의 설치 기준에 관한 법제도의 현황과 특성)

  • Shin, Ick-Soon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.3
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    • pp.1-11
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    • 2013
  • This study investigated Chinese Laws on the kind of urban green spaces and the legal requirements for the green spaces of urban habitat and analyzed the specificities of them intending to provide basic data to suggest bringing in or not the relevant Chinese Laws to Korea. This study can be summarized as follows: First, the concept of Chinese urban green spaces(g.s.) classified by 5 kinds(park g.s., production g.s., protection g.s., attachment g.s., the others g.s.) placed the park and green spaces in the same category unlike the Korean urban green spaces that only distinguishes between park and green spaces. The Chinese Urban Park is classified by 4 kinds(composite park, community park, special park, linear park) at the 'Standard for urban green spaces classification' which is below in rank of the legal system. Second, in case of calculation for green spaces ratio of urban green spaces in China, the green rooftop landscaping area should not be included as a green spaces area except the rooftop of a basement or semi basement building to which residents have easy access. The green spaces requirements and compulsory secure ratio by 3 habitat kinds(habitat, small habit, minimum habitat) of when to act as a residential plan is regulated. Third, the green spaces system is obligated to establish at habitat green spaces plan and is specified to conserve and improve existing trees and green spaces. The green spaces ratio on reconstruction for old habitat is relaxed to be lower than for new habitat and a gradient of green spaces is peculiarly clarified. The details and requirements for establishment and the minimum area intending for each classes of the central green spaces(habitat park, children park, minimum habitat's green spaces) are regulated. Especially at a garden style of minimum habitat's green spaces, intervals between the south and north houses and a compulsory security for green spaces area classifying into two groups(closing type green spaces and open type green spaces) by a middle-rise or high-rise building are clarified. System of calculation for green spaces area is presented at a special regulation. Fourth, a general index(area/person) of public green spaces within habitat to achieve by 3 habitat kinds is determined, in this case, the index on reconstruction for a deterioration zone can be relaxed to be lower to the extent of a specified quantity. A location and scale, minimum width and minimum area per place of public green spaces are regulated. A space plot principle including adjacent to a road, greening area ratio against total area, security of open space and the shadow line boundary of sunshine are also regulated to intend for public green spaces. Fifth, the minimum horizontal distance between the underground cables and the surrounding greening trees are regulated as the considerable items for green spaces when setting up the underground cables. The principle to establish green spaces within public service facilities is regulated according to the kind of service contents. It shall be examined in order to import or not the special regulations that only exist in Chinese Laws but not in Korean Laws. The result of this study will contribute to gain the domestic landscape architect's' sympathy of the research related to Chinese urban green spaces laws requiring immediate attention and will be a good chance to advance into the internationalization of Korean Landscape Architectural Laws.

Analysis on the Present Support Conditions Based on Screening and Needs of Child Care and Education Teachers for Children with Language Developmental Delayed (보육교사의 언어발달지연 유아 선별에 따른 지원 실태와 요구 분석)

  • Lee, Jin Kyung;Cho, Youn Kyung
    • Korean Journal of Childcare and Education
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    • v.7 no.4
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    • pp.1-26
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    • 2011
  • The purpose of this study was to examine the screening and its validation of children with language developmental delay in child care and education centers, the response of parents with children with language developmental delay and the assistance needs of child care and education teachers for those children. Teacher interview with semi-structural method, transcription and content analysis method were used. The subjects in this study were 13 teachers and 30 infants and toddlers with language developmental delay in 10 child care and education centers in Seoul. The findings of the study were as follows: First, the child care and education teachers screened children with language developmental delay in their classes based on their verbal characteristics and maladjusted behavior. Their screenings were turned out correct. Second, as for the response of parents, the parents who had children with language developmental delay were indifferent, were aware of the fact in advance or asked the teachers for counseling on their children's language developmental delay. Third, the teachers couldn't provide the appropriate supports for the children in needs. Fourth, regarding the assistance needs of the child care and education teachers, they called for assistance from specialists and professional institutions, and wanted to receive education on language development. Besides, they asked for relevant supporting materials and screening criteria, and considered it necessary to reduce the ratio of teacher to children.

Mobility Support Scheme Based on Machine Learning in Industrial Wireless Sensor Network (산업용 무선 센서 네트워크에서의 기계학습 기반 이동성 지원 방안)

  • Kim, Sangdae;Kim, Cheonyong;Cho, Hyunchong;Jung, Kwansoo;Oh, Seungmin
    • KIPS Transactions on Computer and Communication Systems
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    • v.9 no.11
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    • pp.256-264
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    • 2020
  • Industrial Wireless Sensor Networks (IWSNs) is exploited to achieve various objectives such as improving productivity and reducing cost in the diversity of industrial application, and it has requirements such as low-delay and high reliability packet transmission. To accomplish the requirement, the network manager performs graph construction and resource allocation about network topology, and determines the transmission cycle and path of each node in advance. However, this network management scheme cannot treat mobile devices that cause continuous topology changes because graph reconstruction and resource reallocation should be performed as network topology changes. That is, despite the growing need of mobile devices in many industries, existing scheme cannot adequately respond to path failure caused by movement of mobile device and packet loss in the process of path recovery. To solve this problem, a network management scheme is required to prevent packet loss caused by mobile devices. Thus, we analyse the location and movement cycle of mobile devices over time using machine learning for predicting the mobility pattern. In the proposed scheme, the network manager could prevent the problems caused by mobile devices through performing graph construction and resource allocation for the predicted network topology based on the movement pattern. Performance evaluation results show a prediction rate of about 86% compared with actual movement pattern, and a higher packet delivery ratio and a lower resource share compared to existing scheme.

Design and Implementation of Safe-Guard for Elementary School Students (초등학생 안전도우미 설계 및 구현)

  • Kim, Jin-Mook;Moon, Jeong-Kyung
    • Journal of the Korea Convergence Society
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    • v.4 no.2
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    • pp.29-33
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    • 2013
  • From one elementary school of last 2005 Pusan was started "the school police" system is being applied the effect in the elementary school of the human nature receiving entire country. But "with school police system " have a limit about manpower that is insufficient. So we try to make "Baumter-Gikimy " that is extended scollo police in seoul. Despite being like that at 2010 and 2011 cannot forget the elementary student suicide events which are shocking or sexual assault events occur from the campus.From elementary school 4 grade the students between junior high school 1 grade crime occurrence ratio are highest. These people the group leaving out mainly, suicide, with group violence and sexual assault problem gets up same problems. In order to solve like this problems stands the countermeasure of the dimension which is national certainly is necessary. But so far only the damage student and the parents have an interest in about like this problems and they hurt. We the smart phone of Android bases it will be able to solve like this problem points [ayp] from under planning and development boil the elementary student safe helper it will can use. When it uses the elementary student safe helper system which we propose before the accident occurs, it will grasp the state information of the student and it will be able to prevent an accident in advance. We will try to more efficient safe guard to elementary school student by real-time monitoring skill soon.

Descending Aorta Blood Flow Characteristics before the Development of Necrotizing Enterocolitis in Preterm Neonates

  • Kim, Kyung Min;Kim, Hyo Sup;Yoon, Ji Hong;Lee, Eun-Jung;Yum, Sook Kyung;Moon, Cheong-Jun;Youn, Young-Ah;Kwun, Yoo Jin;Lee, Jae Young;Sung, In Kyung
    • Neonatal Medicine
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    • v.25 no.2
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    • pp.78-84
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    • 2018
  • Purpose: To investigate the hemodynamic risk factors for necrotizing enterocolitis (NEC), we analyzed the characteristics of descending aorta (DA) blood flow in preterm neonates, who later developed NEC. Methods: This was an observational case-control study on 53 preterm neonates at a tertiary referral center. Clinical and echocardiographic data were collected from 23 preterm neonates with NEC (NEC group), and compared with those of 30 preterm neonates without NEC (control group). Echocardiography was done at a median (interquartile range) of 5 (3-9) days after birth and 2 (1-2.5) days before the diagnosis of NEC. Results: Basic clinical characteristics including gestational age, birth weight, Apgar score, breast feeding status, use of umbilical catheters, and mode of invasive ventilator care were similar between the groups. Compared with the control group, the lowest diastolic velocity of DA was significantly decreased, whereas the diastolic reverse flow and the ratio of diastolic reverse to systolic forward flows were significantly increased in the NEC group. In addition, the resistive index (RI) of DA was significantly increased in the NEC group and showed a positive association with the development of NEC. Multivariate logistic regression analysis showed that increasing RI of DA was an independent risk factor for the development of NEC (P=0.008). Conclusion: Significant changes in DA flow characteristics including decreased diastolic velocity and increased diastolic reverse flow along with increased peripheral vascular resistance were observed before the development of NEC in preterm neonates. These findings may help clinicians stratify in advance neonates at a risk of developing NEC and may help improve outcomes in these neonates.

The Development of the Conceptual Model Visualization Program (개념모델 가시화 프로그램의 개발)

  • Choi, Hong-Seok;Okazaki, Akira
    • Science of Emotion and Sensibility
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    • v.13 no.3
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    • pp.573-580
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    • 2010
  • The earlier KANSEI evaluation had to choose not to overlap the opposite meaning of the words, had to choose that some figures are shown step by step and had to choose be prepared things in advance. However, The Study shows a method which visualizes the imprecise evaluations of human without choosing evaluation items which are not prepared figures. The program is used the way which is entered by hand-drawing that the subjects use the way to enter their subjective feelings about the evaluations presented by using the mouse or the graphics tablet. It is possible to express imprecise things about evaluations and the method of drawing is free. The program provides that we can express our thinking by drawing and there are a few limits and the prescribed standard. The area ratio of each circle is expressed as a pie chart and the area of circle what is drawn which is counted automatically at the same time. These things are possible not only to modify a transparency, a thickness of a line, a color and the area of circle what is drawn, but also to adjust the area of circle. The conceptual model is visualized that expresses something by hand-drawing such as a circle. The conceptual model has wide range of applications such as a personnel evaluation, a suffering evaluation and product evaluation. The program currently has been testing the effective of the program's possibilities which is used with the personnel appraisal tool of the nurses themselves who work in nurse support department where the St. Marianna University School of Medicine Hospital is. And also the program is proceeding with development to visualize the conceptual model by dynamic interfaces effectively and the program is applied such as KJ method and a program is used to express the kind of the patient's pain and its level.

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