• 대한간호학회지
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• 제33권2호
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• pp.275-283
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• 2003

Purpose: This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea. Method: This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids. Result: The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001). Conclusion: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.

• 보건행정학회지
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• 제20권3호
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• pp.21-35
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• 2010

This study examined the changes in the service mix of Korean hospitals in 6 metropolitan cities between 2003 and 2005, and assessed whether the sample hospitals exhibit consistent trend or chance variation in multiple years. Three measures of hospital service mix, focusing on the specialization of services, were applied: information theory index, internal Herfindahl index, and number of distinct diagnosis-related groups (DRGs) treated. National Health Insurance claims were used to calculate the indexes. Specialization indexes were calculated in each year, and then examined to identify the pattern over time. Kappa analysis was applied to assess the agreements of specialization score between two years after hospitals were categorized into 4 groups with quartiles. Kappa score showed that the service mix of hospitals were changed during the study years. Specialization scores were increased given the market structure for three years. Hospitals which showed higher or lower specialization scores than the average of the scores consistently classified into the same group. Specialization indexes showed relatively consistent pattern over 3 years, and such consistencies were evident for hospitals regardless of the specialization status. Policy makers can identify the degree of specialization with the indexes, and it could provide a picture of how hospital services were mixed and changed over time.

• 한국도로학회논문집
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• 제18권5호
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• pp.83-93
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• 2016

PURPOSES : The aim of this article is to compare and identify eco-friendly competitiveness between (regional) motorway and high-speed rail(HSR) from the perspective of $CO_2$ emission in the Republic of Korea. METHODS : In order for an analysis of low-carbon competitiveness between the two modes, $CO_2e$ emission, $CO_2eppk$ (equivalent $CO_2$ gram per passenger kilometer), is employed as a comparison index. As for HSR, the index is calculated based on the passenger transport data and the gross of $CO_2e$ produced by Kyungbu high-speed line in 2013. Additionally, the gross of $CO_2e$ is computed by the greenhouse gas emission factors of domestic electricity generation mix. Regarding the index of motorway, it is directly calculated using both the official $CO_2e$ emission factor and the passenger-car occupancy of motorway. RESULTS : The results revealed, in the case of inter-regional transport, that the $CO_2e$ emission of displacement-based cars is 54.9% less than that of HSR, as the domestic electric power systems heavily relies on the thermal power plants over 66%. Note that internal combustion engines commonly used for vehicles are more energy-efficient than steam-driven turbines usually utilized for thermal power generation. CONCLUSIONS : It can be seen, at the very least in our study, that HSR has no superiority over motorway in the case of $CO_2e$ emission under the situations of domestic electricity generation mix. In addition, advanced eco-friendly vehicles have strong advantages over HSR. Therefore, all-out efforts should be made to develop and harvest renewable energy sources in order to achieve low-carbon HSR, sparing fossil fuels.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• 한국건축시공학회지
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• 제17권1호
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• pp.39-46
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• 2017

최근 건축물의 기초는 구조체의 안정성과 연관하여 두꺼운 매스콘크리트 형태가 설계되어지고 있다. 그런데, 이와 같은 매트 매스콘크리트는 800mm 이상의 두꺼운 부재로 설계되는 경우가 많아짐에 따라 수화열에 의한 균열이 문제점으로 제기 되고 있다. 이에, 본 연구에서는 상 하부를 구분하여 타설하는 실무조건을 고려하여, 컴퓨터 프로그램상으로 하부와 상부의 최적치를 도출한 다음, 실구조체에 적용 해석치와 실측치간을 비교하므로서 효율적인 수화열균열 저감방안을 제안하고자 하였다. 그 결과, 상 하부 타설 콘크리트간의 저발열 배합정도를 고려한 수화발열량차 적용은 침하균열 방지 및 수화열 균열제어에 효과적인 것으로 밝혀졌다.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.390-403
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• 1988

The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

• 보건행정학회지
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• 제18권2호
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• pp.67-85
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• 2008

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

• 한국병원경영학회지
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• 제6권3호
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• Computers and Concrete
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• 제30권3호
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• pp.165-173
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• 2022

The effect of basalt and polypropylene fibers on the flexural behavior of reinforced concrete (RC) beams is investigated in this paper. The compressive and tensile behaviors of the basalt concrete and polypropylene concrete cylinders are also investigated. Eight beams and 28 cylinders were made with different percentages of basalt and polypropylene fibers. The dosages of fiber were selected as 0.6%, 1.3%, and 2.5% of the total cement weight. Each type of fiber was mixed solely with the concrete mix. Basalt and polypropylene fibers are modern and cheap materials that can be used to improve the structural behavior of RC members. This research is designed to find the optimum percentage of basalt and polypropylene fibers for enhancing the flexural behavior of RC beams. Test results showed that the addition of basalt and polypropylene fibers in any dosage (0.6%, 1.3%, and 2.5%) can increase the flexural strength and displacement ductility index of the beams where the maximum enhancement was measured with 1.3% fibers. The maximum increments in the flexural strength and the displacement ductility index were 30.39% and 260% for the basalt fiber case, while the maximum improvement for the polypropylene fibers case was 55.5% and 230% compared to the control specimen. Finite element (FE) models were then developed in ABAQUS to predict the numerical behaviour of the tested beams. The FE models were able to predict the experimental behaviour with reasonable accuracy. This research confirms the efficiency of basalt and polypropylene fibers in enhancing the flexural behavior of RC beams, and it also suggests the optimum dosage of fibers.

• 국제초고층학회논문집
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• 제12권1호
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• pp.63-74
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• 2023

Large-capacity public transportation systems, represented by urban metro lines, are the key to alleviating the significant increase in urbanization and motorization in China. But to improve the agglomeration effect of metro stations in a more accurate and targeted way requires scientific evaluation and classification of the surrounding areas of metro stations. As spatial and functional design are the core factors for urban renewal design, this study took Beijing as an example, using multi-source data to evaluate the morphology and functional composition surrounding areas of metro stations, and the Boston Consulting Group (BCG) matrix was used to classify and characterize each type of surrounding areas from morphological-functional dimensions. It shows a negative correlation of the mix-use index with the floor area ratio, and only about 20% of the areas achieve the ideal situation of high construction intensity with high mix-use diversity. Hoping to provide a reference for city managers and designers in dealing with the surrounding metro stations with different construction intensities in a more precise way.