• 한국정보전자통신기술학회논문지
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• 제15권2호
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• pp.178-188
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• 2022

탄소중립 달성의 핵심인 분산형 재생에너지의 확산에 따라 발생하는 계통수용성 문제의 해결을 위해 가상발전소의 도입이 활발히 논의되고 있다. 하지만 가상발전소와 같은 신사업은 일반적으로 보상 메커니즘이 존재하지 않아 도입 초기의 경제성 확보가 어렵다. 이에 조기 활성화를 위해서는 보조금을 포함한 적절한 지원이 필요하다. 지원 수준의 결정을 위해서는 비용모델이 필요하나 신사업의 경우 충분한 데이터가 부족한 문제가 있다. 본 연구에서는 국내 전문가를 대상으로 가상발전소 도입에 필요한 요건, 적정 규모와 비용에 대한 설문을 통하여 비용 추정 모델을 도출하였다. 우선 가상발전소의 자원구성 형태가 비용에 미치는 영향을 고려하여 설문조사에 따라 자원구성 시나리오를 설계하였다. 각자의 자원구성 시나리오에 대한 비용추계를 기반으로 로지스틱회귀분석을 통하여 시나리오에 따른 비용 추정 모델을 도출하였다. 가상발전소 규모와 자원구성 시나리오에 따른 사례분석으로 적절한 초기 보상 규모를 비교 분석하였다. 20MW~500MW 규모의 가상발전소에서 중대형 위주와 소형 자원을 포함한 자원구성 시나리오를 적용하였을 때, 중대형 위주의 구성 시 비용이 29~51% 낮게 나타났다.

• 한국임상약학회지
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• 제32권3호
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• pp.215-225
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• 2022

Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

• 콘크리트학회논문집
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• 제21권3호
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• pp.359-366
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• 2009

본 논문은 해양 RC 구조물의 새로운 생애주기비용 (LCC) 평가 모델을 제시한다. 이 모델 방법은, 기존의 LCC 평가 모델과 달리, 구조물을 설계하는 동안 추가적인 염화물 침투의 새로운 데이터가 있을 때 계속적으로 생애주기비용을 업데이트 할 수 있다. 이는 베이지안 기법을 통하여 이루어진다. 일반적인 중요 구조물에서는 각 부재에 대한 다양한 모니터링 시스템을 이용하기 때문에 어려움 없이 베이지안 기법에 필요한 데이터를 얻을 수 있다. 베이지안 기법을 사용하여 구조물의 생애유지 관리비용을 높은 정밀도로 예측할 수 있다.

• 자원ㆍ환경경제연구
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• 제12권1호
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• pp.75-90
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• 2003

본 연구는 도로혼잡의 외부효과를 제거하기 위한 정책방안으로 선행연구들이 제안한 피구세의 타당성 여부를 편익측면의 분석을 통해 재조명하고 있다. 본 연구는 예산제약 조건과 시간제약 조건하의 효용극대화 모형을 이용하여 고속도로 이용을 통해 얻을 수 있는 사적 한계편익과 사회적 한계편익을 규명하고 있다. 그 결과 본 연구는 사적 한계편익과 사회적 한계편익의 차이인 외부 시간비용 만큼을 피구세로 부과할 것을 제안하고 있다. 이 때 외부 시간비용은 고속도로 혼잡으로 인해 고속도로 이용자가 추가로 부담하는 한계시간비용의 가치를 나타낸다. 그리고 본 연구는 효용 극대화 모형을 통해 도출한 피구세의 크기와 이윤(또는 부)의 극대화를 통해 선행연구들이 도출한 피구세의 크기가 동일하다는 사실을 이론적으로 보여주고 있다. 아울러 본 연구는 효용극대화 모형을 통하여 사회적 평균혼잡비용과 사적 한계혼잡비용이 일치한다는 사실도 동시에 보이고 있다.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.187-191
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• 2013

Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999 to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P<0.001). Conclusions Based on our study, the pedicled TRAM flap remains a cost-effective technique in breast reconstruction when compared to the newer, more expensive and tedious DIEP flap.

• 한국건설관리학회논문집
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• 제8권5호
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• pp.71-79
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• 2007

최근 가치공학과 생애주기비용 분석의 중요성이 대두됨에 따라 항만구조물의 VE/LCC(Value Engineering/Life Cyccle Cost) 분석에 대한 연구개발이 활발하게 진행되고 있다. 반면에 항만구조물의 생애주기비용 산정과 가치분석의 실무 적용에 있어 이론적 모델과 표준지침 및 소프트웨어 등이 정립되어있지 않기 때문에 분석자에 따라 일관성과 전문성에 한계를 나타내고 있다. 특히 생애주기비용의 분석에 있어 현행의 확정론적 방법으로는 파괴손실비용의 산정이 어렵기 때문에 퍼지 신뢰성해석에 따라 파기확률을 파괴손실비용에 반영할 수 있는 확률론적 방법의 도입이 반드시 필요한 실정이다 따라서 본 연구에서는 안벽구조물의 설계에 있어 대안별 열화성능 차원의 설계를 수행하도록 유도하기 위하여 퍼지신뢰성 이론에 기초한 확률론적 VE/LCC 분석모델을 제안하였으며, 제안된 분석모델의 신뢰성과 활용성을 향상시키기 위한 측면에서 실제 대상 구조물에 적용하였다. 본 연구에서 제안된 방법론은 향후 다양한 분야의 설계 및 유지관리단계에서의 생애주기 비용과 가치분석의 의사결정에 활용되어질 것으로 사료된다.

• 한국통신학회논문지
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• 제27권3A호
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• pp.268-275
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• 2002

본 논문에서는 프레임차 에너지의 전위차를 이용한 비용으로 비디오 객체를 추출하는 영역 기반 분할 알고리즘을 제안한다. 첫 번째 단계에서는 파티션의 영역 내에 비디오 객체의 윤곽이 포함되지 않도록 공간적인 밝기 값을 이용하여 동질한 영역들로 세밀하게 분할을 한다. 이렇게 세밀하게 분할된 파티션은 두 번째 단계인 시공간 분할의 초기 파티션이 된다. 시공간 분할에서는 각각의 인접한 영역들의 동질성 비용을 두 영역의 프레임차 에너지 중에서 작은 에너지를 가지는 영역의 프레임차 에너지와 두 영역에 의하여 만들어지는 윤곽상에 존재하는 프레임차 에너지로 계산한다. 다음에 동질성의 비용이 최소인 두 영역을 찾아서 병합하구 파티션을 새롭게 갱신한다. 이러한 반복적 병합은 프레임차 에너지의 전위차가 큰 윤곽들이 남을 때까지 수행한다. 마지막으로 후처리 단계에서는 객체 내부의 윤곽들을 제거하여 비디오 객체를 추출한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.348-355
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• 2022

Objectives: To compare the vital sign stability and cost of two commonly used sedatives, midazolam (MDZ) and dexmedetomidine (DEX). Patients and Methods: This retrospective study targeted patients who underwent mandibular third molar extractions under intravenous sedation using MDZ or DEX. The predictor variable was the type of sedative used. The primary outcome variables were vital signs (heart rate and blood pressure), vital sign outliers, and cost of the sedatives. A vital sign outlier was defined as a 30% or more change in vital signs during sedation; the fewer changes, the higher the vital sign stability. The secondary outcome variables included the observer's assessment of alertness/sedation scale, level of amnesia, patient satisfaction, and bispectral index score. Covariates were sex, age, body mass index, sleeping time, dental anxiety score, and Pederson scale. Descriptive statistics were computed including propensity score matching (PSM). The P-value was set at 0.05. Results: The study enrolled 185 patients, 103 in the MDZ group and 82 in the DEX group. Based on the data after PSM, the two samples had similar baseline covariates. The sedative effect of both agents was satisfactory. Heart rate outliers were more common with MDZ than with DEX (49.3% vs 22.7%, P=0.001). Heart rate was higher with MDZ (P=0.000). The cost was higher for DEX than for MDZ (29.27±0.00 USD vs 0.37±0.04 USD, P=0.000). Conclusion: DEX showed more vital sign stability, while MDZ was more economical. These results could be used as a reference to guide clinicians during sedative selection.

• 의학교육논단
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• 제25권3호
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• pp.273-284
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• 2023

According to the World Health Organization, for medical schools to fulfill their obligation of social accountability, it is necessary for medical education, research, and service areas to ref lect the healthcare system's relevance, quality, cost-effectiveness, and equity. This study utilized Boelen and Heck's (1995) social accountability grid model to analyze the degree to which the Accreditation Standards of Korean Institute of Medical Education and Evaluation 2019 (ASK2019) standards apply the World Federation for Medical Education's (WFME) standards. The social accountability characteristics of the former were compared to those of the WFME, the Liaison Committee on Medical Education, and the Australian Medical Council. Experts with experience and certification in medical education and evaluation classified the ASK2019 standards according to the grid model, evaluated social accountability perspectives, and categorized them according to the process, content, and outcome. Of the 92 standards, 61 (66.30%) were selected as social accountability standards; these encompassed all areas. There was a particular focus on outcome-related areas, such as "mission and outcomes," "student assessment," "educational evaluation," and "continuous improvement." Education and quality were the most common (33, 54.11%), followed by 18 standards related to education and relevance. However, the standards on cost effectiveness and equity corresponding to education, research, and service were significantly insufficient. As a result of classification using a logic model, many criteria were incorporated into the process, producing results similar to those of international accreditation institutions. Therefore, to fulfill medical schools' social accountability, it is necessary to develop cost effectiveness and equity standards with reference to grid models and expand them beyond education to include research and service areas. Developing content and outcome standards is also required.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.