• Title/Summary/Keyword: Cost & Benefit

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A Study on Reputation as Corporate Asset (기업자산으로서의 기업명성가치 연구: 국내 4개 기업 슈퍼브랜드와 기업명성, 미디어 이용간 관련성을 중심으로)

  • Lee, Cheol-Han;Cha, Hee-Won
    • Korean journal of communication and information
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    • v.30
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    • pp.203-237
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    • 2005
  • The purpose of this study is to find a model that can measure the public relations programs based on the assumption that the public relations should aim to lift the corporate reputation. It is a trend that corporate's activities are to be measured from the standpoint of cost-benefit efficiency. However, public relations fields in Korea is left behind this trend because the fields lack in sophisticated model. In order to fill this gap, the researchers introduce the reputation measurement model that can calculate individual corporate public relations programs. In addition, this reputation model Is applied to Korean companies with the expectation of producing a PR index which ran be used to measure the reputation as corporate asset, or superbrand. This study examines the effects of superbrand on consumers according to the media use. Based on the expert group interviews and surveys on consumers, the factors of reputation are drawn. These factors contribute to find reputation model and measurement index which are again applied to measure the Korean companies' public relations programs. Using superbrand as dependent variables and managing abilities, corporate responsibility, corporate communication, and product/employee quality, this study seeks to find which factor specifically attribute to lift corporate reputation. Results show that each factor influences the corporate reputation positively. In addition, the researchers find that media use is moderately related to the superbrand building process in cognitive dimension.

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A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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A Study on the Hull-dimension of 89 ton class Stow-net Vessel with Stern-fishing (89톤급 선미식 안강망어선의 선형치수에 관한 연구)

  • Park, Je-Ung;Lee, Hyeon-Sang
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.3
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    • pp.159-165
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    • 1997
  • This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

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A Study on Suitable Site for Day Nursery in Tae-gu (대구의 보육시설 현황과 입지선정)

  • Bae, Sook-Hee
    • Journal of the Korean association of regional geographers
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    • v.2 no.1
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    • pp.25-38
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    • 1996
  • As the proportion of women's participation in economic activities is rising, the increase of husband and wife both working and nuclear families makes children up-bringing a social problem. But many families have difficulties by the shortage of day nurseries which can solve it. As we can see in the research, the most urgent problem is the extension of nurseries in quantity. In Taegu, since it became a wide-area city, there are 473 nurseries. But in the respect of distribution, only less than 10% of Dongs have more than 7 nurseries and more than 90% of Dongs have less than 7 nurseries. Consequently nurseries are extremely insufficient. Moreover 29 Dongs don't have any nurseries at all and they take 18.6% of Dongs. The second problem is the unbalanced distribution of nurseries. West and north ward which are industrial complex and swarmed with low-income families, and Tal-sung county which is recently included in the wide-area city keenly need the establishment of nurseries. Besides, Bi-san 1 Dong and Non-gong which have only $1{\sim}2$ nurseries though they have high proportion of children and women who can be pregnant are also the areas which take precedence of nursery establishment. The third problem is that government support must be increased in the areas which have many small, petty and profit-making private nurseries so that good quality teachers can make breeding activities in nice facilities and environment. In materials which are obtained by the interviews with publich servants in charge of family welfare in some ward offices. Young and unexperienced persons who aquired certificate of qualification take day-nursery permits and run nurseries only a few months. and if the profits are insufficient, they sell the nurseries for premiums to third persons who are not qualified. Then the third managers only think of profits without thought of good quality childcare. As the result, the nurseries become asylums not nurseries. That is why the conditions of nursery establishment must be restricted to suitable scale and experienced persons. The fourth problem is that the nurseries in work places are extremely insufficient. The women who have jobs have many things to do before they go to work such as preparing meals and leaving children in the care of someone. Hence the childcare problem of working women must be solved. In nuclear families, childcare is the most serious problem for working women. The fifth one is the reduction of childcare expenses. Women must sacrifice themselves a lot to make social activities. To say nothing of physical and mental burden, they have to spend much of their salaries on childcare. And yet they don't take the benefit of good quality childcare. For the participation of women in public affairs, society must support the childcare problem to have then be devoted to their jobs without worries about their children. Therefore Taegu wide-area city must select west, north ward which are industrial complex and the low-income swarmed area before everything and establish many national, public and corporate nurseries which cost less expenses.

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Current Status and Prospects of Various Methods used for Screening Probiotic Microorganisms (Probiotic 미생물 검사에 사용되는 다양한 방법들에 대한 현황과 향후 전망)

  • Kim, Dong-Hyeon;Kim, Hong-Seok;Jeong, Dana;Chon, Jung-Whan;Kim, Hyunsook;Kim, Young-Ji;Kang, Il-Byung;Lee, Soo-Kyung;Song, Kwang-Young;Park, Jin-Hyeong;Chang, Ho-Seok;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.4
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    • pp.203-216
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    • 2016
  • Probiotic microorganisms are thought to provide health benefits when consumed. In 2001, the World Health Organization defined probiotics as "live microorganisms which confer a health benefit on the host, when administered in adequate amounts." Three methods for screening potential probiotics have currently widely available. (1) In vitro assays of potential probiotics are preferred because of their simplicity and low cost. (2) The use of in vivo approaches for exploring various potential probiotics reflects the enormous diversity in biological models with various complex mechanisms. (3) Potential probiotics have been analyzed using several genetic and omics technologies to identify gene expression or protein production patterns under various conditions. However, there is no ideal procedure for selecting potential probiotics than testing cadidate strains on the target population. Hence, in this review, we provide an overview of the different methodologies used to identify new probiotic strains. Furthermore, we describe futre perspectives for the use of in vitro, in vivo and omics in probiotic research.

The Effects of Female Wage on Fertility in Korea (여성의 임금수준이 출산율에 미치는 영향 분석)

  • Kim, Jungho
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.105-138
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    • 2009
  • Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

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On the Improvement of Precision in Gravity Surveying and Correction, and a Dense Bouguer Anomaly in and Around the Korean Peninsula (한반도 일원의 중력측정 및 보정의 정밀화와 고밀도 부우게이상)

  • Shin, Young-Hong;Yang, Chul-Soo;Ok, Soo-Suk;Choi, Kwang-Sun
    • Journal of the Korean earth science society
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    • v.24 no.3
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    • pp.205-215
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    • 2003
  • A precise and dense Bouguer anomaly is one of the most important data to improve the knowledge of our environment in the aspect of geophysics and physical geodesy. Besides the precise absolute gravity station net, we should consider two parts; one is to improve the precision in gravity measurement and correction of it, and the other is the density of measurement both in number and distribution. For the precise positioning, we have tested how we could use the GPS properly in gravity measurement, and deduced that the GPS measurement for 5 minutes would be effective when we used DGPS with two geodetic GPS receivers and the baseline was shorter than 40km. In this case we should use a precise geoid model such as PNU95. By applying this method, we are able to reduce the cost, time, and number of surveyors, furthermore we also get the benefit of improving in quality. Two kind of computer programs were developed to correct crossover errors and to calculate terrain effects more precisely. The repeated measurements on the same stations in gravity surveying are helpful not only to correct the drifts of spring but also to approach the results statistically by applying network adjustment. So we can find out the blunders of various causes easily and also able to estimate the quality of the measurements. The recent developments in computer technology, digital elevation data, and precise positioning also stimulate us to improve the Bouguer anomaly by more precise terrain correction. The gravity data of various sources, such as land gravity data (by Choi, NGI, etc.), marine gravity data (by NORI), Bouguer anomaly map of North Korea, Japanese gravity data, altimetry satellite data, and EGM96 geopotential model, were collected and processed to get a precise and dense Bouguer anomaly in and around the Korean Peninsula.

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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A Study on the Acceptance Factors of the Capital Market Sentiment Index (자본시장 심리지수의 수용요인에 관한 연구)

  • Kim, Suk-Hwan;Kang, Hyoung-Goo
    • Journal of Intelligence and Information Systems
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    • v.26 no.3
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    • pp.1-36
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    • 2020
  • This study is to reveal the acceptance factors of the Market Sentiment Index (MSI) created by reflecting the investor sentiment extracted by processing unstructured big data. The research model was established by exploring exogenous variables based on the rational behavior theory and applying the Technology Acceptance Model (TAM). The acceptance of MSI provided to investors in the stock market was found to be influenced by the exogenous variables presented in this study. The results of causal analysis are as follows. First, self-efficacy, investment opportunities, Innovativeness, and perceived cost significantly affect perceived ease of use. Second, Diversity of services and perceived benefits have a statistically significant impact on perceived usefulness. Third, Perceived ease of use and perceived usefulness have a statistically significant effect on attitude to use. Fourth, Attitude to use statistically significantly influences the intention to use, and the investment opportunities as an independent variable affects the intention to use. Fifth, the intention to use statistically significantly affects the final dependent variable, the intention to use continuously. The mediating effect between the independent and dependent variables of the research model is as follows. First, The indirect effect on the causal route from diversity of services to continuous use intention was 0.1491, which was statistically significant at the significance level of 1%. Second, The indirect effect on the causal route from perceived benefit to continuous use intention was 0.1281, which was statistically significant at the significance level of 1%. The results of the multi-group analysis are as follows. First, for groups with and without stock investment experience, multi-group analysis was not possible because the measurement uniformity between the two groups was not secured. Second, the analysis result of the difference in the effect of independent variables of male and female groups on the intention to use continuously, where measurement uniformity was secured between the two groups, In the causal route from usage attitude to usage intention, women are higher than men. And in the causal route from use intention to continuous use intention, males were very high and showed statistically significant difference at significance level 5%.