• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.6 no.1
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• pp.1-11
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• 1986

Welded connectors of the cover plates, the transverse stiffeners of the plate girders, and the gusset plates of the plates girders or box girders, were selected as studying objects. A simplified method of drawing the S-N curves in these welded joints by a computer program without the direct fatigue tests was established. The plots on the S-N curve using the values from the practical fatigue tests were compared with the results from the method of the computer programming. The results of these studies are as follows. It appeared that the fatigue life by calculation method was a little less than the practical fatigue life from the actual tests. The latter values included both life $N_c$ of occurrence of initial crack $a_i$ and the life $N_p$ of propagation of critical crack. On the other hand, the former values included only the life $N_p$. Therefore, these results should be considered as justifiable ones. Since the difference between the two results was not significant, the results by calculation method should be in the conservation side when the safety of the structures was considered. Consequently, the results by calculation method should be applicable to the fracture fatigue design of structure. For reference, the same fatigue tests were performed with the specimens of 3 pieces in each case made of the low-strength steel, SS 41. The results went unexpected showing that the fatigue strength was lower in the case of low-strength steel. That is, in the case of the cover plate, the fatigue strength became slowly higher than the case of high-strength steel, SWS 50. That was observed when the maximum testing stress was higher than $14kg/mm^2$. In addition, in the case of the transverse stiffener, the fatique strength became rapidly higher than the case of SWS 50. That was observed when the maximum testing stress was lower than $31kg/mm^2$. It was thought that more such fatigue tests should be performed for more reliable results.

• Progress in Medical Physics
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• v.23 no.4
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• pp.279-284
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• 2012

The X ray has been widely used in both diagnosis and treatment. Recently, a miniature X ray tube has been developed for radiotherapy. The miniature X ray tube is directly inserted into the body irradiated, so that X rays can be guided to a target at various incident angles according to collimator geometry and, thus, minimize patient dose. If such features of the miniature X ray tube can be applied to development of X ray imaging as well as radiation treatment, it is expected to open a new chapter in the field of diagnostic X ray. However, the miniature X ray tube requires an added filter and a collimator for diagnostic purpose because it was designed for radiotherapy. Therefore, a collimator and an added filter were manufactured for the miniature X ray tube, and mounted on. In this study, we evaluated beam characteristics of the miniature X ray tube for diagnostic X ray system and accuracy of measuring the HVL. We used the Si PIN Photodiode type Piranha detector (Piranha, RTI, Sweden) and estimated the HVL of the miniature X ray tube with added filter and without added filter. Through an another measurement using Al filter, we evaluated the accuracy of the HVL obtained from a direct measurement using the automatic HVL calculation function provided by the Piranha detector. As a result, the HVL of the miniature X ray tube was increased around 1.9 times with the added filter mounted on. So we demonstrated that the HVL was suitable for diagnostic X ray system. In the case that the added filter was not mounted on, the HVL obtained from use of the automatic HVL calculation function provided by Piranha detector was 50% higher than the HVL estimated using Al filter. Therefore, the HVL automatic measurement from the Piranha detector cannot be used for the HVL calculation. However, when the added filter was mounted on, the HVL automatic measurement value using the Piranha detector was approximately 15% lower than the estimated value using Al filter. It implies that the HVL automatic measurement can be used to estimate the HVL of the miniature X ray tube with the added filter mounted on without a more complicated measurement method using Al filter. It is expected that the automatic HVL measurement provided by the Piranha detector enables to make kV-X ray characterization easier.

• Asian-Australasian Journal of Animal Sciences
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• v.27 no.7
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• pp.917-925
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• 2014

An accurate feed formulation is essential for optimizing feed efficiency and minimizing feed cost for swine and poultry production. Because energy and amino acid (AA) account for the major cost of swine and poultry diets, a precise determination of the availability of energy and AA in feedstuffs is essential for accurate diet formulations. Therefore, the methodology for determining the availability of energy and AA should be carefully selected. The total collection and index methods are 2 major procedures for estimating the availability of energy and AA in feedstuffs for swine and poultry diets. The total collection method is based on the laborious production of quantitative records of feed intake and output, whereas the index method can avoid the laborious work, but greatly relies on accurate chemical analysis of index compound. The direct method, in which the test feedstuff in a diet is the sole source of the component of interest, is widely used to determine the digestibility of nutritional components in feedstuffs. In some cases, however, it may be necessary to formulate a basal diet and a test diet in which a portion of the basal diet is replaced by the feed ingredient to be tested because of poor palatability and low level of the interested component in the test ingredients. For the digestibility of AA, due to the confounding effect on AA composition of protein in feces by microorganisms in the hind gut, ileal digestibility rather than fecal digestibility has been preferred as the reliable method for estimating AA digestibility. Depending on the contribution of ileal endogenous AA losses in the ileal digestibility calculation, ileal digestibility estimates can be expressed as apparent, standardized, and true ileal digestibility, and are usually determined using the ileal cannulation method for pigs and the slaughter method for poultry. Among these digestibility estimates, the standardized ileal AA digestibility that corrects apparent ileal digestibility for basal endogenous AA losses, provides appropriate information for the formulation of swine and poultry diets. The total quantity of energy in feedstuffs can be partitioned into different components including gross energy (GE), digestible energy (DE), metabolizable energy (ME), and net energy based on the consideration of sequential energy losses during digestion and metabolism from GE in feeds. For swine, the total collection method is suggested for determining DE and ME in feedstuffs whereas for poultry the classical ME assay and the precision-fed method are applicable. Further investigation for the utilization of ME may be conducted by measuring either heat production or energy retention using indirect calorimetry or comparative slaughter method, respectively. This review provides information on the methodology used to determine accurate estimates of AA and energy availability for formulating swine and poultry diets.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.32 no.5A
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• pp.255-266
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• 2012

Main cable of a suspension bridge is the important member which shows the overall structure integrity at bridge completion. Configuration of main cable is a free hanging state at cable erection completion and is different from that at bridge completion supporting the dead loads such as hanger, girder, and so on. Accordingly, the configuration control under cable erection is considerably significant because the configuration at cable erection completion has direct influence on that at bridge completion. That is performed by sag adjustments at center, side span and tension adjustments at anchor span. The former needs the sag sensitivity which represents the control quantity of strand length corresponding to that of sag. The latter requires the tension sensitivity which shows the change of strand tension according to that of strand temperature. In this study, the fundamental equations of cable were derived with the assumption of either catenary or parabola shape, the differential-related equations using chain rule on horizontal tension were drawn from those and finally the estimation methods of the sag / tension sensitivity were proposed from both those. The nonlinear numerical analysis flow charts of sag sensitivity based on the catenary equations were proposed and the sag sensitivities grounded on the differential-related equations were compared with the results using them for various parameters of sag change. Also, considering the combinations of sag change parameters, the calculation method of the final variation for the cable sag was suggested. For the real suspension bridge under construction with PPWS method, the sag/tension sensitivity were estimated considering the construction conditions like the change of PPWS length, PPWS temperature, bridge span, etc.. We hope that this study will be a systematic guideline for the configuration control under main cable erection and improved highly by field verification in the real bridge site.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.45 no.4
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• pp.300-309
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• 2017

A spacecraft obtains a reaction momentum required for an orbit correction and an attitude control by exhausting a combustion gas through a small thruster in space. If the exhaust plume collides with spacecraft surfaces, it is very important to predict the exhaust plume behavior of the thruster when designing a satellite, because a generated disturbance force/torque, a heat load and a surface contamination can yield a life shortening and a reduction of the spacecraft function. The purpose of the present study is to ensure the core technology required for the spacecraft design by analyzing numerically the exhaust gas behavior of the 10 N class bipropellant thruster for an attitude control of the spacecraft. To do this, calculation results of chemical equilibrium reaction between a MMH for fuel and a NTO for oxidizer, and continuum region of the nozzle inside are implemented as inlet conditions of the DSMC method for the exhaust plume analysis. From these results, it is possible to predict a nonequilibrium expansion such as a species separation and a backflow in the vicinity of the bipropellant thruster nozzle.

• Health Policy and Management
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• v.4 no.2
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• pp.77-110
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• 1994

This study is an empiriacl analysis of effects of government intervention on the health care delivery system in Korea. The purposes of this study are to find out the effects of government intervention on the per capita national health expenditure(per capita NHE), crude mortality rate(CMR), and institutional efficiency. Here, the institutional efficiency is defined as a formula shown below: log$\frac{100-curde mortality rate }{per capita NHE}$$\times$100. The formula indicates that the instiutional efficiency increases if the CMR and/or per capita NHE goes down. In the meantime the government intervention is measured by six independent variables: I) the degree of social developments, ii) the numberr of physicians per 100, 000 population, iii) the proportion of specialists among the total physicians, iv) the proportion of public expenditure among the NHE, v) the proportion of public beds to the total number of beds, vi) the proportion of physicians working at the public sector to the total number of physicians. In the above six independent variables iv), v) and vi) are the ones that reflect the degree of government intervention. In actual calculation, the two independent variables v) and vi) are integrated into a new variable based on one to one correspondence. The materials used are the time-series data from 1970 through 1990 in Korea. A path analysis and the time-series regression analysis were adopted to estimate and examine the causal relationship between variables involved. And decomposition of the effect of causal relationship is made to find net effect, direct and indirect effect. The major findings are as follows; 1. The effect of public expenditure, number of physicians per 100, 000 population, the proportion of specialists among the total physicians and social development shows a positive relationship with per capita NHE. Only if the government intervention would be counted, the effects of the number of physicians and the proportion of specialists succeed in containing per capita NHE. 2. In additionn to the above four variables, one additional variable, per capita NHE, was also responsible for the reduction of CMR. The factor of social development found to be the most potent predictor of the CMR reduction. However, the CMR reduction due to government intervention was negligible. 3. Meanwhile, the above four variables were found to was have negative effects on the institutional efficiency. The reverse is true when the government intervention is counted. For example, the number of physicians and the proportion of specialists have played a positive role in raising institutional efficiency via goverment intervention. This comes from the factual effect that the increment of institutional efficiency via the reduction of per capita NHE is bigger than via the reduction of CMR.

• Korean Journal of Agricultural and Forest Meteorology
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• v.5 no.3
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• pp.200-207
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• 2003

'||'||'||'&'||'||'||'quot;Overheating index'||'||'||'&'||'||'||'quot;, the normalized difference in incident solar energy between a target surface and a level surface, is helpful in estimating the spatial variation in daily maximum temperature at the landscape scale. It can be computed as the ratio of the 4-hour cumulative solar irradiance surplus or deficit from that over a level surface to the maximum possible deviation (15 MJ $m^{-2}$ ) during the midafternoon. Ecosystem models may, for simplicity, use an empirical proxy (exposure index) variable combining slope and aspect in place of the overheating index to account for the variation of midafternoon solar irradiance. A comparative study with real-world landscape data was carried out to evaluate the performance of exposure index in replacing the overheating index. Overheating indices for summer solstice, fall equinox and winter solstice were calculated at 573,650 grid cells constituting the land surface of Donggye-Myun, Sunchang County in Korea, based on a 10-m DEM. Exposure index was also calculated for the same area and fitted for the variation of overheating index to derive a 2$^{nd}$ -order linear regression equation. The coefficient of determination ($R^2$) was 0.50 on summer solstice, 0.56 on fall equinox, and 0.44 on winter solstice, respectively. These are much lower than the theoretically calculated $R^2$ values ranging from 0.7 in summer to 0.9 in autumn. According to our study, exposure index failed to accurately predict the cumulative solar irradiance over a complex terrain, hindering its application to daily maximum temperature estimation. We suggest direct calculation of the overheating index in preference to using the exposure index.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.69
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• pp.589-616
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• 2016

The reviewing of an analysis of the Korea-China FTA due to guidance introduced for the new regulations or exceptional regulations compared to the KORUS, Korea-EU, Korea-ASEAN FTA. Commodity sectors in the Korea-China FTA and the KORUS, Korea-EU, Korea-ASEAN FTA(the majority in the country and trade criteria analysis result) compared and analyzed the results, rules of origin and the customs clearance procedures of origin, preferential tariff rate of origin and the origin preferential specific rules are somewhat difference, but customs and trade facilitation regulations are already quite consistent with the Korea customs system. Relatively important research results were as follows. First, the calculation of the regional value content in KORCHINA FTA is that I'm to use the deduction method can comprehensively reflect a regional value ratio, with respect to the materials acquired originating status as the FTA in the US and EU use the product non it's not to consider the value of the originating materials originating materials can be utilized for intermediate goods. Second, even if a non-treaty country in the middle with the exception of direct transport rules, and acknowledge the country of origin are under customs control, there are provisions for the period are temporarily stored in a non-treaty countries separately, that period goods imported into the non-treaty countries and up to three months from the day. If the situation of the occurrence of force majeure be greater than three months, but has so exceed six months. Third, the materials acquired originating status in the Korea-China FTA not to consider the value of non-originating materials used in its products as the KORUS FTA and Korea-EU FTA, that can be utilized originating materials for intermediate goods. It is expected that higher utilization of rules of origin. Meanwhile, Korea-China FTA has provisions to allow requests for preferential tariff applied on imports Customs declaration of intention to apply pre-condition for a preferential tariff applied to the importer. In other words, if the import customs tariff preference when applying post-intention not to advance is to be noted that any preferential treatment to prevent the later application.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.272-280
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• 2017

Background: The high cost of intrathecal morphine pump (ITMP) implantation may be the main obstacle to its use. Since July 2014, the Korean national health insurance (NHI) program began paying 50% of the ITMP implantation cost in select refractory chronic pain patients. The aims of this study were to investigate the financial break-even point and patients' satisfaction in patients with ITMP treatment after the initiation of the NHI reimbursement. Methods: We collected data retrospectively or via direct phone calls to patients who underwent ITMP implantation at a single university-based tertiary hospital between July 2014 and May 2016. Pain severity, changes in the morphine equivalent daily dosage (MEDD), any adverse events, and patients' satisfaction were determined. We calculated the financial break-even point of ITMP implantation via investigating the patient's actual medical costs and insurance information. Results: During the studied period, 23 patients received ITMP implantation, and 20 patients were included in our study. Scores on an 11-point numeric rating scale (NRS) for pain were significantly reduced compared to the baseline value (P < 0.001). The MEDD before ITMP implantation was 0.59 [IQR: 0.55-0.82]. The total MEDD increased steadily to 0.77 [IQR: 0.53-1.08] at 1 year, which was 126% of the baseline (P < 0.001). More than a half (60%) responded that the ITMP therapy was somewhat satisfying. The financial break-even point was 28 months for ITMP treatment after the NHI reimbursement policy. Conclusions: ITMP provided effective chronic pain management with improved satisfaction and reasonable financial break-even point of 28 months with 50% financial coverage by NHI program.