• 한국병원경영학회지
• /
• 제19권4호
• /
• pp.57-68
• /
• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• 보건의료산업학회지
• /
• 제11권3호
• /
• pp.51-64
• /
• 2017

Objectives : This study examined the effect of private health insurance on medical care utilization by subscription type. Methods : The data used were the six waves of the Korea Health Panel (2009-2014), and 16,187 persons were the subjects of the analysis. We performed a panel regression with a fixed effects model. Results : Indemnity private health insurance was positively related to the number of physician visits, number of admissions, and total length of stays. However, fixed-benefit private health insurance was not related to medical care utilization. Conclusions : The result of this study, which shows the difference by subscription type in the effect of private health insurance on medical care utilization, suggests that continuous monitoring of indemnity private health insurance is needed in the future.

• 한국병원경영학회지
• /
• 제22권2호
• /
• pp.58-69
• /
• 2017

Recently, with the increase in the number of private health insurance subscribers, interest in overuse of the medical service is increasing. This study analyzed the impacts of private health insurance (PHI) on medical institution selection in outpatient service utilization among persons with arthritis. In order to control patients' health status, we extracted outpatient episodes with the same disease (KCD6, M13) from Korea Health Panel. The unit of analysis was an outpatient visit with arthritis in 2014 (n=23,363). In the light of insurance coverage, we redefined three type of private health insurance (ex, indemnity, fixed benefit, and non-insured) as a test variable and two type of medical institution (ex, hospital and physician visit) as a dependent variable. We conducted a probit regression analysis to identify the impacts of PHI on medical institution selection controlling for heteroscedasticity. The results of this study showed that the insured with indemnity were more likely to choose hospital departments than clinics (marginal effect=0.0475, p=0.000). The impact of participation of fixed benefit PHI was not as clear as that of indemnity type (marginal effect=0.0162, p=0.047). In conclusion, this study confirmed that PHI, particularly indemnity type has a significant impact on the selection of medical institutions. Healthcare policy makers should consider that PHI not only affects the overall quantitative increase in healthcare utilization, but also influences the selection of medical institutions.

• 보건행정학회지
• /
• 제33권3호
• /
• pp.325-337
• /
• 2023

Background: While there are many studies estimating the effects of private health insurance on various types of health care utilization, few have examined how such effects change in conjunction with important policy reforms in national health insurance (NHI). This study examined how the effect of private health insurance (supplemental and fixed cash benefit) on high-cost outpatient imaging test utilization changed following the expansion of magnetic resonance imaging (MRI) coverage in 2018, which is a key example of the NHI benefit expansion policy in recent years. Methods: Data from the 2017 and 2019 Korea Health Panel Survey, which contained information about healthcare utilization before and after the expansion of MRI coverage in 2018, were used. The incremental effect of private health insurance on high-cost outpatient imaging test utilization for each period were quantified and compared, with special attention given to the type of private health insurance. Results: While people with supplemental private health insurance were more likely to use high-cost outpatient imaging tests than those without, both before and after the expansion of MRI coverage, the incremental effect increased from 1.6% points in 2017 to 2.5% points in 2019. Conclusion: Benefit expansion in NHI does not necessarily reduce disparities in the use of health care between private health insurance subscribers and non-subscribers. The results of our study also suggest that the path through which private health insurance affects healthcare utilization may not be limited to the price mechanism alone but can be more complex.

• 한국유기농업학회지
• /
• 제10권1호
• /
• pp.49-63
• /
• 2002

In order to supply 85% of total organic feed in ruminants and 80% in non-ruminants for organic animal production, nitrogen fixation ability of legume should be used in domestic roughages production. 50% of Europe organic farmer use intercropping legume in as green manure. This article is dealing with amount of biologically fixed nitrogen used by legumes and methods for estimating the transfer of biologically fixed N in rotation and separating the N benefit into fixed N and non-fixed N components are reviewed. Available data indicate that transfer amount of N to non legumes was from 50∼9.6(kg/ha) in legume-cereal rotations and proportion of legume N varied with seasons, 90% in summer, 50% in autumn. The important point in cropping system for legumes have to be included for organic forage production 6 year rotation is based on pasture system of 3 year pasture + 2 year annual(com, sudangrass), again pasture. Rye, barly and Italian ryegrass+legumes(vetch, crimson and pea) can be one of option in spring, com, soybean, sudangrass and Japanese bamyard millet would be seeded after spring harvest in the field. Farmer can make good use of rice paddy field as forge production potential area after harvesting rice. Italian, burly and rye+vetch and crimsonclover may be grown in autumn or spring time at the rice field.

• 대한치과보철학회지
• /
• 제31권1호
• /
• pp.151-162
• /
• 1993

The author installed $3.75mm\times10mm$ $Br{\aa}nrmark$ osseointegrated implants and $3.5mm\times8mm$ I.T.I. hollow screw implants(Benefit) as a free standing abutment to replace lower left and right molars of 44-year-old female patient. Form the foregoing procedure, the author obtained the following results. 1. Free-standing $Br{\aa}nrmark$ and I.T.I. Hollow screw implants(Benefit) could be used to replace molars effectively without reduction of adjacent natural teeth, 2. Rotation of occlusal gold screw of $Br{\aa}nrmark$ implants was observed under occlusal force. 3. Adjustment of height of I.T.I. abutments was necessary in the mandibular second molar because of the limited occlusal clearance. 4. Form the oral examination, patient comments, panoramic and periapical radiographs, there were no pain, gingival imflammation and mobility, but slight reduction of alveolar bone level was shown around both implant systems. 5. Patient comments were comfortable on both systems. but the patient complained about economic problem of $Br{\aa}nrmark$ system and long treatment treatment time of both systems.

• International Journal of Control, Automation, and Systems
• /
• 제5권5호
• /
• pp.479-491
• /
• 2007

This paper presents a new adaptive observer design method for a class of uncertain nonlinear systems by using spline approximation. This scheme leads to a simplified observer structure which requires only fixed number of integrations, regardless of the number of parameters to be estimated. This benefit can reduce the number of integrations of the observer filter dramatically. Moreover, the proposed adaptive observer automatically generates the required spline elements according to the varying output value and, as a result, does not requires the pre-knowledge of upper and lower bounds of the output. This is another benefit of our approach since the requirement for known output bounds have been one of the main drawbacks of practical universal approximation problems. Both of the benefits stem from the local support property, which is specific to splines.

• 한국도서관정보학회지
• /
• 제47권2호
• /
• pp.231-257
• /
• 2016

이 연구는 2014년 "출판문화산업진흥법"의 개정으로 새로운 내용의 도서정가제가 시행됨에 따라 공공도서관 자료구입과정에서 쟁점으로 부각되고 있는 문제를 짚어 본 다음, 이를 토대로 개정된 도서정가제의 취지를 살림과 동시에 보다 효율적인 자료구입이 이루어지기 위한 과제를 제안하고자 하였다. 연구를 통해 도출된 결과는 다음과 같다. 첫째, 개정 도서정가제 시행으로 가격경쟁 비중이 축소된 상황에서 도서관은 업무이행능력 등 질적인 측면에 초점을 맞추어 자료납품업체를 선정할 수 있는 방안을 마련해야 한다는 점 둘째, 자료납품업체로서 지역서점의 개념과 범위를 명확하게 설정하여 무자격업체의 응찰을 방지함과 동시에 지역서점 활성화 정책의 취지를 살려야 한다는 점 셋째, 경제상의 이익 처리에 대한 보다 명확한 규정이 마련되어야 한다는 점 등이 그것이다.

• 한국해양공학회지
• /
• 제35권5호
• /
• pp.382-392
• /
• 2021

In recent years, floating offshore wind turbines have attracted more attention as a new renewable energy resource while bottom-fixed offshore wind turbines reach their limit of water depth. Various projects have been proposed with the rapid increase in installed floating wind power capacity, but the economic aspect remains as a biggest issue. To figure out sensible approaches for saving costs, a comparison analysis of the levelized cost of electricity (LCOE) between floating and bottom-fixed offshore wind turbines was carried out. The LCOE was reviewed from a social perspective and a cost breakdown and a literature review analysis were used to itemize the costs into its various components in each level of power plant and system integration. The results show that the highest proportion in capital expenditure of a floating offshore wind turbine results in the substructure part, which is the main difference from a bottom-fixed wind turbine. A floating offshore wind turbine was found to have several advantages over a bottom-fixed wind turbine. Although a similarity in operation and maintenance cost structure is revealed, a floating wind turbine still has the benefit of being able to be maintained at a seaport. After emphasizing the cost-reduction advantages of a floating wind turbine, its LCOE outlook is provided to give a brief overview in the following years. Finally, some estimated cost drivers, such as economics of scale, wind turbine rating, a floater with mooring system, and grid connection cost, are outlined as proposals for floating wind LCOE reduction.

• 한국도로학회논문집
• /
• 제9권4호
• /
• pp.33-43
• /
• 2007

단일로에 위치한 보행자 신호기는 지역제어기에 사전입력된 값에 의해 매주기마다 보행신호를 제공해 주고, 이로 인해 보행자 교통량이 적은 단일로의 경우 보행자가 없는 경우에도 보행자 신호를 제공함으로써 신호운영상 비효율적인 면이 존재해 왔다. 이로 인해 운전자들은 보행자가 존재하지 않는데도 불구하고, 보행자 신호가 제공됨에 따라 불필요한 신호대기시간을 겪게 되고 교통신호의 비효율적인 운영에 대한 불만이 쌓여 왔고, 그 결과 신호를 위반하고 횡단보도를 통과하는 운전자가 발생함으로써 범법자를 양산하게 되었다. 보행자 안전과 보행자 신호의 효율성을 높이기 위한 방안으로 근래에 일부지역에 보행자작동신호기를 설치하여 운영하고 있지만, 예산 등의 문제 및 보행자작동신호기의 효용성 인식이 부족한 원인 등으로 전국적으로 확대설치가 지연되고 있다. 본 연구에서는 보행자작동신호기 설치 시 비용과 편익을 현장조사 및 시뮬레이션을 이용하여 분석함으로써 이의 효과를 가시적으로 제시하였다. 4개의 연구대상지점을 선정하여 실제 차량 및 보행자교통량을 조사하여 보행자작동신호기의 효과를 검증해 본 결과, 4개소 모두 B/C가 1이 넘어 보행자작동신호기 설치가 타당하다는 결론이 나왔다. 또한 차량교통량과 보행자교통량에 따른 민감도 분석을 한 결과 보행자교통량이 90인/시 보다 많을 경우에는 보행자작동신호기의 효과가 없는 것으로 나타났으며, 보행자 교통량이 90인/시 이하이고, 차량교통량이 2,500대/시 이상일 경우에는 보행자작동신호기에 대한 B/C가 1이 넘어, 이 경우 보행자작동신호기 설치가 타당하다고 나타났다. 또한, 차량교통량이 많고 보행자교통량이 적을수록 그 효과는 더 큰 것으로 나타났다. 본 연구에서는 보행자작동신호기의 설치기준의 근거를 경제성분석을 통해서 제시하였으며, 본 연구의 결과가 향후 보행자작동신호기 확대설치방안을 뒷받침 할 수 있는 기초자료로 사용될 수 있기를 기대한다.