• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.398-406
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• 2018

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

• 지역사회간호학회지
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• 제21권3호
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• pp.362-373
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• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• 벤처창업연구
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• 제14권1호
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• pp.167-185
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• 2019

대부분의 G20 국가에서 향후 수십 년 동안 의료 지출이 급격하게 성장할 것으로 예상하고 있듯이, 고연령 인구와 만성질환자의 증가로 인해 전 세계적으로 의료비 부담은 지속적으로 늘어나고 있으며 의료서비스의 지속적인 질 개선도 해결해야 할 과제로 대두되고 있다. 그러나 헬스케어와 IT 융합의 급변하는 기술 환경 하에서 이런 변화를 제대로 인식하지 못하고 적절한 대비를 하지 않는데서 그 문제가 더 커질 수 있다. 패러다임 변화와 의료 분야 문제 증대 상황에서 기술적, 제도적, 사업적 측면에서의 복합적인 대응이 절실히 필요하다. 핵심은 의료분야에 IT를 융합한 사업에 적합한 비즈니스모델의 도출이라 할 수 있다. 4차 산업혁명시대의 도래와 함께 사물인터넷 등의 신기술이 e헬스케어에 적용되면서 새로운 비즈니스모델의 필요성이 대두 되었다. 기존 인터넷 시대의 e헬스케어에서는 전통적인 조직 기반 (Firm-centric) 비즈니스모델이 되었으나 사물인터넷 시대에는 사물인터넷의 역동성 (Dynamics) 및 복잡성 (Complex)의 특성으로 인하여 단위 조직 (Firm-Centric)보다는 비즈니스생태계 (Business Ecosystem)기반의 접근이 필요하다. 본 논문에서는 사물인터넷 등 이머징 기술 (Emerging Technology)기반의 e헬스케어의 비즈니스생태계에 대한 연구 결과로 e헬스케어 비즈니스생태계의 3-레이어 (Layer) 구조에 기반한 생태계의 주요 발전 인자를 분석 제시한다. 3-레이어 비즈니스생태계는 (1) 인프라 스트럭처 레이어 (Infrastructure Layer), (2) 특성 레이어 (Characteristics Layer) 및 (3) 이해당사자 레이어 (Stakeholder Layer)로 정의하여 분석하였다. e헬스케어 비즈니스생태계의 주요 발전 인자측면에서는 (1) i헬스케어 개념의 도입, (2) 비즈니스생태계의 확장, (3) 비즈니스생태계 변화 프로세스 혁신, (4) 비즈니스생태계 리더쉽 혁신의 4가지 인자를 제안한다.

• 한국병원경영학회지
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• 제1권1호
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• pp.83-107
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• 1996

This study discusses how to rationalize or innovate the managerial practice of the profitability-deteriorated hospitals in Korea, and attempts to suggest proper planning models and strategies to reorient them. For these purposes, the hospitals' financial indicators were analysed, the process of profit planning were reviewed, and strategic assessment were made, using relevant data. The analysis shows that failures both in proper capital investment to fixed assests and in effective containment of operating costs have been causing the worsening of profitability. For the improvement of the profitability management, seven procedural and behavioral strategies were suggested from the innovative and rationalizing perspectives, together with necessary prerequisite conditions to be equipped with for their implementation. This study concludes that the top management should attempt the changs on their own initiative.

• Journal of the Korean Data and Information Science Society
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• 제21권3호
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• pp.589-595
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• 2010

In discriminant analysis, we consider an intraclass correlation pattern by principal component analysis. We assume that the two populations are equally likely and the costs of misclassification are equal. In this situation, we consider two procedures, i.e., the test and proportion procedures, for selecting the principal components in classifica-tion. We compare the regular classification method and the proposed two procedures. We consider two methods for estimating error rate, i.e., the leave-one-out method and the bootstrap method.

• 약학회지
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• 제55권6호
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• pp.500-509
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• 2011

This study was to identify factors influencing drug compliance based on the subjects' interview regarding community pharmacy utilization for 2 weeks, in 2005 KNHANES. Good compliance was regarded as important factors in improving the effectiveness and minimizing adverse drug reaction, resulting in reducing the medical costs. 83% of total 11,208 pharmacy visits in 7,066 subjects showed good compliance. Good satisfaction for pharmacist's medication counseling (OR=2.23, 95% CI 1.92-2.58), higher out-of-pocket money (OR=1.32, 95% CI 1.14-1.54), and users of prescription drugs than non-prescription (OR=2.21, 95% CI 1.91-2.57) drugs were significant factors for better compliance. Disease of nervous system and mental and behavioral disorders showed lower drug compliance.

• Journal of the Korean Data and Information Science Society
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• 제21권2호
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• pp.355-361
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• 2010

This paper addresses a mathematical approach to decision making in a real-world material distribution situation. The problem is characterized by a low-volume and highly-varied mix of products, therefore there is a lot of material movement between the facilities. This study focuses especially on the transportation scheduler with a tool that can be used to quantitatively analyze the volume of material moved, the type of truck to be used, production schedules, and due dates. In this research, we have developed a mixed integer programming problem using the minimum cost, multiperiod, multi-commodity network flow approach that minimizes the overall material movement costs. The results suggest that the optimization approach provides a set of feasible solution routes with the objective of reducing the overall fleet cost.

• Journal of the Korean Data and Information Science Society
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• 제24권1호
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• pp.189-200
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• 2013

In this paper, it will be assumed that there are two distinct populations which are multivariate normal with equal covariance matrix. We also assume that the two populations are equally likely and the costs of misclassification are equal. The classification rule depends on the situation whether the training samples include missing values or not. We consider the conditional bootstrap confidence intervals for classification error rate when a block of observation is missing.

• 약학회지
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• 제54권2호
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• pp.126-133
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• 2010

This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

• 한국병원경영학회지
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• 제4권2호
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• pp.305-329
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• 1999

Financial ratio indicators of the 46 sample hospitals provided by the Korea Health Industry Development Institute, together with the survey data responded by the 57 sample hospitals, were analysed to identify the characteristics of the red-figured hospitals' financial structure, financial operational efficiency and management decision-making behavior, The financial characteristics identified through the analysis include high dependency to liabilities, high salary expenses and overhead costs, low profitability of the unduly large amount of fixed assets, and low managerial efficieny of inventory. The hospitals, in face of the IMF economic impasse, took the necessary decision-making and counter measures to cut down salary expenses, to increase the number of patient and medical revenue, and to reduce investment to fixed assets. Based on these findings this study suggested that the hospitals should take more active cost containment measures, financial structural reorganization, and developoment of the strategies that can contribute to increase of the number of patient and medical revenue and that do not. require much capital funds.