• Journal of Trauma and Injury
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• 제25권4호
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• Journal of Hospice and Palliative Care
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• 제20권1호
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• pp.8-17
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• 2017

종합적인 보건시스템을 지원하기 위한 완화의료정책의 개발과 강화가 세계적으로 강조되고 있다. 우리나라에서는 암정복 10개년 계획과 국가암관리종합계획의 기틀 하에 암정책의 일환으로, 호스피스완화의료정책이 시행되어왔고, 2003년 암관리법(Cancer Control Act)을 제정하여 법적 근거를 마련하였으며, 최근 호스피스 완화 의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법을 제정하여 시행할 예정이다. 호스피스완화의료정책의 대상은 최근 관련법의 제정에 따라, 말기암환자에서 암(Cancer), 후천성면역결핍증(Acquired immune deficiency syndrome, AIDS), 만성 폐쇄성 호흡기질환(Chronic Obstructive Pulmonary Disease, COPD), 만성간경화(Chronic Liver Disease/Live Cirrhosis) 등으로 확대되었고, 급여체계는 2015년에 모든 의료기관에 일당 정액수가와 행위별 수가의 복합지불방식으로 완화의료 건강보험제도가 시행되었다. 전달체계관련 건강보험제도는 입원형과 자문형, 그리고 가정형으로 구분되고, 완화의료전문기관의 지정 평가 지원제도가 운영되고 있으며, 재원체계는 건강보험기금과 국가지원금으로 조달되고 있다. 호스피스 완화의료 관련법의 시행에 앞서, 정책대상의 사회적 합의가 요구되며, 낮은 급여체계의 현실화, 민관협력을 통한 호스피스완화의료 표준설정과 전문요원양성, 질 관리 및 평가체계정립, 그리고 장기요양보험과 호스피스기금 등을 활용한 안정적인 재정체계를 마련해야 할 것이다.

• 아태비즈니스연구
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• 제15권1호
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• pp.193-207
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• 2024

Purpose - With the increase of non-face-to-face activities due to the spread of COVID-19, O2O industry has grown rapidly which reduces contact points between suppliers and consumers. O2O platform is now recognized as an indispensable channel of distribution, but the voice is getting louder that it is necessary to check how it contributes to the performance of suppliers or how its fee system or contract terms affects the expansion of O2O industry as the leading companies tend to monopolize the market. Design/methodology/approach - In this study, the scope was limited to the restaurant industry in which transactions are the most active among the O2O industry and a regression analysis was done on 775 businesses that had used guarantor service from the Seoul Credit Guarantee Foundation. Findings - Analysis on the impact of O2O platform system, information, and service quality on the business performance of the sole proprietors revealed that the system quality represented by ease of use and the information quality determined by level of timely, accurate and reliable information provided to the consumers have a statistically significant effect on the improvement of business performance. In addition, the effect of business performance on the loyalty measured by the likelihood of users continuing to use the service as well as recommending it to others was moderated by the satisfaction with contract terms, not by the fee system. Research implications or Originality - Although the number of O2O platform providers has increased manyfold, the membership rate is no more than 20%, which means that the small business owners are still struggling with digital transformation. In order for the O2O industry, which is now commonplace, to form a healthy ecosystem that satisfies both suppliers and consumers, the standard contract guidelines that are acceptable to both parties must be established and the O2O providers must offer services that help suppliers to improve performance.

• 수산경영론집
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• 제41권1호
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• pp.53-72
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• 2010

The objects of this study are to consider the current features and the development process of the utilizing system of aquaculture farms in Japan, and to suggest the theoretical basis for improvement of aquaculture system of Korea in the future through the analysis of background of the liberalization theory proposed recently. The aquaculture-fishery system of Japan was begun from the Meiji Era Fishery Act and New Fishery Act of the World war II. A small sum of fishery fee is paid to the fishery cooperative having fishing rights for securing fishing area newly, because the aquaculture of Japan belong to fishery cooperative not individual ownership of union membr of cooperative society, the other words, cultivation fisheries household. In case of Korea, there are several differences with Japan as follows; almost cultivation fisheries household has a individual license, the lisence of fishing rights are recognized as an article, the license of fishing lights are able to do sale. Therefore, it is needed to paid a lots of money for securing fishing area newly. On the other hand, advanced countries in the marine aquaculture such as Norway have reached the stage where the managing abilities of marine aquaculture are similar to those in the manufacturing industry. And the number of large scale aquaculture farms with developed technologies and advanced marketing strategies in those countries is increasing. Considering that the marine aquaculture in Japan under the similar fishery systems of Korea has developed the state-of-the-art management skills or lead to large scale management, it is difficult to expect the decrease in the production costs under the small scale family business in Korea and this will lead to the decreasing competitive advantage over the imported seafood. Therefore marine aquaculture in Korea needs to increase the economy of scale to acquire the competitive advantage.

• 디지털융복합연구
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• 제15권11호
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• pp.167-174
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• 2017

최근 우리나라 기업의 회계투명성에 대한 불신이 심각한 상황이다. 회계투명성에 대한 불신은 기업의 자본조달비용을 증가시키므로 수익성을 악화시킨다. 감사업계는 낮은 회계투명성의 원인을 감사인과 피감사기업 간의 수의계약으로 보고 있다. 피감사기업이 감사인을 고용하면서 낮은 감사보수를 요구하며, 이론적으로 낮은 감사보수는 감사자원 투입의 저하를 초래하여 감사품질을 감소시킨다. 그러나 이에 대한 실증적 증거는 전무한 상황이다. 본 연구에서는 연도-산업별로 감사보수가 평균보다 낮은 감사인을 저가수임 감사인으로 선정하고, 이러한 감사인들의 감사품질이 상대적으로 낮은지를 검증하였다. 연구 결과, 저가수임 감사인으로부터 감사를 받은 피감사기업의 재량적 발생액이 상대적으로 높은 것으로 나타났다. 이러한 결과는 저가수임이 감사품질에 부정적 영향을 미치는 것으로 해석할 수 있다. 본 연구는 감사보수와 관련된 여러 정책개발에 실증적 증거로 제시될 수 있다.

• 한국조경학회지
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• 제34권4호
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• pp.84-95
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• 2006

This study begins by examining the reason for the lack of urban planning that takes the water cycle into consideration. While there are institutions that support environmentally friendly development or smooth water circulation, these designs are not reflected in planning nor in the real world. After reviewing foreign case studies, policy suggestions and possible policy implications for Korea are derived. In Korea, there is not a sufficient level of relevant laws or institutions systematically established to make it possible to deal with rainwater in a decentralized way. Instead, facility standards or guidelines are considered separately for the control of water and for preventing natural disasters. And even though an environmentally friendly approach is stipulated in relevant laws in terms of spatial planning, there are no planning systems or implementation tools to actualize this kind of approach. The factors that make decentralized rainwater management possible in urban planning are analyzed based on the case study of Germany. Germany requires developers to plan in order to achieve ecological urban development. In addition, as a detailed implementation tool to promote conservation of the water cycle, the law provides for various kinds of measures such as restrictions on the proportion of impervious surface area according to the use of the land, required compensation measures for environmental degradation following development, introduction of a fee for rainwater runoff and the establishment of ecological landscape planning. The actual reason these measures can be implemented however is the provision of planning guidelines and design criteria for rainwater utilization, absorption and containment, and the construction of a database for various environmental information.

• 한국조경학회지
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• 제31권2호
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• pp.28-35
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• 2003

This study was conducted to identify the characteristics of social carrying capacity at mega-events, especially the 2000 Kwangju Biennale in Korea. In particular, this paper has proposed some management policies for mega events taking into account the relations between social carrying capacity, satisfaction and crowding. The research method was to look into the general characteristics and distributive forms of the location, and then to confirm the possibility of sampling the factors involved in satisfaction degree; last, A factor analysis for causal analysis of perceived crowding was performed. The study needed correlation analysis in order to compare expected crowding and perceived crowding, and performed regression to examine the causality of perceived crowding and satisfaction. The research results were as follows: the correlation of expected crowding, perceived crowding, and the total satisfaction was very low or meaningless. The relation between satisfaction and elements for factor analysis such as convenient facilities and value experience showed partial meaningfulness. The factors of convenient facilities, entrance fee, parking lot use, toilet convenience, and exhibit room use had meaningful results; on the other hand, the factors of value experience showed a meaningful result in the guide service of an event place. In conclusion when those holding an event make a basic project, they should consider management measures for convenience of facilities, proper education for guide service, and systematic guidance. Also, as a method for perceived crowding lower than expected crowding, the study has proposed that it is possible to lower expected crowding by providing appropriate information on the number of tourists expected on the weekends and weekdays. Future research should control variables such as personal characteristics, seasons proper for vacation and holidays, and carefully consider their investigation and design. Moreover, it is necessary to study variables involved in expected crowding of more various space-intensive sightseeing places (mesa-events).

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• 보건행정학회지
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• 제13권3호
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• pp.104-128
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• 2003

Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

• 보건행정학회지
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• 제23권2호
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• pp.124-131
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• 2013

Background: This study aimed to measure the opportunity income by identifying the economic length of stay (ELOS) which is the intersection point of daily revenue and cost on appendectomy and pneumonia cases. Methods: The research subjects were 460 patients of appendectomy and 606 patients of pneumonia, discharged from a general hospital between July 1, 2009 and June 30, 2010. ELOS calculated with both of total revenue on diagnosis-related group (DRG) and fee-for service (FFS). The cost is calculated by activity-based costing system of the hospital. Results: Average length of stay (ALOS) of appendectomy was 4.48 days and its average revenue per case were 1,710,215 (1,989,105) won by DRG (FFS). The variable cost was 491,262 won which was 28.7% (24.7%) of DRG (FFS) total revenue. And 97.2% of the total variable cost was incurred within 2 days from admission. The ELOS was 4 (5) days in DRG (FFS). Shortening three days (two days) would increase opportunity income 52.0% (82.2%) in DRG (FFS). ALOS of pneumonia case was 4.86 days and its average revenue per case were 489,448 (761,426) won by DRG (FFS). The variable cost was 27,230 won which was 5.6% (3.6%) of DRG (FFS) total revenue. Thirty-eight point nine percent of the daily variable cost was incurred in discharge date. The ELOS was 2 (4) days in DRS (FFS). Shortening three days (one day) would increase opportunity income 27.6% (37.2%) in DRG (FFS). Conclusion: The ELOS would be used by strategic index for achieving minimum profit and developing the ways to get there. But we also should not pass over that the opportunity income obtained by the reducing ALOS may cause some problem of quality.