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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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Red Pepper (Capsicum annum) Drying Using Flat-Plate Solar Collectors (평판집열기(平板集熱機)를 이용(利用)한 고추 건조(乾燥)에 관(關)한 연구(硏究))

  • Kim, Dong-Man;Kim, Man-Soo;Chang, Kyu-Seob
    • Korean Journal of Agricultural Science
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    • v.6 no.1
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    • pp.56-64
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    • 1979
  • Two types of fiat-plate collector were designed and constructed for utilizing the solar energy as heating source of red pepper drying. It was performed to investigate the basic factors on using the collectors and the drying effect on various types of red pepper, and the results obtained are summarized as follows. 1. The optimum tilted angles of the collector in Daejeon area were ${\phi}-15^{\circ}$ in summer season and ${\phi}+15^{\circ}$ in winter season when it was adjusted two times per a year: 2. In the conditions during experiment period, average atmospheric temperature and relative humidity were $25.6^{\circ}C$ and 52.6%, respectively, and $42.0^{\circ}C$, 74.2% in the control chamber. The temperature in the drying chamber connected to the water heater was the highest but relative humidity in the chamber connected to the air heater was the lowest among the chambers. 3. The drying velocity of whole red pepper in the chamber connected to the water heater was the fastest as 2.3 times as compared to the whole type on the mat drying followed by air heater and control in decreasing order. The horizontally cut red pepper in the chamber connected to the water heater was dried exceedingly fast among twelve plots. 4. The content of capsaicine as pungent principle and of capsanthine as red pigment in the red pepper were reduced during drying but there were no differences significantly on the drying method, and it could not affect much on the quality of dried product.

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A Experimental Study on Exclusion Ability of Riprap into Bypass Pipe (저층수 배사관 내 유입된 사석 배출능력에 대한 연구)

  • Jeong, Seok Il;Lee, Seung Oh
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.37 no.1
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    • pp.239-246
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    • 2017
  • There are various transversal structures (small dams or drop structures) in median and small streams in Korea. Most of them are concrete structures and it is so hard to exclude low-level water. Unless drainage valves and/or gates would not be installed near bottom of bed, sediment from upstream should be deposited and also contaminants attached to the sediments would devastatingly threaten the water quality and ecosystem. One of countermeasures for such problem is the bypass pipe installed underneath the transversal structure. However, there is still issued whether it would be workable if the gravels and/or stones would roll into and be not excluded. Therefore, in this study, the conditions to exclude the rip stone which enter into the bypass pipe was reviewed. Based on sediment transport phenomenon, the behavior of stones was investigated with the concepts from the critical shear stress of sediment and d'Alembert principle. As final results, the basis condition (${\tau}_c{^*}$) was derived using the Lagrangian description since the stones are in the moving state, not in the stationary state. From hydraulic experiments the relative velocity could be obtained. In order to minimize the scale effect, the extra wide channel of 5.0 m wide and 1.0 m high was constructed and the experimental stones were fully spherical ones. Experimental results showed that the ratio of flow velocity to spherical particle velocity was measured between 0.5 and 0.7, and this result was substituted into the suggested equation to identify the critical condition wether the stones were excluded. Regimes about the exclusion of stone in bypass pipe were divided into three types according to particle Reynolds number ($Re_p$) and dimensionless critical shear force (${\tau}_c{^*}$) - exclusion section, probabilistic exclusion section, no exclusion section. Results from this study would be useful and essential information for bypass pipe design in transveral structures.

Quantitative Analysis of Digital Radiography Pixel Values to absorbed Energy of Detector based on the X-Ray Energy Spectrum Model (X선 스펙트럼 모델을 이용한 DR 화소값과 디텍터 흡수에너지의 관계에 대한 정량적 분석)

  • Kim Do-Il;Kim Sung-Hyun;Ho Dong-Su;Choe Bo-young;Suh Tae-Suk;Lee Jae-Mun;Lee Hyoung-Koo
    • Progress in Medical Physics
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    • v.15 no.4
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    • pp.202-209
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    • 2004
  • Flat panel based digital radiography (DR) systems have recently become useful and important in the field of diagnostic radiology. For DRs with amorphous silicon photosensors, CsI(TI) is normally used as the scintillator, which produces visible light corresponding to the absorbed radiation energy. The visible light photons are converted into electric signal in the amorphous silicon photodiodes which constitute a two dimensional array. In order to produce good quality images, detailed behaviors of DR detectors to radiation must be studied. The relationship between air exposure and the DR outputs has been investigated in many studies. But this relationship was investigated under the condition of the fixed tube voltage. In this study, we investigated the relationship between the DR outputs and X-ray in terms of the absorbed energy in the detector rather than the air exposure using SPEC-l8, an X-ray energy spectrum model. Measured exposure was compared with calculated exposure for obtaining the inherent filtration that is a important input variable of SPEC-l8. The absorbed energy in the detector was calculated using algorithm of calculating the absorbed energy in the material and pixel values of real images under various conditions was obtained. The characteristic curve was obtained using the relationship of two parameter and the results were verified using phantoms made of water and aluminum. The pixel values of the phantom image were estimated and compared with the characteristic curve under various conditions. It was found that the relationship between the DR outputs and the absorbed energy in the detector was almost linear. In a experiment using the phantoms, the estimated pixel values agreed with the characteristic curve, although the effect of scattered photons introduced some errors. However, effect of a scattered X-ray must be studied because it was not included in the calculation algorithm. The result of this study can provide useful information about a pre-processing of digital radiography.

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Application of Off-axis Correction Method for EPID Based IMRT QA (EPID를 사용한 세기조절방사선치료의 정도관리에 있어 축이탈 보정(Off-axis Correction)의 적용)

  • Cho, Ilsung;Kwark, Jungwon;Park, Sung Ho;Ahn, Seung Do;Jeong, Dong Hyeok;Cho, Byungchul
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.317-325
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    • 2012
  • The Varian PORTALVISION (Varian Medical Systems, US) shows significant overresponses as the off-center distance increases compared to the predicted dose. In order to correct the dose discrepancy, the off-axis correction is applied to VARIAN iX linear accelerators. The portal dose for $38{\times}28cm^2$ open field is acquired for 6 MV, 15 MV photon beams and also are predicted by PDIP algorithm under the same condition of the portal dose acquisition. The off-axis correction is applied by modifying the $40{\times}40cm^2$ diagonal beam profile data which is used for the beam profile calibration. The ratios between predicted dose and measured dose is modeled as a function of off-axis distance with the $4^{th}$ polynomial and is applied to the $40{\times}40cm^2$ diagonal beam profile data as the weight to correct measured dose by EPID detector. The discrepancy between measured dose and predicted dose is reduced from $4.17{\pm}2.76$ CU to $0.18{\pm}0.8$ CU for 6 MV photon beam and from $3.23{\pm}2.59$ CU to $0.04{\pm}0.85$ CU for 15 MV photon beam. The passing rate of gamma analysis for the pyramid fluence patten with the 4%, 4 mm criteria is improved from 98.7% to 99.1% for 6 MV photon beam, from 99.8% to 99.9% for 15 MV photon beam. IMRT QA is also performed for randomly selected Head and Neck and Prostate IMRT plans after applying the off-axis correction. The gamma passing rare is improved by 3% on average, for Head and Neck cases: $94.7{\pm}3.2%$ to $98.2{\pm}1.4%$, for Prostate cases: $95.5{\pm}2.6%$, $98.4{\pm}1.8%$. The gamma analysis criteria is 3%, 3 mm with 10% threshold. It is considered that the off-axis correction might be an effective and easily adaptable means for correcting the discrepancy between measured dose and predicted dose for IMRT QA using EPID in clinic.

THE ECOLOGY, PHYTOGEOGRAPHY AND ETHNOBOTANY OF GINSENG

  • Hu Shiu Ying
    • Proceedings of the Ginseng society Conference
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    • 1978.09a
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    • pp.149-157
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    • 1978
  • Ginseng is the English common name for the species in the genus Panax. This article gives a broad botanical review including the morphological characteristics, ecological amplitude, and the ethnobotanical aspect of the genus Panax. The species of Panax are adapted for life in rich loose soil of partially shaded forest floor with the deciduous trees such as linden, oak, maple, ash, alder, birch, beech, hickory, etc. forming the canopy. Like their associated trees, all ginsengs are deciduous. They require annual climatic changes, plenty of water in summer, and a period of dormancy in winter. The plant body of ginseng consists of an underground rhizome and an aerial shoot. The rhizome has a terminal bud, prominent leafscars and a fleshy root in some species. It is perennial. The aerial shoot is herbaceous and annual. It consists of a single slender stem with a whorl of digitately compound leaves and a terminal umbel bearing fleshy red fruits after flowering. The yearly cycle of death and renascence of the aerial shoot is a natural phenomenon in ginseng. The species of Panax occur in eastern North America and eastern Asia, including the eastern portion of the Himalayan region. Such a bicentric generic distributional pattern indicates a close floristic relationship of the eastern sides of two great continental masses in the northern hemisphere. It is well documented that genera with this type of disjunct distribution are of great antiquity. Many of them have fossil remains in Tertiary deposits. In this respect, the species of Panax may be regarded as living fossils. The distribution of the species, and the center of morphological diversification are explained with maps and other illustrations. Chemical constituents confirm the conclusion derived from morphological characters that eastern Asia is the center of species concentration of Panax. In eastern North America two species occur between longitude $70^{\circ}-97^{\circ}$ Wand latitude $34^{\circ}-47^{\circ}$ N. In eastern Asia the range of the genus extends from longitude $85^{\circ}$ E in Nepal to $140^{\circ}$ E in Japan, and from latitude $22^{\circ}$ N in the hills of Tonkin of North Vietnam to $48^{\circ}$ N in eastern Siberia. The species in eastern North America all have fleshy roots, and many of the species in eastern Asia have creeping stolons with enlarged nodes or stout horizontal rhizomes as storage organs in place of fleshy roots. People living in close harmony with nature in the homeland of various species of Panax have used the stout rhizomes or the fleshy roots of different wild forms of ginseng for medicine since time immemorial. Those who live in the center morphological diversity are specific both in the application of names for the identification of species in their communication and in the use of different roots as remedies to relieve pain, to cure diseases, or to correct physiological disorders. Now, natural resources of wild plants with medicinal virtue are extremely limited. In order to meet the market demand, three species have been intensively cultivated in limited areas. These species are American ginseng (P. quinquefolius) in northeastern United States, ginseng (P. ginseng) in northeastern Asia, particularly in Korea, and Sanchi (P. wangianus) in southwestern China, especially in Yunnan. At present hybridization and selection for better quality, higher yield, and more effective chemical contents have not received due attention in ginseng culture. Proper steps in this direction should be taken immediately, so that our generation may create a richer legacy to hand down to the future. Meanwhile, all wild plants of all species in all lands should be declared as endangered taxa, and they should be protected from further uprooting so that a. fuller gene pool may be conserved for the. genus Panax.

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Development of Industrial Embedded System Platform (산업용 임베디드 시스템 플랫폼 개발)

  • Kim, Dae-Nam;Kim, Kyo-Sun
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.47 no.5
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    • pp.50-60
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    • 2010
  • For the last half a century, the personal computer and software industries have been prosperous due to the incessant evolution of computer systems. In the 21st century, the embedded system market has greatly increased as the market shifted to the mobile gadget field. While a lot of multimedia gadgets such as mobile phone, navigation system, PMP, etc. are pouring into the market, most industrial control systems still rely on 8-bit micro-controllers and simple application software techniques. Unfortunately, the technological barrier which requires additional investment and higher quality manpower to overcome, and the business risks which come from the uncertainty of the market growth and the competitiveness of the resulting products have prevented the companies in the industry from taking advantage of such fancy technologies. However, high performance, low-power and low-cost hardware and software platforms will enable their high-technology products to be developed and recognized by potential clients in the future. This paper presents such a platform for industrial embedded systems. The platform was designed based on Telechips TCC8300 multimedia processor which embedded a variety of parallel hardware for the implementation of multimedia functions. And open-source Embedded Linux, TinyX and GTK+ are used for implementation of GUI to minimize technology costs. In order to estimate the expected performance and power consumption, the performance improvement and the power consumption due to each of enabled hardware sub-systems including YUV2RGB frame converter are measured. An analytic model was devised to check the feasibility of a new application and trade off its performance and power consumption. The validity of the model has been confirmed by implementing a real target system. The cost can be further mitigated by using the hardware parts which are being used for mass production products mostly in the cell-phone market.

Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

Effect of Sludge-Fertilizer on Growth of Horticultural Plants (스럿지비료(肥料)가 원예작물(園藝作物)의 생육(生育)에 미치는 효과(效果))

  • Ku, Ja Hyeong;Kim, Tae Ill;Ahn, Joo Won;Lee, Kyu Seung;Kim, Moon Kyu
    • Korean Journal of Agricultural Science
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    • v.19 no.1
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    • pp.16-27
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    • 1992
  • To determine a potential of new sludge fertilizer for horticultural crops, comparative studies between commercial fertilizers (Jandibiryo and Wonyebokbi) and sludge fertilizer (Sludgebiryo) were made through examining the growth responses on zoysiagrass (Zoysia japponica Steud.) and several horticultural plants. 1. The pH of new sludge fertilizer remained near 6.5 regardless the particle size. The solubility of elements was highest in phosphorus, followed by nitrogen and potassium in the order. Especially, desorption of potassium was continued up to 48 hrs after solubilization. 2. There was an increase in shoot number per plant, length of stolon and rhizome, and root weight as well as clipping yield of zoysiagrass in the treatment of large size Sludgebiryo compared to small one and Jandibiryo. 3. Regardless the size of fertilizers, Sludgebiryo increased flower numbers in salvia (Salvia officinalis L. 'Hatzazz') compared to Wonyebokbi, although the difference was not great, However, leaf area and fresh weight of plant were more increased in Wonyebokbi application. 4. Flower diameter of marigold (Tagetes erecta L. 'Inca') was slightly increased in Sludgebiryo application, but the average number of lateral shoots and fresh weight per plant were significantly increased in the treatment of Wonyebokbi application. 5. Sludgebiryo effectively increased the length of both main and lateral shoots, number of flowers and weight of shoot in vinca (Vinca rosea L. 'Little Linde'), but root growth of plant was higher in Wonyebokbi application. 6, No differences between Wonyebokbi and Sludgebiryo were found in promoting the growth of leaves of perilla (Perilla frutescens Hara 'Yubsil' ), but chlorophyll content and seed weight were slightly higher in the application of Wonyebokbi compared to Sludgebiryo. In conclusion, the effectiveness of Sludgebiryo for horticultural plants was almost equal to commercial fertilizers such as Jandibiryo or Wonyebokbi. Expecially, Sludgebiryo appeared to effective on the growth of zoysiagrass, and the increase of flower size and numbers in flower crops. Results indicate that new-made Sludgebiryo can be recommended for turfgrass culture, and the flower crops in which quality depends on flower number and flower size.

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A Prediction Model for the Radiation Safety Management Behavior of Medical Cyclotrons (의료용 Cyclotron의 방사선안전관리 행위 예측모형)

  • Jung, Ji-Hye;Han, Eun-Ok;Kim, Ssang-Tae
    • Journal of Radiation Protection and Research
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    • v.33 no.2
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    • pp.77-86
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    • 2008
  • This study attempted to provide reference materials for improving the behavior level in radiation safety managements by drawing a prediction model that affects the radiation safety management behavior because the radiation safety management of medical Cyclotrons, which can be used to produce radioisotopes, is an important factor that protects radiation caused diseases not only for radiological operators but average users. In addition, this study obtained follows results through the investigation applied from January 2 to January 30, 2008 for the radiation safety managers employed in 24 authorized organizations, which have already installed Cyclotrons, through applying a specific form of questionnaire in which the validity was guaranteed by reference study, site investigation, and focus discussion by related experts. The radiation safety management were configured as seven steps: Step 1 is a production preparation step, Step 2 is an RI production step, Step 3 is a synthesis step, Step 4 is a distribution step, Step 5 is a quality control step, Step 6 is a carriage container packing step, and Step 7 is a transportation step. it was recognized that the distribution step was the most exposed as 15 subjects (62.5%), the items of 'the sanction and permission related works' and 'the guarantee of installation facilities and production equipments' were the most difficult as 9 subjects (37.5%), and In the trouble steps in such exposure, the item of 'the synthesis and distribution' steps were 4 times, respectively (30.8%). In the score of the behavior level in radiation safety managements, the minimum and maximum scores were 2.42 and 4.00, respectively, and the average score was $3.46{\pm}0.47$ out of 4. Prosperity and well-being programs in the behavior and job in radiation safety managements (r=0.529) represented a significant correlation statistically. In the drawing of a prediction model based on the factors that affected the behavior in radiation safety managements, general characteristics, organization characteristics, and selfefficacy didn't show a significant path statistically in which the prosperity and well-being programs in job characteristics affected the behavior in radiation safety managements. Therefore, it is necessary to establish a strategy that improves the level of prosperity and well-being levels in job characteristics in order to increase the behavior in radiation safety managements. Thus, this study provides basic materials for the radiation safety management of Cyclotron through the full-scale investigation that is first applied in Korea.