의료기관 경쟁력 향상에 영향을 미치는 핵심 요인 (The Critical Factors on Improvement of Medical institution Competitiveness)
-
- 한국병원경영학회지
- /
- 제12권1호
- /
- pp.1-30
- /
- 2007
The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.
Perfluoropolymers represent the ultimate resistance to hostile chemical environments and high service temperature, attributed to the presence of fluorine in the polymer backbone, i.e. to the high bond energy of C-F and C-C bonds of fluorocarbons. Copolymers of Tetrafluoroethylene (TEE) and 2, 2, 4Trifluoro-5Trifluorometoxy- 1, 3Dioxole (TTD), commercially known as HYFLON AD, are amorphous perfluoropolymers with glass transition temperature (Tg)higher than room temperature, showing a thermal decomposition temperature exceeding 40
Hybrid rockets have lately attracted attention as a strong candidate of small, low cost, safe and reliable launch vehicles. A significant topic is that the first commercially sponsored space ship, SpaceShipOne vehicle chose a hybrid rocket. The main factors for the choice were safety of operation, system cost, quick turnaround, and thrust termination. In Japan, five universities including Hokkaido University and three private companies organized "Hybrid Rocket Research Group" from 1998 to 2002. Their main purpose was to downsize the cost and scale of rocket experiments. In 2002, UNISEC (University Space Engineering Consortium) and HASTIC (Hokkaido Aerospace Science and Technology Incubation Center) took over the educational and R&D rocket activities respectively and the research group dissolved. In 2008, JAXA/ISAS and eleven universities formed "Hybrid Rocket Research Working Group" as a subcommittee of the Steering Committee for Space Engineering in ISAS. Their goal is to demonstrate technical feasibility of lowcost and high frequency launches of nano/micro satellites into sun-synchronous orbits. Hybrid rockets use a combination of solid and liquid propellants. Usually the fuel is in a solid phase. A serious problem of hybrid rockets is the low regression rate of the solid fuel. In single port hybrids the low regression rate below 1 mm/s causes large L/D exceeding a hundred and small fuel loading ratio falling below 0.3. Multi-port hybrids are a typical solution to solve this problem. However, this solution is not the mainstream in Japan. Another approach is to use high regression rate fuels. For example, a fuel regression rate of 4 mm/s decreases L/D to around 10 and increases the loading ratio to around 0.75. Liquefying fuels such as paraffins are strong candidates for high regression fuels and subject of active research in Japan too. Nakagawa et al. in Tokai University employed EVA (Ethylene Vinyl Acetate) to modify viscosity of paraffin based fuels and investigated the effect of viscosity on regression rates. Wada et al. in Akita University employed LTP (Low melting ThermoPlastic) as another candidate of liquefying fuels and demonstrated high regression rates comparable to paraffin fuels. Hori et al. in JAXA/ISAS employed glycidylazide-poly(ethylene glycol) (GAP-PEG) copolymers as high regression rate fuels and modified the combustion characteristics by changing the PEG mixing ratio. Regression rate improvement by changing internal ballistics is another stream of research. The author proposed a new fuel configuration named "CAMUI" in 1998. CAMUI comes from an abbreviation of "cascaded multistage impinging-jet" meaning the distinctive flow field. A CAMUI type fuel grain consists of several cylindrical fuel blocks with two ports in axial direction. The port alignment shifts 90 degrees with each other to make jets out of ports impinge on the upstream end face of the downstream fuel block, resulting in intense heat transfer to the fuel. Yuasa et al. in Tokyo Metropolitan University employed swirling injection method and improved regression rates more than three times higher. However, regression rate distribution along the axis is not uniform due to the decay of the swirl strength. Aso et al. in Kyushu University employed multi-swirl injection to solve this problem. Combinations of swirling injection and paraffin based fuel have been tried and some results show very high regression rates exceeding ten times of conventional one. High fuel regression rates by new fuel, new internal ballistics, or combination of them require faster fuel-oxidizer mixing to maintain combustion efficiency. Nakagawa et al. succeeded to improve combustion efficiency of a paraffin-based fuel from 77% to 96% by a baffle plate. Another effective approach some researchers are trying is to use an aft-chamber to increase residence time. Better understanding of the new flow fields is necessary to reveal basic mechanisms of regression enhancement. Yuasa et al. visualized the combustion field in a swirling injection type motor. Nakagawa et al. observed boundary layer combustion of wax-based fuels. To understand detailed flow structures in swirling flow type hybrids, Sawada et al. (Tohoku Univ.), Teramoto et al. (Univ. of Tokyo), Shimada et al. (ISAS), and Tsuboi et al. (Kyushu Inst. Tech.) are trying to simulate the flow field numerically. Main challenges are turbulent reaction, stiffness due to low Mach number flow, fuel regression model, and other non-steady phenomena. Oshima et al. in Hokkaido University simulated CAMUI type flow fields and discussed correspondence relation between regression distribution of a burning surface and the vortex structure over the surface.
본 연구는 제작된 27.12 MHz 라디오파 해동기의 성능을 분석하고, 냉동 식재료의 해동 중 열전달 특성을 분석하기 위하여 수행되었다. 라디오파 해동 중 크기에 따른 가열 특성 분석을 위한 한천겔 블록과 식품 및 출력별 해동 속도와 최대가열온도를 분석하기 위하여 일정한 크기의 시료를
NO, CO 및 CH4의 동시 산화를 위한 4 종의 Mn-M/Al2O3 (M = Cu, Fe, Co, Ce) 촉매를 제조하여 산화 활성을 비교하고, 동시 산화활성이 가장 높은 Mn-Cu/Al2O3 촉매에 대해 XRD, Raman, XPS, O2-TPD 분석을 수행하였다. XRD 분석 결과, Mn-Cu/Al2O3 촉매에서는 담지된 Mn과 Cu는 복합산화물로 존재하였다. Raman 및 XPS 분석을 통해 Mn-Cu/Al2O3 촉매는 Mn-O-Cu 결합의 형성 과정에서 Mn 이온과 Cu 이온 간의 전자 수수가 일어남을 알 수 있었다. XPS O 1s 및 O2-TPD 분석을 통해 Mn-Cu/Al2O3 촉매는 Mn/Al2O3 촉매에 비해 이동성이 우수한 흡착산소 종이 증가했음을 알 수 있었다. Mn-Cu/Al2O3 촉매의 높은 동시 산화 활성은 이러한 결과에 기인한다고 판단된다. Mn-Cu/Al2O3 촉매 상에서 NO는 CO와 CH4 산화를 촉진하지만, NO 산화는 억제되었다. 이는 NO로부터 산화된 NO2가 CO 및 CH4의 산화제로 사용되었기 때문이라고 추측된다. CO와 CH4의 산화 반응은 경쟁하지만 촉매 활성 온도가 다르기 때문에 그 효과가 두드러지지 않았다.
천리안 해양위성 2호(Geostationary Ocean Color Imager-II, GOCI-II)에서 관측된 대기상층 복사휘도에서 해양환경 분석이 가한 원격반사도(remote-sensing reflectance, Rrs) 자료를 얻기 위해서 복사 전달 모델 기반의 대기 보정을 수행한다. 이 Rrs는 다시 엽록소, 총부유사, 용존유기물 농도 등의 다양한 해양환경변수 산출에 이용되고 있기 때문에 대기보정은 모든 해색 산출물의 정확도에 영향을 주는 중요한 알고리즘이다. 맑은 해역에서는 대기의 복사휘도가 청색 파장대의 해수 복사휘도보다 10배 이상 높다. 따라서 대기보정 과정에서 1%의 대기 복사휘도 추정 오차가 10% 이상의 Rrs 오차를 유발할 수 있으며, 이처럼 대기보정은 매우 높은 오차 민감도를 가진 알고리즘이다. 그 결과 대기보정 산출물인 Rrs의 품질 평가는 신뢰성 있는 해양 위성 기반 자료 분석을 위해 반드시 선행되어야 한다. 본 연구에서는 Sea-viewing Wide Field-of-view Sensor (SeaWiFS) Bio-optical Archive and Storage System (SeaBASS)을 통해 데이터베이스화 된 현장 측정 Rrs 기반 통계적 신뢰성을 평가하는 Quality Assurance (QA) 알고리즘을 GOCI-II의 분광 특성에 맞게 수정 및 적용하였다. 이 방법은 National Oceanic and Atmospheric Administration (NOAA)의 해색위성 자료처리 시스템에 공식적으로 적용되어 서비스 중이며, Rrs의 품질 분석 점수(0~1점)를 제공할 뿐 아니라 해수의 유형(23 유형)도 구분해 준다. 실제로 검보정 초기 단계의 GOCI-II 자료에 QA를 적용한 결과, Rrs는 비교적 낮은 값인 0.625에서 가장 높은 빈도를 보여주었지만 추가적인 검보정을 통해 개선된 GOCI-II 대기보정 결과에 QA 알고리즘을 적용했을 시 기존보다 높은 0.875에서 가장 높은 빈도를 보여주었다. QA 알고리즘을 통한 해수 유형 분석 결과, 동해 및 남해 일부 그리고 북서태평양 해역은 주로 탁도가 낮은 case-I 해역이었으며 서해 연안 및 동중국해는 주로 탁도가 높은 case-II 해역으로 구분되었다. 이처럼 QA 알고리즘의 적용을 통해 대기보정 과정에서 오차가 크게 발생한 Rrs 자료를 객관적으로 판별하여 배제할 수 있으며 이는 배포자료 및 검보정의 신뢰도 향상으로 이어질 수 있다. 본 방법은 추후 GOCI-II의 대기보정 flag에 적용되어 사용자들이 양질의 Rrs 자료만을 적용할 수 있도록 도움을 줄 것이다.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70