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Analyses of the Efficiency in Hospital Management (병원 단위비용 결정요인에 관한 연구)

  • Ro, Kong-Kyun;Lee, Seon
    • Korea Journal of Hospital Management
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    • v.9 no.1
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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Identification of a New Potyvirus, Keunjorong mosaic virus in Cynanchum wilfordii and C. auriculatum (큰조롱과 넓은잎 큰조롱에서 신종 포티바이러스(큰조롱모자이크바이러스)의 동정)

  • Lee, Joo-Hee;Park, Seok-Jin;Nam, Moon;Kim, Min-Ja;Lee, Jae-Bong;Sohn, Hyoung-Rac;Choi, Hong-Soo;Kim, Jeong-Soo;Lee, Jun-Seong;Moon, Jae-Sun;Lee, Su-Heon
    • Research in Plant Disease
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    • v.16 no.3
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    • pp.238-246
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    • 2010
  • In 2006 fall, a preliminary survey of viruses in two important medicinal plants, Cynanchum wilfordii and C. auriculatum, was conducted on the experimental fields at the Agricultural Research and Extension Services of Chungbuk province in Korea. On each experimental fields, percentage of virus infection was ranged from 20 to 80%, and especially an average of disease incidence propagated by roots was twice higher than that by seeds. The various symptoms were observed in Cynanchum spp. plants, such as mosaic, mottle, necrosis, yellowing, chlorotic spot and malformation etc. In electron microscopic examination of crude sap extracts, filamentous rod particles with 390-730 nm were observed in most samples. The virus particles were purified from the leaves of C. wilfordii with typical mosaic symptom, and the viral RNA was extracted from this sample containing 430-845 nm long filamentous rod. To identify the viruses, reverse transcription followed by PCR with random primers was carried out. The putative sequences of P3 and coat protein of potyvirus were obtained. From a BLAST of the two sequences, they showed 26-38% and 62-72% identities to potyviruses, respectively. In SDS-PAGE analysis, the subunit of coat protein was approximately 30.3 kDa, close to the coat protein of potyvirus. In bioassay with 21 species in 7 families, Chenopodium quinoa showed local lesion on inoculated leave and chlorotic spot on upper leave, but the others were not infected. RT-PCR detection using specific primer of C. wilfordii and C. auriculatum samples, all of 24 samples with virus symptom was positive, and five out of seven samples without virus symptom were also positive. On the basis of these data, the virus could be considered as a new member of potyvirus. We suggested that the name of the virus was Keunjorong mosaic virus (KjMV) after the common Korean name of C. wilfordii.

Molecular Genetic Classification of Phytophthora Species and P. infestans-specific Marker Selection by RAPD Fingerprinting (Phytophthora species의 분자유전학적 분류 및 RAPD fingerprinting을 이용한 P. infestans-specific 분자마커의 선발)

  • Kim, Kyoung-Su;Shin, Whan-Sung;Kim, Hee-Jong;Woo, Su-Jin;Ham, Young-Il;Shin, Kwan-Yong;Lee, Jeong-Oon;Kim, Byung-Sup;Shim, Jae-Ouk;Lee, Min-Woong;Lee, Youn-Su
    • The Korean Journal of Mycology
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    • v.27 no.6 s.93
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    • pp.394-398
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    • 1999
  • Taxonomic and genetic analysis of Phytophthora species belonging to six different morphological groups (GI, GII, GIII, GIV, GV, GVI) was conducted using RAPD method. Amplified fragments ranged $0.3{\sim}3.2$ kb in their molecular weights. Among total of 145 bands, there were 109 polymorphic bands. Seven isolates of P. infestans showed high similarities of $0.92{\sim}0.99$, and P. infestans isolate 3 from potato showed similarities of $0.93{\sim}0.95$ compared with other P. infestans. Among isolates of P. capsici, similarities of $0.77{\sim}0.86$ were observed and they were grouped in 80% level. P. cinnamomi and P. cryptogea isolates which belonging to group GVI showed very similar RAPD fingerprinting pattern. Primers OPA-04, OPA-17, OPA-18, OPA-19, and OPB-12 showed high level of differences among the tested isolates in major bands and molecular weights. The similarity between the isolates was 0.67. P. megasperma and P. sojae in group GV showed similarity of 0.65. These two isolates showed big differences in single major band in reactions with primers OPA-08, OPA-17, and OPA-19. Phytophthora-specific and P. infestans-specific molecular markers were also selected with one of the random primers tested. In reaction with primer OPA-20, all the genus Phytophthora showed common band at 600 bp, and all the P. infestans isolates showed specific band at 680 bp. These markers can be useful for identification of Phytophthora speices or P. infestans. As a result, P. infestans isolated from tomato and/or potato can easily be differentiated from other Phytophthora species with this primer.

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A Study on Reading Pupillary and Distance Between Optical Centers suitable for Korean (한국인 체형에 적합한 근용안경의 광학중심간 거리에 대한 연구)

  • Youk, Do-Jin
    • Journal of Korean Ophthalmic Optics Society
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    • v.8 no.2
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    • pp.37-45
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    • 2003
  • This study investigated that total 1071 reading glasses wearers (male 432, female 639) without any eye disease or deformation in eyelid, orbit, eyeball (over 50 years old), were tested. Reading pupillary distance of 524 (male 202, female 322) of 1071 were examined and reading glasses power was examined for all 1071 patients. As a result of average reading diopters analysis by sex. male had S+2.34Dptr, female had S+2.23Dptr in average and male had a little more average power than female by 0.11Dptr. However, the difference was not much enough and by aging accommodation reduction changes were applied to both male and female. After dividing ready-made reading glasses on sale in optical shops into 5 groups by F.P.D. the average D.B.O.C(distance between optical centers) of each 5 group was examined (1st group 64.04 mm, 2nd group 66.96 mm, 3rd group 68.28 mm, 1th group 62.03 mm, 5th group 72.00 mm : the average of all groups was 66.96 mm : each group included 3 random samples : 195 ready-made reading glasses were measured), and compared with the average reading P.D of males and females (male 60.04 mm, female 58.23 mm). The result showed D.B.O.C of ready-made reading glasses on sale was bigger than the average reading P.D of them. The result reviewed the average range for male was $0.23{\Delta}(minimum){\sim}5.06{\Delta}(maximum)$, and for female was $0.46{\Delta}{\sim}5.79{\Delta}$. In conclusion when wearing ready-made reading glasses, female got more effected by average $0.45{\Delta}$ because reading P.D of female was smaller than that of male.

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Analysis of Microsatellite DNA Polymorphism for Parentage Testing in Dog Breeds (개의 친자감정을 위한 Microsatellite DNA 다형성 분석)

  • Cho, G. J.;Cho, B. W.;Kim, S. K.;Lee, K. W.;Kim, Y. K.
    • Journal of Animal Science and Technology
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    • v.45 no.2
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    • pp.191-198
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    • 2003
  • This study was carried out to investigate a usefulness of the microsatellite DNA markers for individual identification and parentage verification in three dog breeds. A total of 59 random dog (31 Chiwawa, 20 Poongsan, 8 Labrador Retriever) samples were genotyped by using 14 markers (Chiwawa dog), 16 markers (Poongsan dog), and 12 markers (Labrador Retriever dog) among the 17 international standard markers (PEZ1, 3, 5, 6, 8, 10, 11, 12, 13, 15, 16, 17, 20, 21, FHC2010, FHC2054 and FHC2079), respectively. The number of alleles per locus varied from 4 to 14 with a mean value of 6.07 in Chiwawa dog, 2 to 9 with a mean of 4.75 in Poongsan dog, and 3 to 5 with a mean of 4.00 in Labrador Retriever dog. Observed heterozygosity was ranged 0.419${\sim}$0.968 (mean 0.755), 0.300${\sim}$0.950 (mean 0.597) and 0.125${\sim}$0.750 (mean 0.604), and expected heterozygosity was ranged 0.432${\sim}$0.883 (mean 0.711), 0.262${\sim}$0.817 (mean 0.559) and 0.425${\sim}$0.808 (mean 0.660) in these three dog breeds. PIC value was ranged 0.397${\sim}$0.856 (mean 0.659), 0.222${\sim}$0.772 (mean 0.503) and 0.354${\sim}$0.717 (mean 0.563) in these three dog breeds. Of the 17 markers, PEZ1, PEZ3, PEZ6, PEZ10, PEZ12 loci, PEZ1, PEZ6, PEZ13 loci, and PEZ8, PEZ12 loci have relatively high PIC value (>0.7) in Chiwawa dog, Poongsan dog and Labrador Retriever dog, respectively. The exclusion probability was ranged 0.240${\sim}$0.741, 0.111${\sim}$0.616, and 0.198${\sim}$0.529, and the combination of microsatellite loci was 0.9999, 0.9991, and 0.9968 in Chiwawa dog, Poongsan dog and Labrador Retriever dog, respectively. These results can give basic information for developing parentage verification and individual identification system in these three dog breeds.

Promoter Polymorphisms of ST3GAL4 and ST6GAL1 Genes and Associations with Risk of Premalignant and Malignant Lesions of the Cervix

  • de los Angeles Rivera-Juarez, Maria;Rosas-Murrieta, Nora Hilda;Mendieta-Carmona, Victoriano;Hernandez-Pacheco, Raquel Esneidy;Zamora-Ginez, Irma;Rodea-Avila, Carlos;Apresa-Garcia, Teresa;Garay-Villar, Onix;Aguilar-Lemarroy, Adriana;Jave-Suarez, Luis Felipe;Diaz-Orea, Maria Alicia;Milflores-Flores, Lorena;Reyes-Salinas, Juan Salvador;Ceja-Utrera, Francisco Javier;Vazquez-Zamora, Victor Javier;Vargas-Maldonado, Tomas;Reyes-Carmona, Sandra;Sosa-Jurado, Francisca;Santos-Lopez, Gerardo;Reyes-Leyva, Julio;Vallejo-Ruiz, Veronica
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1181-1186
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    • 2014
  • Sialyltransferase gene expression is altered in several cancers, including examples in the cervix. Transcriptional regulation of the responsible genes depends on different promoters. We aimed to determine the association of single-nucleotide polymorphisms in the B3 promoter of the ST3GAL4 gene and the P1 promoter of the ST6GAL1 gene with cervical premalignant lesions or cervical cancer. A blood sample and/or cervical scrapes were obtained from 104 women with normal cytology, 154 with premalignant lesions and 100 with cervical cancer. We also included 119 blood samples of random donors. The polymorphisms were identified by sequencing from PCR products. For the B3 promoter, a fragment of 506 bp (from nucleotide -408 to +98) was analyzed, and for the P1 promoter a 490 bp (-326 to +164) fragment. The polymorphism analysis showed that at SNP rs10893506, genotypes CC and CT of the ST3GAL4 B3 promoter were associated with the presence of premalignant lesions (OR=2.89; 95%CI 1.72-4.85) and cervical cancer (OR=2.23; 95%CI 1.27-3.91). We detected only one allele of each polymorphism in the ST6GAL1 P1 promoter. We did not detect any genetic variability in the P1 promoter region in our study population. Our results suggest that the rs10893506 polymorphism -22C/T may increase susceptibility to premalignant and malignant lesions of the cervix.

Analysis of the Utilization Characteristics of Electrical Power and Equipments on the Farms (농촌의 전력및 전기기기의 이용특성분석)

  • 박승우;류한열
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.17 no.4
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    • pp.3943-3955
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    • 1975
  • The purposes of this study are to evaluate the utilization characteristics of electrical power consumption, to grasp the present trends in the use of electrical equipments, to estimate the demand factor and load factor being held, and to evaluate the efficiency of electical uses for the recently electrified farms cultivating paddy rice. For the purposes, 109 sample farms located in eleven villiages electrified in six different years from 1968 to 1973, were chosen at random and investigated on 35 items concerning to electrical uses and wiring systems. The survey was carried out in 1975, in the vinicity of Suweon city. The results are summarized as follows: i) The average annual power consumption on sample farms is considered to be low, being 242.9 Kwh. in 1974, and varied according to the different electrified year and size of cultivated land, respectively. It has significant positive correlation to the area of farm, too. ii) Between the number of year of electrical uses and the power consumption, there is very significant positive correlation, which could be expressed as Y=43.041+16.108 X, where X represents the number of years of electrical uses. The annual increment of power consumption is much greater at the beginning of the electrification than that at the later years, its average being approximately 20 percent. However, it is recommended that any estimation of long-term increments should be carefully investigated. iii) The monthly power consumption varies considerably throughout a year, in which the heaviest farm load occurs in November. Observing the seasonal variation of consumption, the winter-time is the heaviest season while the summer is the lowest. The result implies house lighting is chief contribution to the present electrical consumption on the farms. Comparing the variation of monthly consumption ratios between the sample farms and industries, the electrical uses on the farms are independant of the industrial uses, and further, the agricultural uses are of inverse pattern to the farms from the results that there is negative correlationship between them, iv) The number of electrical equipments used on the farms are occupied chiefly by lighting sources. Next to the lighting sources, household appliances of small quantity and some motors are used. The mean electrical quantity is about 1, 127.4 watt, which corresponds to about 37.6 per cent to the contracted quantity. The composition of quantity is chiefly occupied by the electrical motor of about 1.5 hp., single-phased. The number of the annual utilization hours of each equipment is tabulated in Table IV-5. In contradiction to the high utilization of lighting sources and small household appliances, the motor is poorly used for approximately 22 hours in a year. v) More than 55 per cent of farms want to purchase new electrical equipments such as small household appliances and electrical motors in their number. The impulse of purchasing such items is stimulated by the contacts to the mass media and their knowledge on such equipments. Consequently, the increase of electrical uses could be prompted by such trials as education and demonstration. vi) The demand and load factors on the farms vary considerably according to the greater variation of the power consumption, daily or monthly. The daily demand factor is 22.4 per cent and load factor 18.6 per cent, while the annual demand factor is 1.3 per cent and load factor 70 per cent approximately. Therefore, the low efficiency of construction cost requires re-evaluation of the present contracted quantity of 3 Kw. or increase of electrical uses. vii) The electrical energy on the farms devoted chiefly to lighten the farm residences does not contribute to the farm incomes. Consequently, the cost of electrical consumption presses considerably upon the farm economy. Therefore, there is great need to build up the electrical uses on the farms through the development of new works and techinques to utilize any electrical equipments on the production of farm products. Further more, such the development should be related to increase the actual income of the farm consumers.

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A Web-based 'Patterns of Care Study' System for Clinical Radiation Oncology in Korea: Development, Launching, and Characteristics (우리나라 임상방사선종양을 위한 웹 기반 PCS 시스템의 개발과 특성)

  • Kim, Il Han;Chie, Eui Kyu;Oh, Do Hoon;Suh Chang-Ok;Kim, Jong Hoon;Ahn, Yong Chan;Hur, Won-Joo;Chung, Woong Ki;Choi, Doo Ho;Lee, Jae Won
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.291-298
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    • 2003
  • Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

DEVELOPMENT OF SCALE FOR MEASURING DELINQUENT BEHAVIOR (청소년 비행행동 측정도구 개발)

  • Kim, Hyun-Sil;Kim, Hun-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.79-90
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    • 2000
  • Objective:This study was performed in order to develop a measuring instrument for assessing and predicting delinquent behavior of the adolescents in Korea. Methods:This study was methodological research for developing a questionnaire for measuring delinquent behavior. Through the relevant literature review and personal interview using open-ended question with 12 adolescents in schools, outpatient basis and the juvenile corrective institutions, the author developed a pre-questionnaire with 31 items for assessing delinquent behavior among delinquentprone adolescents. Statistical method employed were test-retest reliability and Cronbach's alpha coefficient for testing reliability and factor analysis for testing validity of this questionnaire, and t-test for mean difference between student adolescents and delinquent adolescents, using SAS program. Subject served for this study consisted of 2,177 adolescents including 1,206 students and 971 delinquent adolescents by proportional stratified random sampling method. Results:1) Three stable factors were emerged and these contributed 52.2% of the variance in the total score. All 31 items loaded above .40 on each factor. 2) Factor I was named as antisocial delinquent behavior(17 items), factor II was named as aggressive delinquent behavior(8 items), and factor III was named as psychopathic delinquent behavior(6 items). 3) Comparison of these 3 factors between student adolescents and delinquent adolescents showed that there was a significant difference in factor Ⅰ(t=-42.91(student), -41.71(delinquent), p=.0001), factor II(t=-34.10(student), -35.72(delinquent), p=.0001), factor III(t=-14.24(student), -14.26 (delinquent), p=.0000), and total score(t=37.02(student), -36.38(delinquent), p=.0001). 4) Internal consistency reliability was tested by Cronbach's ${\alpha}$. Cronbach's ${\alpha}$ was .952 for total 31 items and .950, .866 and .721 for each 3 factors related to delinquent behavior. Conclusions:The author confirmed that this scale can use for measuring delinquent behavior, and hope to make a contribution to screening test and prevention of juvenile delinquency in Korea.

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THE CHARACTERISTICS OF THEIR FAMILY ENVIRONMENT AND CHARACTER TRAIT AMONG DELINQUENT ADOLESCENTS IN KOREA (한국비행 청소년의 가정환경 및 개인내적 특성)

  • Kim, Hun-Soo;Kim, Hyun-Sil
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.57-69
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    • 1997
  • Objective:At the present time in Korea, for a considerable proportion of children and adolescent, delinquent behavior and violence has become as a way of life in their lives and a major social problem issue as well. The contributing factors to this problem were assumed to be the negative interaction between family environment and character of adolescent. The purpose of this study is to search the relationship between these constructs and juvenile delinquency. Method:Data were collected through questionnaire survey over a period of 2 months. Subjects served for this study consisted of 1,863 adolescents including 657 delinquent adolescents and 1,206 student adolescents in Korea, sampled from Korean student population and delinquent adolescent population confined in juvenile corrective institutions, using proportional stratified random sampling method. Their age ranged between 12 and 18 years. Data were analysed by IBM PC using SAS program. Statistical methods employed were Chi-square and principal component analysis. Results:The results of this study were as follows:Inconsistency by parental child rearing patterns tended to affect delinquent behavior among delinquent adolescents. On the other hand, adolescent students were consistently reared by their parent with democratic, flexible, trusting their children and reward-oriented attitudes. In comparison of both parents in the degree of influence on their children, it was revealed that paternal child rearing pattern was more influential on their children’s behaviors than maternal’s. The psychological instability of family, disharmonious parent-child relationships tended to be contributing to delinquent behavior among delinquent adolescents. Especially, It was an interesting finding that student’s mother is the higher employed than delinquent’s mother. However working mother was more prevalent in the student’ adolescents than in student adolescents in previous studies. The delinquent adolescents have more depressive trend, more complaints of psychosomatic symptoms, the higher degree of need frustration, the more maladaptive and antisocial personality pattern than student adolescents. Conclusion:Recently, many studies on association between family factor, character of adolescent and juvenile delinquent behavior have produced relatively consistent results. This study showed that family environment and character trait of adolescent also were linked with delinquent behavior such as smoking, drinking, runaway and physical assaults etc. The results of this survey may provide impetus for future speculation and study of correlation or reciprocal interaction between family factor, character trait of adolescent and delinquent behavior during adolescence and beyond.

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