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Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county) (의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究))

  • Park, Jung-Yeon
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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Effects of Cover Plants on Soil Microbial Community in Organic Apple Orchards (피복작물이 유기 사과과원 토양미생물상에 미치는 영향)

  • Oh, Young-Ju;Kang, Seok-Boem;Song, Yang-Ik;Choi, Jin-Ho;Paik, Woen-Ki
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.5
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    • pp.822-828
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    • 2012
  • Organic fruit production has increased due to consumer's interest and government's political support for environmentally-friendly agriculture. The aim of this study was to investigate the effects of cover plants on soil microbial community and establish the fruit cultivation method by organic farming techniques. Cover plants used as an organic nutrient source in an apple orchard were rye and barley, the Gramineae and red clover and hairy vetch, the Leguminosae. In the effects of cover plants on the soil chemical characteristics, the soil pH values were higher than that of conventional organic pear orchard. The content of P showed no significant difference between control and cover plant plots. Organic matter level was similar in control and Gramineae cover plant plots, while organic matter content in cover plants belong to Leguminosae was lower than that of control plot. K content was lower in the plots treated with rye and red clover than control plot, while K content in hairy vetch treated plot was higher than control plot. Ca content was lower in control plot than in cover plant treated plots. Concentrations of Mg in the plots treated with barley and hairy vetch was lower than control plot. In August rye and red clover covered soil showed higher bacterial community density than that of control soil and barley treated soil showed highest Actinomycetes community density among treatments. Barley and hairy vetch soils showed higher level of fungi community density than that of control soil in August. In pyrosequencing analysis barley treated soil showed highest distribution ratio of Actinomycetes among treatment. Our findings might be used as basic data for choosing cover plant with effective organic matter decomposition and nutrition supply capacity.

The Causes of Conflict and the Effect of Control Mechanisms on Conflict Resolution between Manufacturer and Supplier (제조-공급자간 갈등 원인과 거래조정 방식의 갈등관리 효과)

  • Rhee, Jin Hwa
    • Journal of Distribution Research
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    • v.17 no.4
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    • pp.55-80
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    • 2012
  • I. Introduction Developing the relationships between companies is very important issue to ensure a competitive advantage in today's business environment (Bleeke & Ernst 1991; Mohr & Spekman 1994; Powell 1990). Partnerships between companies are based on having same goals, pursuing mutual understanding, and having a professional level of interdependence. By having such a partnerships and cooperative efforts between companies, they will achieve efficiency and effectiveness of their business (Mohr and Spekman, 1994). However, it is difficult to expect these ideal results only in the B2B corporate transaction. According to agency theory which is the well-accepted theory in various fields of business strategy, organization, and marketing, the two independent companies have fundamentally different corporate purposes. Also there is a higher chance of developing opportunism and conflict due to natures of human(organization), such as self-interest, bounded rationality, risk aversion, and environment factor as imbalance of information (Eisenhardt 1989). That is, especially partnerships between principal(or buyer) and agent(or supplier) of companies within supply chain, the business contract itself will not provide competitive advantage. But managing partnership between companies is the key to success. Therefore, managing partnership between manufacturer and supplier, and finding causes of conflict are essential to improve B2B performance. In conclusion, based on prior researches and Agency theory, this study will clarify how business hazards cause conflicts on supply chain and then identify how developed conflicts have been managed by two control mechanisms. II. Research model III. Method In order to validate our research model, this study gathered questionnaires from small and medium sized enterprises(SMEs). In Korea, SMEs mean the firms whose employee is under 300 and capital is under 8 billion won(about 7.2 million dollar). We asked the manufacturer's perception about the relationship with the biggest supplier, and our key informants are denied to a person responsible for buying(ex)CEO, executives, managers of purchasing department, and so on). In detail, we contact by telephone to our initial sample(about 1,200 firms) and introduce our research motivation and send our questionnaires by e-mail, mail, and direct survey. Finally we received 361 data and eliminate 32 inappropriate questionnaires. We use 329 manufactures' data on analysis. The purpose of this study is to identify the anticipant role of business hazard (environmental dynamism, asset specificity) and investigate the moderating effect of control mechanism(formal control, social control) on conflict-performance relationship. To find out moderating effect of control methods, we need to compare the regression weight between low versus. high group(about level of exercised control methods). Therefore we choose the structural equation modeling method that is proper to do multi-group analysis. The data analysis is performed by AMOS 17.0 software, and model fits are good statically (CMIN/DF=1.982, p<.000, CFI=.936, IFI=.937, RMSEA=.056). IV. Result V. Discussion Results show that the higher environmental dynamism and asset specificity(on particular supplier) buyer(manufacturer) has, the more B2B conflict exists. And this conflict affect relationship quality and financial outcomes negatively. In addition, social control and formal control could weaken the negative effect of conflict on relationship quality significantly. However, unlikely to assure conflict resolution effect of control mechanisms on relationship quality, financial outcomes are changed by neither social control nor formal control. We could explain this results with the characteristics of our sample, SMEs(Small and Medium sized Enterprises). Financial outcomes of these SMEs(manufacturer or principal) are affected by their customer(usually major company) more easily than their supplier(or agent). And, in recent few years, most of companies have suffered from financial problems because of global economic recession. It means that it is hard to evaluate the contribution of supplier(agent). Therefore we also support the suggestion of Gladstein(1984), Poppo & Zenger(2002) that relational performance variable can capture the focal outcomes of relationship(exchange) better than financial performance variable. This study has some implications that it tests the sources of conflict and investigates the effect of resolution methods of B2B conflict empirically. And, especially, it finds out the significant moderating effect of formal control which past B2B management studies have ignored in Korea.

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The design of the high efficiency DC-DC Converter with Dynamic Threshold MOS switch (Dynamic Threshold MOS 스위치를 사용한 고효율 DC-DC Converter 설계)

  • Ha, Ka-San;Koo, Yong-Seo;Son, Jung-Man;Kwon, Jong-Ki;Jung, Jun-Mo
    • Journal of IKEEE
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    • v.12 no.3
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    • pp.176-183
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    • 2008
  • The high efficiency power management IC(PMIC) with DTMOS(Dynamic Threshold voltage MOSFET) switching device is proposed in this paper. PMIC is controlled with PWM control method in order to have high power efficiency at high current level. DTMOS with low on-resistance is designed to decrease conduction loss. The control parts in Buck converter, that is, PWM control circuits consist of a saw-tooth generator, a band-gap reference circuit, an error amplifier and a comparator circuit as a block. The Saw-tooth generator is made to have 1.2 MHz oscillation frequency and full range of output swing from ground to supply voltage(VDD:3.3V). The comparator is designed with two stage OP amplifier. And the error amplifier has 70dB DC gain and $64^{\circ}$ phase margin. DC-DC converter, based on Voltage-mode PWM control circuits and low on-resistance switching device, achieved the high efficiency near 95% at 100mA output current. And DC-DC converter is designed with LDO in stand-by mode which fewer than 1mA for high efficiency.

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The Comparative Study on Performance Evaluations of Social Service Delivery Types (사회서비스 공급유형별 성과평가 비교 : 노인관련 사회서비스를 중심으로)

  • Seo, Jeong-Min;Kim, Nang-Hee
    • Journal of Digital Convergence
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    • v.14 no.5
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    • pp.39-46
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    • 2016
  • The history of Social service is above 10 years. Owing to corresponding to the user's needs social services sector is expanding. And, to deal with them, the social delivery systems has been changed. Traditional social welfare delivery system is provided by public facilities and private facilities. On the other hand, Social Services is made up of the traditional social welfare delivery system and new delivery system which is composed of profit organizations and non-profit organizations. Considering this, Study attempted to compare the performance evaluation of supply type-profit and non-profit social service organizations. Performance evaluation method was applied to net income, except for expenditure in total revenue. Net income difference between profit organization non-profit organization was assessed by T-test. We conclude that the two population means are different at the 0.05 significance level. Looking in detail, the non-profit organizations were found to be higher than the non-profit organizations, labor costs, operating costs, facility cost and consumable costs, but part of the business expense costs, the non-profit organizations was higher than the profit organizations.

A Study on the Regional Policy for Promoting the Creation of Technology Based Innovation Firms (기술혁신형 중소기업의 창업환경 조성방안)

  • Lee, J.H.;Bae, B.Y.
    • Korean Business Review
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    • v.21 no.1
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    • pp.91-117
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    • 2008
  • Since the late 20th century, due to the globalization of markets and the rapid developments of information and communication technologies, the world has entered into the age of fierce competition. With their abundant low-cost labor, former communist countries such as China, Russia and East Europe and former low-developed countries such as India and Brazil have received foreign investments from major industrial companies. Thus, there are no other alternatives remained for Korea and OECD countries other than moving the industrial economies to the knowledge based innovation systems. In the knowledge based innovation systems, economic developments and employments of regions and nations depend solely on companies situated in their territories. In this article, after reviewing the current state of technological based innovation small firms in korea, we provide a theoretical framework to promote the level of technology based innovation and entrepreneurship. The theoretical framework for analysis and policy suggestions is based on the Schumpeter's value system model that consist of supply factors, demand factors, and supporting institutions. In order to create more innovative small businesses, we insist on the followings. First, more R&D and innovation activities related with promising new technologies should be performed. Second, more R&D funds for technological innovation small companies should be provided from governments. Third, more M&A transactions and technology transactions should be marketed freely and competitively. Fourth, more business incubating services and venture capital services should be provided. Fifth, entrepreneurship and innovation culture should be popular and institutionized among people.

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Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

Spatio-Temporal Distribution Analysis of One-Person Household - The Case of Busan City - (1인가구의 시공간적 분포 분석 - 부산시를 사례로 -)

  • Yoo, Chang-Ju;Nam, Kwang-Woo
    • Journal of the Korean Association of Geographic Information Studies
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    • v.17 no.2
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    • pp.59-71
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    • 2014
  • At present, Korean one-person households have been continuously increased in spite of the reduction of total population. The increasement of one-person household has become a social and institutional issue. It is necessary to response socially and economically to not only changes of housing demand but also the disadvantaged classes such as the socially weak and single elderly household from the national level. In this respect, this research examined the spatial distribution (such as the increasing area, high-density area, and majority area) of one-person household with census data in the city of Busan. The clusters of one-person households were selected by focusing on the spatial distributions by time series changes of 2000, 2005, and 2010 and considering their housing characteristics. In terms of policy efficiency, the clusters of one-person households to be supported by priority were derived by analyzing the census data from 6066 output areas in the city of Busan. As a result, lots of one-person households of juniors were distributed around the university town, office facility, and station service area. Lots of one-person households at middle-aged class were distributed in Busan's original downtown and mountain-side road. Generalizing these characteristics, cluster analysis was conducted. As a result, one-person household dense area in Busan could be classified into four types. This research should be utilized as a counterplan for increasing the housing demand of one-person household or basic data for supporting small housing supply policies in the future.

Current Status and Projection of Spent Nuclear Fuel for Geological Disposal System Design (심지층 처분시스템 설계를 위한 사용후핵연료 현황 분석 및 예측)

  • Cho, Dong-Keun;Choi, Jong-Won;Hahn, Pil-Soo
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.4 no.1
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    • pp.87-93
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    • 2006
  • Inventories, and characteristics such as dimension, fuel rod array, weight, $^{235}U$ enrichment, and discharge burnup of spent nuclear fuel (SNF) generated from existing and planed nuclear power plants based on National 2nd Basic Plan for Electric Power Demand and Supply were investigated and projected to support geological disposal system design. The historical and projected inventory by the end 2057 is expected to be 20,500 and 14,800MTU for PWR and CANDU spent nuclear fuel, respectively. The quantity of SNF with initial $^{235}U$ enrichment of 4.5 wt.% and below was shown to be 96.5% in total. Average burnup of SNF revealed $\sim36$ GWD/MTU and $\sim40$ GWD/MTU for the period of 1994-1999 and 2000-2003, respectively. It is expected that the average burnup of SNF will be $\sim45$ GWD/MTU at the end of 2000's. From the comprehensive study, it was concluded that the imaginary SNF with $16\times16$ Korean Standard Fuel Assembly, cross section of $21.4cm\times21.4cm$, length of 453cm, mass of 672 kg, initial $^{235}U$ enrichment of 4.5 wt.%, discharge burnup of 55 GWD/MTU could cover almost all SNFs to be produced by 2057.

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Optimized Path Finding Algorithm for Walking Convenience of the People with Reduced Mobility (교통약자의 이동편의를 위한 최적경로 탐색 기법)

  • Moon, Mikyeong;Lee, Youngmin;Yu, Kiyun;Kim, Jiyoung
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.34 no.3
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    • pp.273-282
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    • 2016
  • There has been growing social interest recently in the movement rights of people with reduced mobility. However, it simply eliminates the temporary inconvenience of walking of people with reduced mobility because it focuses only on supply of institutional facilities. Therefore, we look forward to improving movement welfare by proposing an optimized path finding algorithm for people with reduced mobility that takes into consideration physical elements affecting their movement, such as slope, steps etc. We selected Walking barrier factor by analyzing previous studies and calculated the relative importance of Walking barrier factors using an Analytic Hierarchy Process(AHP). Next, through the fuzzy system, the Walking disturbance level of link, which integrates the weights of Walking barrier factors and the attributes of each link, is derived. Then, Walking path cost that takes into consideration the ‘length’ factors is calculated and an optimized path for people with reduced mobility is searched using Dijkstra’s Algorithm. Nineteen different paths were searched and we confirmed that the derived paths are meaningful in terms of improving the mobility of people with reduced mobility by conducting a field test. We look forward to improving movement welfare by providing a navigation service using the path finding algorithm proposed in this study.