• Korea Journal of Hospital Management
• /
• v.9 no.1
• /
• pp.66-94
• /
• 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.

• The Korean Journal of Health Service Management
• /
• v.2 no.1
• /
• pp.105-124
• /
• 2008

The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
• /
• v.7 no.2
• /
• pp.195-205
• /
• 2012

This study examines runaway youths at risk in a youths' shelter who are preparing for an independent life and both the facilitating and adverse factors to personal characteristics and independence of runaway youths at risk with the aim to grasp their recognition of independence and level of desire for it and find out necessary factors for a successful independence in multidimensional perspectives including the economic independence, educational independence, psychological independence, and social independence for their sound growth. This will provide the basis for desirable interventions for youths runaway youths at risk to prepare for an independent life. The findings of this study on the factors that affect the preparation for an independent life are as follows: First, as a result of analyzing the effect of micro-systematic factors on the preparation for an independent life, it turned out that problem-solving abilities and self-efficacy had influence on the preparation for a career Second, as a result of analyzing the effect of mesoscopic-systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by whether to participate in independence preparation programs and institutional supports, and that career maturity of runaway youths at risk were affected only by the relationship with teachers and participation in independence preparation programs. Third, as a result of analyzing the effect of macro systematic variables on the preparation for an independent life, it turned out that the preparation for a career were affected by participation of the local community and service network, and that participation of the local community was an predictor variable that would affect a career maturity of runaway youths at risk. Fourth, as a result of analyzing ecological systematic variables that might affect the preparation for a career, it turned out that intervening variables and macro systematic variables had the most powerful influence on the preparation for a career among runaway youths at risk. It is necessary, therefore, to provide education programs organized by policies in order to develop problem-solving abilities and vocational capabilities so that runaway youths at risk, and to train and appoint more professional teachers at shelters. Programs for independence preparation need to be developed actively and practically in consideration of the characteristics of shelters, and the network with the local community for support also need to be established in utilization of the human resources and service programs of the community. With the understanding of leaving home of runaway youths at risk as the previous stage of an independence, there should be a housing support for their stable settlement in the perspective of housing welfare until become adults. In addition, there should be education specialized programs for occupation and careers to train runaway youths at risk as professionals including such areas as health, mentality, learning, and voluntary work for their sound growth.

• Journal of the Korean Society of Food Culture
• /
• v.20 no.6
• /
• pp.738-743
• /
• 2005

This study was performed to investigate the quality characteristics of pine mushroom yanggaeng prepared with different additions and different preparations of pine mushroom. Yanggaeng was prepared with three concentration of pine mushroom after different preparations of pine mushroom, A hot wind drying 0.1%, 0.3%, 0.5%, Frozen pine mushroom grinding 0.1%, 0.3%, 0.5%, Freezed drying 0.1%, 0.3%, 0.5%, to which was added cooked red bean, agar, oligosaccharide, salt and water. Proximate composition, hunter's color, texture profile analysis and sensory evaluation of yanggaeng were examined. Lightness of pine mushroom yangaeng increased with increasing pine mushroom content and frozen pine mushroom grinding products were higher than those of the preparation products. In the texture profile analysis, hardness of pine mushroom yangaeng increased with increasing pine mushroom content and cohesiveness, springiness of Frozen pine mushroom grinding 0.1% were the highest. In sensory evaluation, the taste and viscosity scores of Freezed drying 0.1% higher than those of the other products. Also the overall acceptability of freezed drying 0.1% pine mushroom yanggaeng was the highest of the all products.

• KDI Journal of Economic Policy
• /
• v.30 no.2
• /
• pp.99-128
• /
• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Restorative Dentistry and Endodontics
• /
• v.31 no.4
• /
• pp.300-311
• /
• 2006

The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin. Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p < 0.05). There was also no significant difference between the groups with or without mechanical retention (p < 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.

• Journal of Korean society of Dental Hygiene
• /
• v.11 no.3
• /
• pp.325-341
• /
• 2011

Objectives : This research has investigated the reality of the education of the claim and the degree of the education for the claimed of the dentistry recuperation organization in the Daejeon and Chuncheong are for the improvement of the problem in the medical expenses. Methods : It use as a basic data for the vitalizations of the education and performed the survey in the dentistry recuperation organization in the Daejeon and ChungCheong Nam BukDo which are registered in the evaluating organization for judging the health insurance in the present May 2010, and concluded just like the below. Results : 1. The education of the claim in the requirer in the dentistry recuperation organization, and the education of the claim was especially lacking when the dentist was studying in the university, and the dental hygienist had the similar educational experience in the school and the clinic (p<0.05) 2. Most of the requirer in the dental recuperation organization was hoping to get the education related to the claim work, but the dentist and the nurse's aid was relatively low (p<0.05) 3. For fixing the error of the claim, the participation and the extension of the judging standard of the insurance was the highest among the university subordinate dental hospital/dental hospital, but the health center was relatively low (p<0.05). 4. The dentist feels the economic burden in employing the special employee because the raising of the special judging people, compared to others, but the staffs such as the dental hygienist preferred it as one of ways to fix the error of the claim of the dental insurance (p<0.05) 5. Both dentists and the dental hygienist said proper time to teach the insurance was all needed in the school, and the clinic, but other workers relatively believed it should be held in the clinic (p<0.05). 6. The important factors to decide the participation of the lecture was in order of the contents of the lecture, the place of the lecture, the amount for the lecture, the superintendent of the lecture, whether it has gone through the educational score, and whether it has passed the conserving educational score was relatively less important in the university subordinate dentist/dentist, but the medical center was very effective as 4.50 (p<0.05) 7. Health Insurance Review and assessment service was very high as the managing department for supplying the lecture and the information, 70.5%, and the next was the Korean Dental Association/ Korean dental hygiene association, but dentists were preferring the association to manage in than the Health Insurance Review and assessment service to manage (p<0.05) 8. In preferring lecture for the inquiring the insurance, periodontal surgery was the highest as 4.51, the diagnosis standard for injection was high in the university subordinate hospital/dentists, and the more the year of the insurance inquiry, the less the doctor who was hoping for the lecture about the basic treatment. Conclusions : Taken together, it is decided that the inquiry education about the medical expense in the dentist, so the consistent and systematic education should be held to the related people, and from this, it is thought to reduce the problem of the inquiry of the medical expenses by fostering the knowledge and supplying the information which are related to the inquiry of the dentists.

• Neonatal Medicine
• /
• v.15 no.1
• /
• pp.44-53
• /
• 2008

Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

• Journal of the Korean Wood Science and Technology
• /
• v.17 no.2
• /
• pp.34-64
• /
• 1989

Corner block with anchor bolt(CBA) joint method used in knock-down type table furniture manufacturing can reduce the packing and transporting cost. Unfortunately. it also has the disastrous defect to be loosend and unstable during the service life mainly due to fatigue and creep(repeated and prolonged loading). So 22 joint groups constructed were tested to evaluate the effect of some design factors related to the size of side rail(apron). block attachment to side rail. and the number of anchor bolt as well as the effect of the type of corner block(mitered type vs. rectangular type) Usable strength from the stiffness coefficients of each joint group were analysed with SPSS /PC+ and described as the criteria of CBA joint construction. The conclusions were as follows: The height of side rail(50, 75 and 100 mm) and the addition of polyvinyl acetate(PVAc) emulsion in the corner block attactment to side rail had the effect on raising the usable strength of CBA joint with remarkable high significance. And the effect of 2 - anchor bolts was also superior to that of 1 - bolt significantly. However. the thickness of side rail(22 mm vs. 25 mm) had no effect on the strengthening the table joint rigidity. Mitered type corner block joint appeared to he recommendable for CBA jointed table construction rather than the rectangular type one regardless of the method of block attachment to side rail. The best result identified from Duncan's multiple comparison was in the construction with 25 mm thick and 100 mm height of side rail fastened using 2 - anchor bolts in mitered type corner block. But it would be reasonable to use 22 mm thick & 75 mm high side rail and mitered corner block with PVAc emulsion & 2 bolts considering the productivity and production cost down in the MDF furniture manufacturing industries.

• Journal of Bio-Environment Control
• /
• v.14 no.4
• /
• pp.284-288
• /
• 2005

This study was conducted to clarify the effects of supplying methods of selenium on the growth and Se uptake of hydroponically grown tomato plants. Tomato seeds (Lycopersicum esculentum Mill. cv. Momotaro T-93, Daki Seed Co.) were sown in plug tray with fifty holes, and raised for sixty days. Tomato seedlings transplanted to coco fiber slabs were supplied with the nutrient solutions adjusted to EC $2.3dS{\cdot}m^{-1}$ and pH $5.8\~6.2$ recommended by the Japanese Horticultural Experiment Station. Selenium forms used were inorganic $SeO_2$ (here in after referred to Se) and organic selenium chlenium with sugar fatty acid ester (here in after referred to chelated-Se). 10 ppm selenium solutions were treated to tomato plants with foliar applications, drenching, and foliar application plus drenching. Growth characteristics in terms of plant height, number of leaves, leaf area and chlorophyll content were significantly increased in the plot of foliar application ot Se, and in the plot of foliar application plus drenching of chelated-Se than other plots, respectively. Transported contents of selenium into the tomato fruits were highest as 0.302 ppm in the plot of foliar application plus drenching of chelated-Se. Also, it had tended to be higher in the plot of foliar application plus drenching than in the plots of foliar application or drenching in both of Se and chelated-Se. Foliar application and drenching of organic chelated-Se were effective to produce the functional tomato fruits.