• 보건행정학회지
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• 제33권1호
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• pp.19-28
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• 2023

Background: With the enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act in February 2018, legal guidelines for physician orders for life-sustaining treatment (POLST) were presented. This study was conducted to analyze the association of writing POLST on the use of health care before death. Methods: The study analyzed the electronic medical records and POLSTs of 1,003 adult patients who died at a tertiary hospital located in Seoul from February 4, 2018 to February 4, 2019. Results: Of the deaths, 80% (n=804) completed POLST. Among patients who completed POLST before death, 51% (n=412) were written 1-7 days before death, and only 31% (n=246) were completed by patients themselves. 99% (n=799) decided to withdraw or withhold cardiopulmonary resuscitation. As a result of analyzing the effect of POLST on medical use before death, it was found that POLST and inpatient cost had a significant negative correlation, and POLST completion significantly reduced death in the intensive care unit (ICU). However, both inpatient costs and death at ICU increased when the POLST was completed by surrogate decision-makers rather than patients themselves. Conclusion: The enactment of the Hospice, Palliative, Care, and Life-sustaining Treatment Decision-Making Act provided a legal basis for withdrawing and withholding meaningless life-sustaining treatment. By specifying the treatment to be received at the end of one's life through the POLST, inpatient treatment costs and death at the ICU were decreased. However, the frequent decision-making by the surrogates and completion of POLST close to death may hinder the original purpose of the law.

• 산업경영시스템학회지
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• 제29권3호
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• pp.135-142
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• 2006

Engineers are always concerned with life cycle costs for making important economic decisions through engineering action like reliability of products. Decisions during the reliability growth development of products involve trade-offs between invested costs and its returns. In order to find minimal LCC containing the reliability improvement cost, production cost, repair and replacement costs, and holding cost of spare parts for failure items we suggest in this paper relationship between development cost and sustaining cost in values of growth parameter $\beta$ of AMSAA model. This model is applied to the reliability growth program based on AMSAA model during R&D phase, the warranty activities of items and the block replacement policy for maintenance of items in avionic equipment.

• 대한간호학회지
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• 제34권8호
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• pp.1402-1408
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• 2004

Purpose: The purpose of this study was to analyze the concept of self-care in elders with dementia through a review of nursing literature and to provide more understanding of the definition and perspectives of the concept of self-care notion in elders with dementia. Methods: The technique developed by Walker and Avant was used as a guide in analyzing the concept of self-care. Results: Attributes of self-care in dementia may include a single or group of actions needed for sustaining life, a personal effort to maintain functional independence while minimizing other's assistance, an outcome behavior from the person's interaction with inter-personal and/or contextual environment, and a functional ability that may decline in parallel to cognitive impairment. Antecedents of self-care in dementia may include at least presence of a certain degree of cognitive appraisal for the self-care needs, self-willingness for the self-care action, spatial and visual orientation, cultural pre-conception of the self-care behavior, presence of environmental context/equipment available for self-care, and sufficient time available. The consequences may include sustaining of life, feel of satisfaction, achieving independence, extended life expectancy, increased self-confidence, decreased caregiver distress and/or burden, savings in health care costs. Discussion: Defining attributes and antecedents and consequences of self-care in dementia identified in this study provided empirical ground of a middle-range theory of self-care for a clinical population with dementia and generated possible hypotheses to be tested in future studies.

• 대한간호학회지
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• 제31권2호
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• pp.279-291
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• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

• 한국건축시공학회지
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• 제5권4호
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• pp.91-98
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• 2005

This paper illustrates a comparative analysis on the economic efficiency of remodeling method that is one of major factors in totting more desirable standards and proposes to utilize LCC calculation techniques in generating a required budget for more effective quantity-based analysis that is both objective and effect. Rather than comparing only the initial lost of two different methods, it seems through to compare their entire life cycle cost that includes any repair and reconstruction/ remodeling expenses, thus generate overall quantitative analysis in objective perspective

• STI Policy Review
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• 제6권1호
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• pp.54-69
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• 2015

Although there is progress in developing green sectors in North America and East Asia, the key challenge facing the expansion of economy-wide green innovation and structural change in these regions is the absence of relevant policy follow-up to the green stimulus enacted during the Great Recession. The boost to green sectors provided by such measures is waning quickly, given that much of the green stimulus focused on energy efficiency. The biggest obstacles to sustaining green growth in North America and East Asiaare major market disincentives, especially the under-pricing of fossil fuels and market failures that inhibit green innovation. A three-part strategy to overcome these obstacles would involve: first, removing fossil fuel subsidies; second, employing market-based instruments to further reduce the social costs of fossil fuel use; and third, allocating any resulting revenue to public support for green innovation and investments. Such a strategy would ensure that green growth is not about promoting niche green sectors but instigating economy-wide innovation and structural transformation in North America and East Asia.

• 품질경영학회지
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• 제38권4호
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• pp.521-530
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• 2010

Global regulatory pressures relating climate change and environmental responsibility are asking companies to find out the best way for sustaining their continuous business growths. It could be known that inadequate management for environmental issues are bad for business, negatively affecting brand image, causing unnecessary losses and costs for environmental preservation. For this reason, environmentally conscious green business growth has been recognized as an essential requirement for a company to stay in business. Many companies are looking for green business opportunities of improving their environmental and financial results, and struggling with how green fits into their business. In this paper, the Green Six Sigma, an environmentally conscious Six Sigma methodology, is presented as a way to find solutions for green growths. The Six Sigma is known as a disciplined, data-driven approach and methodology for achieving world-class performance in any process from manufacturing to transactional. In chronological order, the Six Sigma has been evolved from Motorola's quality-oriented methodology to GE's cost-oriented lean approach, and is being evolved and developed as an environment-oriented green growth approach. There is no doubt that the Green Six Sigma, as an engine of green growth, is a power tool for achieving competitive business performance and reducing the impact on the environment.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제16권8호
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• pp.2490-2506
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• 2022

In Mobile Edge Computing (MEC), attackers can speculate and mine sensitive user information by eavesdropping wireless channel status and offloading usage pattern, leading to user privacy leakage. To solve this problem, this paper proposes a Privacy-preserving and Energy-efficient Offloading Algorithm (PEOA) based on Lyapunov optimization. In this method, a continuous Markov process offloading model with a buffer queue strategy is built first. Then the amount of privacy of offloading usage pattern in wireless channel is defined. Finally, by introducing the Lyapunov optimization, the problem of minimum average energy consumption in continuous state transition process with privacy constraints in the infinite time domain is transformed into the minimum value problem of each timeslot, which reduces the complexity of algorithms and helps obtain the optimal solution while maintaining low energy consumption. The experimental results show that, compared with other methods, PEOA can maintain the amount of privacy accumulation in the system near zero, while sustaining low average energy consumption costs. This makes it difficult for attackers to infer sensitive user information through offloading usage patterns, thus effectively protecting user privacy and safety.

• 항공우주시스템공학회지
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• 제17권5호
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• pp.1-10
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• 2023

본 연구는 무인항공기에 대한 계획창정비의 최적 주기결정 목표 하에, 신뢰도 및 정비도 분석결과를 활용하여 신뢰도 및 정비도 기반 시뮬레이션과 운영유지 비용분석을 통해 계획창정비 수행의 효용성 (경제성)을 검증하였고, 무인항공기 운영의 효과성과 유지관리 비용의 균형을 맞추는 최적의 계획창정비 주기를 제시하였다.

• KDI Journal of Economic Policy
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• 제34권2호
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• pp.55-93
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• 2012

우리나라에서 에너지정책은 다양한 에너지 관련 계획들을 통해 구체화된다. 그런데 최근 비전으로서의 성격이 강한 상위계획에서 설정되는 부문별 목표가 지속적으로 상향 조정됨에 따라 상위계획과의 정합성을 유지해야 할 필요가 있는 (실행계획으로서의) 하위계획 수립에서 왜곡이 발생하고 있다. 이와 더불어 개별 하위계획 자체도 미래의 불확실성에 대응하여 계획의 유연성을 확보하는 측면에서 한계를 보이고 있다. 이러한 문제들은 잠재적으로 막대한 사회적 비용을 초래할 위험을 내포하고 있다. 이에 본 논문은 우리나라 에너지 계획의 수립 집행과 관련한 개선방안의 논의에 실증적인 근거를 제시하기 위해 실행계획 가운데 가장 중요하게 인식되고 있는 전력수급기본계획을 주된 분석대상으로 삼아, 전력수급기본계획 자체의 문제, 전력수급기본계획과 상위계획 간 정합성을 유지하는 과정에서 발생할 수 있는 문제를 논리적으로 설명하고, 현실적인 상황을 가정하여 그러한 문제들이 초래할 수 있는 사회적 비용의 규모를 추정하였다. 분석 결과, 전력수급기본계획 수립 시 최대전력이 실적치보다 7%(15%) 적게 추정되는 경우 2020년 기준으로 연간 발전비용이 약 2,860억원(1조 2,160억원) 증가하며, 이러한 사회적 비용은 상위계획인 국가에너지기본계획에서 설정한 미래 전력수요 목표치에 맞추어 전력수급기본계획이 수립 집행되는 경우에도 유사하게 발생함을 보였다. 또한 상위계획인 온실가스 감축 마스터플랜에서 전력부문에 부과하는 감축목표량이 과도하게 설정되어 탄소배출비용이 0일 경우의 적정 전원구성에서 발생하는 온실가스 배출량의 5%를 추가 감축해야 하는 경우에도 연간 발전비용은 2020년 기준으로 약 9,150억원 증가한다. 반면, 우리나라의 경우 전원별 경제성에 큰 차이가 존재하는 특성으로 인해 전력수급기본계획 수립 시 미래 $CO_2$ 가격의 불확실성이 초래하는 잠재적인 사회적 비용의 크기는 매우 작은 수준으로 분석되었다.