• Quality Improvement in Health Care
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• v.14 no.1
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• pp.55-59
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• 2008

Background : The purpose of inner cannula is to protect the upper air way and permit air to pass freely, in addition, to provide endotracheal suction, artificial respiration and to maintain adequate oxygen saturation. The tube needs to be sterilized for maintenance and cleanness of air way and for prevention of bronchospasm. However, it has been reported that there is no guideline for sterilization and many hospitals conduct their own sterilization methods, for example, once a day(13's general hospital), three times a day(The Catholic University of Korea ST Mary's hospital) or even no cleansing. Consequently, the QI team of our hospital suggested the SOP(standard operating procedure) of sterilization and evaluate cost and time effect in nursing. Method : 1) Benchmarking of 13's neurosurgery department of general hospital in Seoul 2) Investigation of test records of sputum culture from patients with intubation for tracheotomy 3) Check of results of O2 Sat. monitoring to confirm of maintaining opened air way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 times a day to once a day) 2) Cost effects: saving over 10 million won per one year 3) Providing better nursing: time effects (30 min a day) permit to conduct more nursing activities Conclusion : It can get Cost and time effects in nursing with improved sterilization method of inner cannula. It needs to do research on improvement of the monthly exchange protocol of outer cannula and provide supporting data for the proper exchange schedule. The result of additional microorganism detection from patients with new process needs to be evaluated further more.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3383-3389
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• 2014

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

• Health Policy and Management
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• v.8 no.1
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• pp.1-14
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• 1998

Analysis of practice variations has been one of important issues in trying to contain costs as well as to manage quality in health care. This study was conducted to provide statistical model for analysing variations in inpatient costs by type of hospitals. Four K-DRGs including Cesarean section, appendectomy, cataract extraction, and pediatric pneumonia with CC class 0 were selected, and means and dispersions of inpatient procedure and operation costs were simultaneously compared between type of hospitals. The results indicated that joint modelling of means and dispersions by gamma distribution was a very useful analytic tool for identifying factors which might have relationship with variations in inpatient costs. This model can be expanded to test the significance of several independent variables in analysing cost variations. In surgical conditions, means and unit variations of procedure and operation costs showed consistent pattern which was tertiarty hospital, general hospital, and hospital in descending order. Different findings were identified in pediatric pneumonia, from which mean and unit variation of procedure and operation cost was the highest in general hospital. The practical implication of this difference could not be drawn from this study. It will be done by further sophisticated researches. In order to develop health policy for cost containment and quality management in Korea, it is essential to find out manageable factors affecting variations in practice patterns which include characteristics of population, providers, regions, and so on. The statistical model presented in this study will give health services researchers useful insights for future investigations in analysing cost variations.

• Environmental and Resource Economics Review
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• v.24 no.1
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• pp.85-107
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• 2015

This study analyzes the effect of applying hyperbolic social discount rate onto the results of benefit-cost analysis of environmental public investment projects in Korea. In order to check the application possibility to the actual feasibility study, the discount factors generated by hyperbolic function, rather than traditional exponential one, would be applied to the benefit and cost data from the pre-feasibility studies which peformed for environmental public investment projects. The results of this study shows that using hyperbolic social discount rate is effective for enhancing test results, only under the condition of which the full expansion of the time periods of analysis is satisfied. According to the simulation results of this study, to achieve higher benefit/cost ratio by using hyperbolic social discount rate, the period should be increased up to 120 to 150 years at least.

• Health Policy and Management
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• v.21 no.1
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• Journal of the Ergonomics Society of Korea
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• v.27 no.4
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• pp.45-58
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• 2008

Ergonomic techniques have been required to analyze the effectiveness of functional clothing design improvement in a systematic and analytic manner. The goals of the present study are to: (1) comprehensively and analytically examine the effectiveness of clothing improvement by using the relationship analysis between clothing design components (D) and ergonomic evaluation measures (E) and (2) prove the usefulness of cost-effectiveness analysis for clothing design optimization. The cost effectiveness analysis is comprised of the preliminary evaluation based on expertise and the in-depth evaluation where the D-E relationship analysis is applied. As a result of the cost effectiveness analysis applied to flame-proof clothing, an optimal design was identified by analyzing costs and qualitative/quantitative effects. In the preliminary evaluation, the expected effectiveness of each design alternative on wear efficiency and wear comfort was estimated. In the in-depth evaluation, however, the effectiveness of each design alternative was analyzed by quantitative evaluation in a wearing test using a questionnaire prepared based on the D-E relationship analysis. It was concluded that the D-E relationship analysis and the cost-effectiveness analysis are useful for comprehensive evaluation and optimization of functional clothing design.

• Korean Journal of Construction Engineering and Management
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• v.15 no.2
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• pp.23-32
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• 2014

Modernized Korean housing (Hanok) with competitive price has been actively developed due to the increased interests in traditional Korean housing. Developing new building materials and methods is an essential area for Modernized Hanok. This paper compared and analyzed two mock-up buildings of Modernized Hanok and one mock-up of Traditional Hanok those were actually constructed as test-beds. Many different new methods were introduced, and their influences on construction cost and schedule were analyzed in order to verify the research results as well as to find implications for future direction. As a result, the construction cost and schedule of Modernized Hanok have been decreased by about 40% and 20%, respectively, when compared with traditional one. 'Wood frame' and 'Roof' are found as being the most influencing areas with highest weights in terms of cost and schedule. Therefore, further development in these two areas would facilitate to reduce overall cost of Modernized Hanok with improved building performance.

• Journal of Korean Society of Forest Science
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• v.106 no.1
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• pp.54-62
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• 2017

This study was carried to develop the chip-harvester and to analysis the operation productivity and cost for effective collection and forwarding of forest biomass. Main target specification of chip-harvester is speed of 8km/h, maximum climbing capacity of $30^{\circ}$ and maximum load capability of 2000 kg. Body structure is articulate type to reduce turning radius. Driving equipment is six-wheel drive, and a rear wheel is tandem bogie type to increase grip force. As a result of the driving test about developed chip-harvester, driving speed was 6.9 km/hr and 8.1 km/hr in ${\pm}10%$ slope with loaded and 7.3 km/hr and 7.9 km/hr in ${\pm}10%$ slope without load. As a result of the operation productivity and cost, operation productivity of grinding and forwarding was approximately $10m^3$ per day, and operation cost was 393,126 won per day.

• Structural Engineering and Mechanics
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• v.8 no.2
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• pp.165-180
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• 1999

The cost effectiveness of using steel roof systems for residential buildings is becoming increasingly apparent with the decrease in manufacturing cost of steel components, reliability and efficiency in construction practices, and the economic and environmental concerns. While steel has been one of the primary materials for structural systems, it is only recently that its use for residential buildings is being explored. A comprehensive system for the design of residential steel roof truss systems is presented. In the first stage of the research the design curves obtained from the AISI-LRFD code for the manufactured cross-sections were verified experimentally. Components of the truss systems were tested in order to determine their member properties when subjected to axial force and bending moments. In addition, the experiments were simulated using finite element analysis to provide an additional source of verification. The second stage of the research involved the development of an integrated design approach that would automatically design a lowest cost roof truss given minimal input. A modified genetic algorithm was used to handle sizing, shape and topology variables in the design problem. The developed methodology was implemented in a software system for the purpose of designing the lowest cost truss that would meet the AISI code provisions and construction requirements given the input parameters. The third stage of the research involved full-scale testing of a typical residential steel roof designed using the developed software system. The full scale testing established the factor of safety while validating the analysis and design procedures. Evaluation of the test results indicates that designs using the present approach provide a structure with enough reserve strength to perform as predicted and are very economical.