• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• Child Health Nursing Research
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• 제7권1호
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• pp.21-34
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• 2001

The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of infant is mostly affected by the quality of parental care and rearing environment. But the new mothers usually do not know what to do because of the lack of experience in these days. Therefore, an educational program regarding maternal role would be necessary. This study was conducted to evaluate the effectiveness of the maternal role education program for mother-infant interaction, child-rearing environment, and infant development. Non-equivalent control group time-series design was used, and Barnard's mother-infant interaction model was used as a conceptual framework of this study. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37 weeks, and their mothers. The final sample consisted of 19 mother-infant dyads for intervention group and 18 dyads for control group. Data were collected from March 15th to September 3rd in 1999. For the intervention group, programmed education which focused on mother-infant interaction, breast feeding, and infant care was provided before discharge. Telephone counselling was provided within one week after discharge. Home visiting for maternal role education was provided twice, one month and three months postpartum. For the control group, home visiting was also conducted but only for data collection. The data were analyzed using chi-square test and t-test to test the equivalence of two groups, and the effectiveness of intervention program was determined with repeated measure ANCOVA and t-test. The results were as follows: 1. Significant differences were found in mother-infant interaction between two groups(p=.000). It indicates that intervention program was effective in improving mother- infant interaction. In subscale analysis, four out of six subscale showed significant differences between the groups: sensitivity to cues (p=.000), social-emotional growth fostering (p=.000), cognitive growth fostering(p=.000) in mothers, and responsiveness to caregiver (p=.019) in infants. 2. The difference in the mean score of childrearing environment (HOME) between the intervention group and control group was significant(p=.003). When each subscale of HOME was examined individually, intervention group showed significantly higher scores in the diversity of stimulation(p=.000), and mother's involvement(p=.001). 3. Three-month-Infants of the intervention group showed higher GQ in the Griffiths mental development scale(p=.026). In subscale analysis, significant differences were found in the personal-social(p=.005), and the hearing and speech(p=.003). In conclusion, the maternal role education program proved to be effective in promoting the mother-infant interaction, organizing the childrearing environment, and fostering the infant development. These results are very meaningful that we found maternal role education necessary for normal infants' mothers, and that nurses can make a great contribution in promoting health of infants and mothers.

• 보건행정학회지
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• 제22권3호
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• pp.297-314
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• 2012

Purpose : The purpose of this study was to analyze the trend of the number of nursing staffs and skill mix and to assess the effectiveness of hospital nurse expansion policies in Korea. Methods : The trend of the number of nursing staffs and skill mix were analyzed using time series data, which composed of yearly series data from 1975 to 2009. The impact of hospital nurse expansion policies was estimated by autoregressive integrated moving average(ARIMA) intervention model. Results : The number of general hospital and hospital nurses per 100 beds was decreased in late 1980s and late 1990s due to rapid growth of beds. As a result of the number of nurse aids per 100 beds decreased, skill mix became high in general hospital but nurse ratio among hospital nursing staffs was about 50%. Expansion of new nurse and revised differentiated inpatient fee were only effective in expansion of hospital nursing staffs. But they had no effect in general hospitals. Conclusion : In Korea, a few policies related to expansion of hospital nurses have an effect on increasing the number of hospital nurse. Nevertheless, level of hospital nursing staffs is inferior to that of general hospital.

• 대한간호학회지
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• 제33권5호
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• pp.633-642
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• 2003

Purpose: This study was conducted to evaluate the effects of foot care education program using foot-reflexo-massage in diabetic patients. Method: A convenience sample of non-equivalent control group time series design was used. It provided foot care education to diabetic patients through small book for both group. For the experimental group, foot-reflexo-massage was taught by a researcher and research assistants. Analysis was done by Repeated Measured ANOVA. Result: There was significant increase in foot care knowledge, self care behavior, between the experimental group and the control group over three different times. There was significant in skin temperature and pulse of foot over three different times and interaction by groups or over time, but there was no significant difference between groups. There was no significant difference in blood flow volume and capillary filling time over three different times, between groups, but there was interaction by groups or over time. But there was significant difference in discrimination in change of dosalis pedis artery blood flow. Conclusion: Findings indicate that this study may contribute to develop nursing intervention for foot care of diabetic patients.

• 대한교통학회지
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• 제24권3호
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• pp.113-123
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• 2006

본 연구는 1990년대 이후 실시된 교통사고 줄이기 운동 실시, 무인단속카메라 설치, 좌석안전띠 착용 의무화, 음주운전 삼진아웃제 등 8가지 교통안전정책의 개입효과를 ARIMA방법을 사용하여 분석하였다. 분석의 관점은 교통안전정책 강화가 전체 교통사고에 미치는 영향. 교통안전정책 강화가 일정지역의 교통사고에 미치는 영향, 특정교통안전정책 강화가 특정 법규위반으로 인한 교통사고에 미치는 영향으로 세분하였다. 분석 결과 교통사고 줄이기 운동 실시, 교통법규위반 신고보상금제, 음주운전 삼진아웃제 등이 교통사고 사망자수를 줄이는데 효과가 있는 것으로 나타났으나 통계적으로 유의하지 못하였다.

• 한국간호교육학회지
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• 제21권3호
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• pp.350-360
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• 2015

Purpose: The purpose of this study was to evaluate the effectiveness and retention period of immediate remediation for infant cardiopulmonary resuscitation (CPR) in child care teachers. Methods: This study used a nonequivalent comparison pre- and post-test design to measure knowledge about and confidence in infant CPR and an interrupted time-series design to determine skill performance. The experimental group (n=25) received both immediate remediation and video learning for infant CPR, and the comparison group (n=28) received video learning only. Knowledge and confidence were measured before and after 4 weeks. Their skill performance was tested immediately, and 4 weeks, 8 weeks, 12 weeks, and 24 weeks after intervention. Data analysis consisted of ${\chi}^2$ tests, t-tests, paired t-tests, and a generalized linear mixed model. Results: There were significant increases in knowledge and confidence within the experimental group. Skill performance showed a significant difference according to the group factor (F=10.81, p=.002) and measurement time (F=146.80, p<.001). The experimental group maintained significantly higher skill performance than did the comparison group. Conclusion: These findings support the necessity of immediate remediation education for infant CPR to maintain skill performance. In addition, appropriate renewal time and the improvement of training programs for child care teachers are necessary.

• Smart Structures and Systems
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• 제24권3호
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• pp.319-332
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• 2019

Structural health monitoring (SHM) is of great importance to super high-rise buildings. The Shanghai Tower is currently the tallest building in China, and a complete SHM system was simultaneously constructed at the beginning of the construction of the tower. Due to the variety of sensor types and the large number of measurement points in the SHM system, an online automatic structural health assessment method with few computations and no manual intervention is needed. This paper introduces a structural health assessment method for the Shanghai Tower that uses the coefficients of an autoregressive (AR) time series model as structural state indicators. An analysis of collected data indicates that the coefficients of the AR model are affected by environmental factors, and the principal component analysis method is used to remove the influence of environmental factors. Finally, the control chart method is used to track the changes in structural state indicators, and a plan for online automatic structure health state evaluation is proposed. This method is applied to long-term acceleration and inclination data from the Shanghai Tower and successfully identifies the changes in the structural state. Overall, the structural state indicators of the Shanghai Tower are stable, and the structure is in a healthy state.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.207-223
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• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

• 응용통계연구
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• 제33권6호
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• pp.697-712
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• 2020

최근 20년간 세계적으로 새로운 전염병이 반복해서 등장해왔으며 코로나-19에 들어서는 일상에까지 큰 변화와 피해를 주고 있다. 이에 더해 앞으로도 새로운 전염병의 등장을 간과할 수 없게 되면서 경제 타격에 대응하기 위한 정책 발굴이 지속적으로 요구되고 있다. 이러한 상황에서 생활인구는 시민들의 생활 패턴 변화를 드러내는 중요한 지표이다. 본 논문에서는 코로나-19에 의한 일상의 변화를 유동인구 관점에서 감지 및 분류하여 시간적 및 사회환경적 특징을 분석한다. 시간 단위로 측정된 서울시 424개 행정동별 생활인구 데이터를 분류하기 위해 k-shape clustering을 사용하였고, 이후에는 각 군집에 개입분석, One-way ANOVA 등을 적용하여 코로나-19 진행 여파에 따른 군집별 특성 및 생활인구 변화 양상을 자세히 살펴보았다. 결론적으로 국내 코로나 환자 발생 전후의 인구 유출입 변동에 있어 각 군집별로 뚜렷한 특징을 확인하였으며, 코로나-19 관련 사건을 바탕으로 지정한 개입 시점에 대해서도 민감하게 반응하는 군집과 그렇지 않은 군집을 구분할 수 있었다.

• 한국산학기술학회논문지
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• 제20권2호
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• pp.458-468
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• 2019

본 연구는 2015년 6월부터 2018년 8월까지 인천국제공항 여객터미널에서 발생한 품목별 식음료 매출액(POS) 데이터를 기반으로 2020년 12월까지 식음료 매출액을 추정하고자 하였다. 이를 위해 연구자는 시계열 분석기법들 중 하나인 ARIMA-Intervention(개입모형)을 이용하여 인천국제공항 식음료 매출액에 영향을 미칠 것으로 판단되는 주요 시계열 영향변수들을 구분하고 그에 따른 변화폭을 추정하였고 그 결과를 토대로 향후 발생가능할 것으로 예측되는 식음료 월별 매출액을 추정하는 것을 목적으로 한 것이다. 개입변수는 국내 THAAD 배치에 따른 중국 정부의 2016년 7월부터 2017년 12월까지 한국 방문을 자제를 권고한 한한령으로 설정하였다. 정상 예측치의 경우에 비록 식사 매출 상승세가 둔화되었다 하더라도 하계 극성수기인 2019년 7월 203억, 2019년 8월 212억으로 월별 매출액이 200억을 돌파할 것으로 예측되며 2020년에는 각각 214억 및 221억으로 증가할 것으로 예측되었다. 음료 매출액은 2019년 7월에는 77억, 2019년 8월에는 81억으로 예측되며 2020년에는 79억 및 82억으로 증가할 것으로 전망되었다. 저비용항공사들은 정규항공사에 비해 식음료 서비스가 전무하거나 유료화 정책으로 운영하기 때문에 저비용항공사 이용객들은 여객터미널에서 출국 및 입국 시 식음료 서비스를 이용하는 빈도가 높을 수 밖에 없을 것이다. 앞서 예측자료에 제시된 것처럼 식음료 매출은 저비용항공사의 성장과 동반하여 증대될 가능성이 높을 것이다.