• Title/Summary/Keyword: Under-utilization

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A Study on the Variation in Meical Service Utilization of The Dead by Cerebrovascular Diseases Patients in Korea (뇌혈관질환 사망자 의료이용 변이의 분석)

  • Hong, Worl-Lan;Jung, Doo-Chae
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.36-61
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    • 2009
  • This study focused on finding the variation of medical service utilization, paths of medical service utilization and medical payments of the patients died by cerebrovascular diseases. For this study, data of the one-year episodes of the health insurance subscribers died in 2004 were selected. The frequency of medical visits, the lengths of stays, the days of outpatient visits, the total period of medical services and the total medical payments were compared by the characteristics of the suppliers and utilizers. This study is useful in reviewing the equity of medical service utilization because it analyzed variance in utilization by episodes. In oder to collect accurate data of the patients died by cerebrovascular diseases in 2004 the 2004 reimbursement data of all medical institutions were matched to the data of funeral fee payment by the National Health Insurance Corporation from January 2004 to May 2005. The major results of the study are as follows. The variation of medical service utilization of cerebrovascular diseases was influenced by supplier factors suppliers, such as types and locations of medical institutions and user factors such as sex and age. It was suspected that the reimbursement by fee-for-service contributed to the variation quite a lot, but we could not compare the variation between the different reimbursement systems in Korea. On the basis of analyzing results this study suggests that the factors of suppliers and utilizers should be reviewed to reduce the under use and over use expressed by variations of medical service. The processes of care, effective communication and management system should be investigated for the equity of medical service utilization and also. alternative medical services would be recommended to reduce the high medical payment. Additionally to find other causes of variation further in depth study controling the severity of diseases, socio-economic status of the users and the system factors is required.

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A Ppoisson Regression Aanlysis of Physician Visits (외래이용빈도 분석의 모형과 기법)

  • 이영조;한달선;배상수
    • Health Policy and Management
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    • v.3 no.2
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    • pp.159-176
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    • 1993
  • The utilization of outpatient care services involves two steps of sequential decisions. The first step decision is about whether to initiate the utilization and the second one is about how many more visits to make after the initiation. Presumably, the initiation decision is largely made by the patient and his or her family, while the number of additional visits is decided under a strong influence of the physician. Implication is that the analysis of the outpatient care utilization requires to specify each of the two decisions underlying the utilization as a distinct stochastic process. This paper is concerned with the number of physician visits, which is, by definition, a discrete variable that can take only non-negative integer values. Since the initial visit is considered in the analysis of whether or not having made any physician visit, the focus on the number of visits made in addition to the initial one must be enough. The number of additional visits, being a kind of count data, could be assumed to exhibit a Poisson distribution. However, it is likely that the distribution is over dispersed since the number of physician visits tends to cluster around a few values but still vary widely. A recently reported study of outpatient care utilization employed an analysis based upon the assumption of a negative binomial distribution which is a type of overdispersed Poisson distribution. But there is an indication that the use of Poisson distribution making adjustments for over-dispersion results in less loss of efficiency in parameter estimation compared to the use of a certain type of distribution like a negative binomial distribution. An analysis of the data for outpatient care utilization was performed focusing on an assessment of appropriateness of available techniques. The data used in the analysis were collected by a community survey in Hwachon Gun, Kangwon Do in 1990. It was observed that a Poisson regression with adjustments for over-dispersion is superior to either an ordinary regression or a Poisson regression without adjustments oor over-dispersion. In conclusion, it seems the most approprite to assume that the number of physician visits made in addition to the initial visist exhibits an overdispersed Poisson distribution when outpatient care utilization is studied based upon a model which embodies the two-part character of the decision process uderlying the utilization.

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An Empirical Investigation for EIS Utilization:On the Basis of TAM (중역정보 시스템의 활용에 관한 실증연구)

  • Kim, Jong-Weon
    • The Journal of Information Systems
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    • v.6 no.1
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    • pp.257-291
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    • 1997
  • Today, executives in the company operate their organizations under highly competitive environments with dynamic technological, economic, and political changes. Under these new environment changes, they play the important role in establishing the future directions and strategic orientations of organizations. In general, executive information systems (EIS) are designed to support these roles of executives. They can help executives access and use the information they require about the organization's internal and external environments. In spite of such potential EIS support for executives, only a limited number of empirical studies have been published in this area. by employing a well-established theory of computer usage behavior (Technology Acceptance Model : TAM), this study systematically investigates the key factors in the successful utilization of an EIS. The empirical results from this study may prove useful for both IS researchers and practitioners.

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A Distributed Dynamic Channel Assignment Algorithm in Highway Microcells

  • Lee, Chae-Young;Park, Hyun-Jeong
    • Journal of the Korean Operations Research and Management Science Society
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    • v.21 no.2
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    • pp.187-201
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    • 1996
  • A distributed dynamic channel assignment is proposed and its performance is examined in a highway microcellular radio environment. In the two step ordered local packing (TOLP) scheme, channels are assigned on an ordered basis under cochannel utilization in congested microcell region. A selection criterion is employed to decide the cell from which a free channel is borrowed. Simulation results show that the proposed scheme outperforms existing methods is channel utilization and call blocking probabilities, especially under asymmetric call arrivals with a lower call switching requirement.

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A Packet Scheduling Algorithm for High-speed Portable Internet System (휴대 인터넷 시스템에서의 패킷 스케줄링 알고리즘 연구)

  • Choi, Seong-Hoon
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.30 no.1
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    • pp.59-65
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    • 2007
  • HPI (High-speed Portable Internet) system which provides high speed internet services is going to be commercialized soon. Since HPI provides simultaneously four different service types such as UGS (Unsolicited Grant Service), rtPS (real time Polling Service), nrtPS(non-real time Polling Service), and BE (Best Effort) under different QoS (Quality of Service) requirements and limited wireless channel resources, efficient packet scheduling mechanisms are necessary to increase the utilization of channels as well as to satisfy the various QoS requirements. This study regards the traffic data to be served as time series and proposes a new packet scheduling algorithm based on the nonparametric statistical test. The performance of the newly proposed algorithm is evaluated through the simulation analysis using a simulator that can evaluate the performance of packet scheduling mechanisms under various values of system parameters and measures such as packet delay time, data transmission rate, number of loss packets, and channel utilization.

Availability and Utilizations of Library Information Resources in Secondary Schools by Special Patrons

  • Asuata, Isibhakhome Eleaena;Emasealu, Helen Uzoezi
    • International Journal of Knowledge Content Development & Technology
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    • v.12 no.1
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    • pp.35-47
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    • 2022
  • This study adopted the descriptive survey research method. The population of this study comprised of the hearing impaired students in selected government secondary schools in Rivers state. The population of hearing impaired students in Rivers State is 257. A simple random sampling technique was used to select a sample size of 159. A self-developed instrument titled "Availability and Utilization of Library Information Resources Questionnaire (AULIRQ)" was utilized for data collection. 153 responses were collated, indicating a 96.2% response rate. The data collected was arranged and analyzed using frequency count, percentages, and mean and standard deviation. Finding reveals that information resources in the libraries understudied were inadequate and under-utilized. Also, it was established that among other barriers, under-funding is a major barrier to making information resources available for the physically challenged. It was recommended that schools offering special education for the hearing impaired should pace up in their developmental gap by providing such resources and ensure adequate funding by all stakeholders.

Assembly and Function of Seed Endophytes in Response to Environmental Stress

  • Yong-Lan Wang;Han-Bo Zhang
    • Journal of Microbiology and Biotechnology
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    • v.33 no.9
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    • pp.1119-1129
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    • 2023
  • Seeds are colonized by diverse microorganisms that can improve the growth and stress resistance of host plants. Although understanding the mechanisms of plant endophyte-host plant interactions is increasing, much of this knowledge does not come from seed endophytes, particularly under environmental stress that the plant host grows to face, including biotic (e.g., pathogens, herbivores and insects) and abiotic factors (e.g., drought, heavy metals and salt). In this article, we first provided a framework for the assembly and function of seed endophytes and discussed the sources and assembly process of seed endophytes. Following that, we reviewed the impact of environmental factors on the assembly of seed endophytes. Lastly, we explored recent advances in the growth promotion and stress resistance enhancement of plants, functioning by seed endophytes under various biotic and abiotic stressors.

Comparision of medical care utilization between newly detected hypertensive patients and known hypertensive patients (정기건강진단으로 밝혀진 고혈압환자의 의료이용에 관한 연구)

  • Cheon, Byung-Yool
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.1 s.23
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    • pp.47-60
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    • 1988
  • The monthly ambulatory treatment days in newly detected hypertension group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling,959 patients were selected : among them, 544 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of these patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparision to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant variable responsible for ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables reponsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical rare utilization, additional variables should be considered.

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The Effect of the Cost Exemption Policy for Hospitalized Children under 6 Years Old on the Medical Utilization in Korea (6세미만 입원 법정본인부담금 면제정책이 의료이용에 미치는 영향)

  • Jeon, Kyeong-Su;Yoon, Seok-Jun;Ahn, Hyeong-Sik;Shin, Hyun-Woong;Yoon, Young-Hye;Hwang, Se-Min;Kyung, Min-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.295-299
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    • 2008
  • Objectives : The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. Methods : A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudo-control group. Results : The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients, with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. Conclusions : The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.

Leaching Behavior of LD Slag

  • Kim, Hyung-Suek;Han, Ki-Hyun;M. S. Oh;Byeon, Tae-Bong
    • Proceedings of the IEEK Conference
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    • 2001.10a
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    • pp.526-531
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    • 2001
  • LD slag, that is, a by-product of steel making process, has been mainly used as land construction materials. Recently, the seashore application of LD slag was tried in Japan and Korea tut the reaction between LD slag and seawater was not studied yet. We tried to clarify the leaching reaction and/or mechanism of LD slag and the reaction between seawater and LD slag. We tried to apply these results to the decarbonization of seawater for seawater magnesia process. At first, LD slag was milled and classified into 5 grades, that is, (ⅰ)45${\mu}{\textrm}{m}$ under, (ⅱ)0.25~0.5mm (ⅲ)0.5~1mm(ⅳ)1~2mm, (ⅴ)2.36~3.35mm. These slags were leached in the distilled water. In case of 45${\mu}{\textrm}{m}$ under, the pH of the leached solution was over 12. The chemical analysis of leached solution showed that the $Ca^{+}$$^2$was main component and the S $i^{+}$$^4$was very low. On the other hand, the content of S $i^{+}$$^4$in leached solution was decreased with the increase of pH of this solution. The nearly pure calcium solution was made and the ultra high purity MgO could be made with this calcium solution. The leaching behavior of LD slag was different between the fine particle and coarse particle. The calcium was leached by bulk dissolution in the coarse particle and by surface controlled reaction in fine particle. The leaching rate was slow in coarse particle and fast in fine particle. Therefore, the high pH solution, that is, over 12, was obtained in fine particle.cle.e.

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