• Title/Summary/Keyword: admission cost

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SmartCAC : Novel Distributed Connection Admission Control Framework for Heterogeneous Networks (이종 네트워크를 위한 분산처리 방식의 효율적인 호 수락 제어 구조)

  • Kim, Hyo-Eun;Kim, Won-Tae;Kang, Eun-Hyun;Park, Yong-Jin
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.44 no.7 s.361
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    • pp.70-80
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    • 2007
  • For supporting various mobile networks, this paper proposes a framework of distributed connection admission control, named SmartCAC. Especially, intelligent CAC operations are adopted in terms of interoperation between mobile nodes and mobile networks. This scheme does not need to correct information between networks. Basically vertical handover call can use guard channel that was reserved for handoff, because SmartCAC addresses the identification between vertical handover call and new call, delay and reliability as requirement of QoS for efficient connection control. The scheme also uses mobile terminal speed for network filtering. Especially an extended protocol is proposed to give different network states information to mobile nodes because there have been no ways for mobile nodes to compare the states of different networks. Sophisticated simulation study is performed in order to evaluate SmartCAC in terms of signaling cost. As a result, signaling cost of ours is up to 96% better than that of the existing scheme.

Multilevel Analysis of Factors Related to Cost and Length of Stay in Acute Myocardial Infarction Patients with Coronary Stenting: Based on Korean National Health Insurance Service's Customized Database in 2010 and 2015 (관상동맥 스텐트를 삽입한 급성 심근경색 환자의 진료비 및 재원일수 관련 요인에 대한 다수준분석: 2010년과 2015년 국민건강보험공단 맞춤형 데이터베이스 자료를 바탕으로)

  • Choi, Boyoung;Lee, Hae-Jong
    • Health Policy and Management
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    • v.30 no.3
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    • pp.418-429
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    • 2020
  • Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

An Analysis on the Characteristics of High Cost Patients in the Regional Medical Insurance Program (의료보험 고액진료비 환자의 특성연구)

  • 문옥륜;강선희;이은표;좌용권;이현실
    • Health Policy and Management
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    • v.3 no.1
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    • pp.53-83
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    • 1993
  • A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

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A Study on Threshold-based Admission Control Algorithm for Multicast Service (멀티캐스트 서비스 환경에서 역치 기반의 연결 수락 제어 방안 연구)

  • Jo Seng Kyoun;Choi Seong Gon;Lee Jong Min;Choi Jun Kyun
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.42 no.12
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    • pp.1-8
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    • 2005
  • In this paper, we study a call admission control algorithm for supporting multicast service under the BcN environment where broadcasting, communication and Internet are converging to be one. It is necessary to control service requests with a certain criteria in order to guarantee QoS because the system capacity is limited. As a possible solution, we divide one multicast service into 3 classes and set up a threshold per each class to control service request. Especially, for the purpose of system benefit, we define system pay-off rate 'GAIN' with the term 'Reward' and 'Penalty' according to admit and reject service request. And we confine the range of threshold which makes GAIN to be maximized. For the performance analysis, we model the system as M/M/m/m queueing system, investigate GAIN under various conditions and show the effectiveness of the proposed algorithm.

Relationship of Nutritional Status at the Time of Admission to Length of Hospital Stay ( LOS ) and Mortality : A Prospective Study Based on Computerized Nutrition Screening (입원당시의 영양상태가 재원일수와 사망률에 미치는 영향 : 전산영양검색을 이용한 전향적 연구)

  • Kim, Yeong-Hye;Kim, Mi-Gyeong;Seo, Ae-Ri;Lee, Yeon-Mi
    • Journal of the Korean Dietetic Association
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    • v.5 no.1
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    • pp.48-53
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    • 1999
  • This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk Ⅰ or At-risk Ⅱ based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group Ⅰ and 8% as At-risk Group Ⅱ. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.

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Performance Analysis of Coordinated Cognitive Radio Networks under Fixed-Rate Traffic with Hard Delay Constraints

  • Castellanos-Lopez, S. Lirio;Cruz-Perez, Felipe A.;Rivero-Angeles, Mario E.;Hernandez-Valdez, Genaro
    • Journal of Communications and Networks
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    • v.16 no.2
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    • pp.130-139
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    • 2014
  • Due to the unpredictable nature of channel availability, carrying delay-sensitive traffic in cognitive radio networks (CRNs) is very challenging. Spectrum leasing of radio resources has been proposed in the so called coordinated CRNs to improve the quality of service (QoS) experienced by secondary users (SUs). In this paper, the performance of coordinated CRNs under fixed-rate with hard-delay-constraints traffic is analyzed. For the adequate and fair performance comparison, call admission control strategies with fractional channel reservation to prioritize ongoing secondary calls over new ones are considered. Maximum Erlang capacity is obtained by optimizing the number of reserved channels. Numerical results reveal that system performance strongly depends on the value of the mean secondary service time relative to the mean primary service time. Additionally, numerical results show that, in CRNs without spectrum leasing, there exists a critical utilization factor of the primary resources from which it is not longer possible to guarantee the required QoS of SUs and, therefore, services with hard delay constraints cannot be even supported in CRNs. Thus, spectrum leasing can be essential for CRN operators to provide the QoS demanded by fixed-rate applications with hard delay constraints. Finally, the cost per capacity Erlang as function of both the utilization factor of the primary resources and the maximum allowed number of simultaneously rented channels is evaluated.

Economic Length of Stay and Opportunity Income of Appendectomy and Pneumonia Using Activity-based Costing (활동기준원가를 이용한 충수절제술과 폐렴의 경제적 재원일과 재원일 단축에 따른 기회이익)

  • Kim, Sang Mi;Lee, Hae Jong;Shin, Dong Gyo
    • Health Policy and Management
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    • v.23 no.2
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    • pp.124-131
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    • 2013
  • Background: This study aimed to measure the opportunity income by identifying the economic length of stay (ELOS) which is the intersection point of daily revenue and cost on appendectomy and pneumonia cases. Methods: The research subjects were 460 patients of appendectomy and 606 patients of pneumonia, discharged from a general hospital between July 1, 2009 and June 30, 2010. ELOS calculated with both of total revenue on diagnosis-related group (DRG) and fee-for service (FFS). The cost is calculated by activity-based costing system of the hospital. Results: Average length of stay (ALOS) of appendectomy was 4.48 days and its average revenue per case were 1,710,215 (1,989,105) won by DRG (FFS). The variable cost was 491,262 won which was 28.7% (24.7%) of DRG (FFS) total revenue. And 97.2% of the total variable cost was incurred within 2 days from admission. The ELOS was 4 (5) days in DRG (FFS). Shortening three days (two days) would increase opportunity income 52.0% (82.2%) in DRG (FFS). ALOS of pneumonia case was 4.86 days and its average revenue per case were 489,448 (761,426) won by DRG (FFS). The variable cost was 27,230 won which was 5.6% (3.6%) of DRG (FFS) total revenue. Thirty-eight point nine percent of the daily variable cost was incurred in discharge date. The ELOS was 2 (4) days in DRS (FFS). Shortening three days (one day) would increase opportunity income 27.6% (37.2%) in DRG (FFS). Conclusion: The ELOS would be used by strategic index for achieving minimum profit and developing the ways to get there. But we also should not pass over that the opportunity income obtained by the reducing ALOS may cause some problem of quality.

Opportunistic Routing for Bandwidth-Sensitive Traffic in Wireless Networks with Lossy Links

  • Zhao, Peng;Yang, Xinyu
    • Journal of Communications and Networks
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    • v.18 no.5
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    • pp.806-817
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    • 2016
  • Opportunistic routing (OR) has been proposed as a viable approach to improve the performance of wireless multihop networks with lossy links. However, the exponential growth of the bandwidth-sensitive mobile traffic (e.g., mobile video streaming and online gaming) poses a great challenge to the performance of OR in term of bandwidth guarantee. To solve this problem, a novel mechanism is proposed to opportunistically forwarding data packets and provide bandwidth guarantee for the bandwidth-sensitive traffic. The proposal exploits the broadcast characteristic of wireless transmission and reduces the negative effect of wireless lossy links. First, the expected available bandwidth (EAB) and the expected transmission cost (ETC) under OR are estimated based on the local available bandwidth, link delivery probability, forwarding candidates, and prioritization policy. Then, the policies for determining and prioritizing the forwarding candidates is devised by considering the bandwidth and transmission cost. Finally, bandwidth-aware routing algorithm is proposed to opportunistically delivery data packets; meanwhile, admission control is applied to admit or reject traffic flows for bandwidth guarantee. Extensive simulation results show that our proposal consistently outperforms other existing opportunistic routing schemes in providing performance guarantee.

The Management of Chronic Wound with Modified Portable Negative Pressure Therapy (만성 창상의 치료에서 이동식 음압요법의 신고안)

  • Kim, Jee Soo;Yoon, In Mo;Yoo, Jung Seok
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.223-228
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    • 2008
  • Purpose: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. Methods: We made newly innovated equipment with 50 cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. Results: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. Conclusion: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.

Medical expenses and lost productivity costs due to the medical use of research arthropathy disease (관절병증 질환자의 의료이용에 따른 의료비 및 생산성 손실비용 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
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    • v.2 no.2
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    • pp.51-63
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    • 2016
  • The aim of this study was to investigate medical expenses and productivity lost costs associated with medical use of arthropathy disease. For this study, Using by Korea Medical pannel 5434 family and 15872 people in 2012, the enrolled 19-year-old arthropathy were considered and 1370 people were analyzed. Research Method was medical management calculation formular. Emergency medical using cost was 42,128,870 won per year, productivity lost costs was 98,640,000 won per year. Admission medical using times were 4.79, medical cost was 42,128,870 won, productivity lost cost was 945,036,820 won. Out patient clinic using time per year were 12.7, medical cost was 42,128,870 won, productivity lost cost was 91,252,728,000 won. According to this study, athropathy disease could affect to medical cost increasing and productivity decreasing, therefore I suggest that exercise and management for decreasing athropathy disease.