• Journal of the Korean Data and Information Science Society
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• 제17권3호
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• pp.743-752
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• 2006

This paper considers a Bayesian approach to replacement policy model with minimal repair. We use the criterion based on the expected cost and the expected downtime to determine the optimal replacement period. To do so, we obtain the expected cost rate per unit time and the expected downtime per unit time, respectively. When the failure time is Weibull distribution with uncertain parameters, a Bayesian approach is established to formally express and update the uncertain parameters for determining an optimal maintenance policy. Especially, the overall value function suggested by Jiagn and Ji(2002) is applied to obtain the optimal replacement period. The numerical examples are presented for illustrative purpose.

• Infection and chemotherapy
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• 제50권4호
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• pp.319-327
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• 2018

Background: Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. Materials and Methods: We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. Results: There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. Conclusion: The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.

• 디지털융복합연구
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• 제10권8호
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• pp.91-96
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• 2012

본 연구의 목적은 공공서비스의 한 분야인 별정우체국의 원가산정 방법론에 대하여 고찰해 보고자 하는 것이다. 본 논문은 이러한 산정방법을 어떻게 적용할 것인가에 대한 방향을 설정하고자 하였다. 왜냐하면 이러한 기간산업을 육성하고 합리적인 방향으로 이끌어 가는데 있어서 올바른 원가산정은 매우 중요하기 때문이다. 바람직한 원가산정 방법으로는 별정우체국 1국마다 평당 임차료를 산정해서 별정우체국의 전체 임차료를 산정하고 별정우체국의 위치에 따라서 기준경비율, 표준감가상각비를 이용하여 인원별, 면적별 등으로 단위당 원가를 산정하여 총원가를 산정한 다음 이를 서비스별로 배분하면 적절한 원가가 산정될 것으로 판단된다.

• 정보관리연구
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• 제29권4호
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• pp.23-43
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• 1998

본 고는 연속간행물 평가방법의 종류와 사례를 살펴보고, KINITl 소장 연속간행물을 이용자의 의견조사법과 비용대효과 분석법을 택하여 평가함으로써 연속간행물 평가시 하나의 지침이 될 수 있는 방법론을 제시하며, 핵심잡지의 성격을 규명함으로써 신규 연속간행물 선정에 참고할 수 있는 자료를 제공하고자 한다.

• Asian-Australasian Journal of Animal Sciences
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• 제7권1호
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• pp.19-29
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• 1994

The annual income (gross margin) in 1989/90 of a sample of 274 farmers in seven milk cooperatives was analyzed in the sugar cane, cassava, and horticulture areas in East Java. On average dairying contributed 42%, crops 29% and off-farm revenue 29%. Dairy income was highest in the cassava area, where it compensated for the low crop income, and lowest in the sugar cane area. Farm area and average milk yield per day per cow correlated positively with farmer's income, whereas crop income increase significantly with farm area and with the number of cows. The level of total cost per cow had a negative impact on dairy and with the number of cows. The level of total cost per cow had a negative impact on dairy and on total income. Government officials and other professionals engaged in dairying had a significantly higher total income than those with their main occupation in dairying, cropping or working as farm labourers. Uneducated farmers obtained a significantly larger income through crops, whereas farmers with tertiary education obtained more income through off-farm work, This study suggests that more attention must be paid to the actual use of labour and the improvement of the dairy output/cost ratio.

• 농업과학연구
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• 제37권2호
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• pp.245-248
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• 2010

This study was conducted to investigate effect of changes in target fat and protein contents in milk on feed cost using a simulation modeling approach based on the 2001 dairy NRC. Two simulations were done; simulation I had a limitation (up to 20%), but simulation II had no limitation for the use of cottonseed hull in a diet. Using commonly used feed ingredients in Korea, we formulated least cost diets that meet nutrient requirement of a lactating dairy cow producing 36 kg of milk with combinations of 0.1% decrease or 0.1% increase in target milk fat or protein, respectively, from the national average milk fat (4.0%) and milk protein (3.1%). The contents of alfalfa and corn in a least-cost diet were decreased and those of tall fescue, whole cottonseed and rapeseed meal were increased with decreasing fat and/or increasing protein in milk. Scenarios that decreased target milk fat percentage from 4.0% to 3.9% reduced feed cost by 2 won per kg. Due to decrease in feed intake, daily feed cost was even more reduced (136 won per head) by decreasing target milk fat percentage. Increase in target milk protein percentage from 3.1% to 3.2% reduced feed cost by 6 won per kg. Among scenarios simulated, the least feed cost was obtained in scenario aimed for 3.9% fat and 3.2% of protein in milk. We conclude that a feeding practice for increasing milk protein percentage does not directly increase feed cost. In addition, feeding practices that increase protein content in milk is expected to improve economic life-span and reproductive performance of dairy cows.

• 보건행정학회지
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• 제4권1호
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• pp.107-122
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• 1994

Many alternatives have been discussed to reduce the medical expenditure and to use the medical resources effectively. Many studies about the economies of scale have been done for the last several decades. This study has analyzed the relationship between the number of beds and the mean expense per hospitalization day in Korea. A Cost Function Model was identified and we wanted to see the minimum optimal size with the cheapest mean expense per hospitalization day. The result is as follows; 1. In the Cost Function Mode, (the number of beds)$^{2}$, the number of personnel, productivity and training institutions are the factors that statisticaly influence the mean expenses. 2. By the univariate analysis the mean expense proved to be the smallest as the level of 150-200bed, The breaked down of the components of expenses shows that the mean labor cost is much different from the mean value of material and administration costs, and that hospital with 150-200 beds also have the minimal expense. The mean expense goes up dramatically in hospitals of 450 beds or more. 3. When the other conditions are constant, according to the multiple regression analysis of the mean expense per adjusted hospitalization day the minimum optimal size with the cheapest expense is a hospital with 191 beds and the hospital with 230 beds takes the lowest mean labor cost. The material or administration costs are not influenced by hospital size. This research has limitation in measuring the variables that influence hospital xpenses, in estimating hospital output by the number of beds in considering outpatient cost and in securing representativeness of hospitals because many hospitals made no responses to the research questionnare. But it is valuable and helpful for development of health policy to figure out the number of beds with the cheapest expense per hospitalization day.

• 문화기술의 융합
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• 제4권4호
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• pp.187-199
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• 2018

본 연구는 2012년 한국의료패널자료의 보건의식행태에 응답한 만 18세 이상만으로 처리하였으며 전체 2,757명, 남자 2,614명(44.6%), 여자 143명(2.3%)으로 선정하였다. 흡연으로 의료이용 및 의료비지출 자료를 통하여 흡연자의 응급. 입원, 외래 의료이용횟수에 따른 의료비를 통하여 사회적 비용을 추계하였다. 사회적비용은 보건경제학자인 Rice(1968)의 의해 정립된 사회적관점을 채택하여 의료이용에 따른 의료비와, 보험자(공단)비용, 본인부담금, 비급여, 생산성 비용을 합산하여 사회적비용을 산출하였다. 흡연상태별 연간 응급의료이용률은 인구 백명당 흡연자 7.5%, 이용횟수 9.8회 사회적비용은 809,003원으로 나타나고 있다. 흡연상태별 인구 백명당 연간 입원의료이용률은 인구 백명당 흡연자 9.6%, 이용횟수 9회, 사회적비용은 706,870원으로 나타나고 있다. 흡연상태별 연간 외래이용률은 흡연 68.6%, 연간의료이용건수는 9건, 사회적비용은 706,870원으로 나타났다.

• 한국의료질향상학회지
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• 제2권2호
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7701-7706
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• 2013

Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.