• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.1
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• pp.85-95
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• 2002

The purpose of this study was to develope a critical pathway for the chemotherapy of non-small cell lung cancer patients and to identify its effects after implementation. Critical pathway was developed through 5 steps including content and clinical validity tests with collaborative efforts of nurses, clinicians, and other allied healthcare professionals with the aim of improving the quality of patient care, while minimizing cost to the patients. This paper was described an evaluation of the impact of a developed critical pathway on complication rate, length of stay, costs, the interval of treatment and patient satisfaction by nonequivalent control group posttest-only non-synchronized research design.Results were compared between the two groups of patients. There were no significant differences in demographic variables and the occurrence of bone marrow suppression between experimental group and control group(t=-0.01, p=0.992). There were statistically significant decreases in the average length of stay(t=-10.45, p=0.000), in the average cost(t=-2.988, p=0.004), and in the interval of treatment(t=-6.75, p=0.000) after implementation of the critical pathway compared to control group. Also, there was a statistically significant improvement of the patient satisfaction after implementation of the critical pathway compared to control group(t=4.57, p=0.000). This paper concludes that critical pathway in chemotherapy for lung cancer, implemented in the context of an general hospital, is the useful tool to shorten the hospital stay, reduce treatment costs, and improve the quality of life in cancer patients. Further study needs to be conducted to identify other clinical outcomes including job satisfaction, collaboration among health professionals and potential for use in education. Also, it is recommended that nurses should revise continuously the developed critical pathway through clinical implementation and maintain their role of patient advocacy through monitoring pathway compliance.

• Clean Technology
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• v.26 no.3
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• pp.168-176
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• 2020

The introduction of the Korea toxics use reduction (TUR) program to build a clean society is generally evaluated based on social economic criteria. Among various techniques, benefit-cost analysis is the most commonly used. This method is focused on the calculation and comparison of all the benefits and costs attributable to the TUR program. However, since it is reasonable to consider not only economic criteria but also policy criteria in the process of evaluation, it is necessary to reflect on the criteria weights found in the benefits and costs. This study aims at developing a new evaluation technique to achieve this purpose and apply it to the Korean TUR program to be implemented in 2020. This study selected competitiveness, toxic substances' emission reduction ratio, and health improvement as policy criteria. The Analytic Hierarchy Process (AHP) technique was initially used to calculate the weight and then, based on the results, the concept of information entropy introduced by Claude Shannon was used to eliminate subjective bias. As a result of the study, it was found that the revised benefit-cost analysis considering the weights of the policy criteria, as well as the existing economic criteria, could be a reasonable alternative in evaluating the feasibility of TUR regulations for highly toxic substances.

• Journal of the Society of Disaster Information
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• v.16 no.2
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• pp.331-342
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• 2020

Purpose: This study concerns the cost of safety management in order to prevent accidents and disabilities in the construction industry. The purpose of the Chapter is to draw up problems and improvement measures for these safety management costs. Method: A detailed questionnaire was developed for 20 construction safety managers for the research. This questionnaire was analyzed and implemented by the Expert Group Interview (FGI) analysis method. Results: In order to understand the safety management cost system, alternatives such as preparing a standard manual, implementing regular on-site training, and establishing a monitoring system for the safety management cost were derived. In addition, there is a need to ensure autonomy in the execution of flexible costs so that they can be deployed immediately in case of emergency to improve the 'efficiency and necessity of the safety negligence system'. And it was analyzed as items that should be improved due to excessive demand for documentation. Conclusion: Through this study, problems should be recognized for the improvement of the construction safety management cost system. And it will have to come up with policy-based and institutional-improvement measures for experts.

• The Korean Nurse
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• v.32 no.5
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• pp.78-92
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• 1994

The purposes of this study were to evaluate the results of the hospital self inspection with the medical insurance and to offer basic materials to the medical insurance inspection and the education of medical insurance. The study was undertaken with 4,730 cases among the total 13,810 medical insurance in patients from Jan. 1990 to Dec. 1990 at one university hospital in Pusan. The major contents of the inspection were the omission of diagnosis and medical fee, curtailment, application mistake, the rates of inclusion, subtraction and total accumulation. The data were collected using patients charts and bills. The results of the paper analysis were as follows. 1. From the pre-discharge hospital self inspection, major omission were treatment and material fee but medication fee were moderately high and high curtailment was operation fee. 2. Decreasing order of operation fee adjustment were digestive(22.4%) muscular(22%) and neuro system operation(21.4%). Majority of the medication fee adjustments were injection form of medication(95.7%). 50% of the treatment fee adjustments were composed of injection fee(27.9%) and dressing or post-operative dressing fee(22.3%). 74.7% of material costs were composed of oxygen(30.6%), blood and the blood composed materials(44.1%). 3. Pre-discharge inspection showed 6% adjustment rate, 4.3% addition and 2.1% curtailment rate. Most of the adjustment were omission(66.1%). 4. Omission were divided by event omission(92.6%)and application mistake(7.4%). The decreasing order of omission fee were operation(21.84%), treatment(18.71 %) diagnosis(18.68%), medication (14.53%) and material costs(10.84%). So operation and treatment part were the major part of the total omission fee(40.55%). 5. The average omission of diagnosis were 1,800 per month.

• Journal of the Korean Dietetic Association
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• v.4 no.2
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• pp.245-253
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• 1998

In this study, the food cost for the urban worker's living expenses was estimated for the Korea Labor Union. The urban workers living expenses are minimum of healthy and decency level expenses with allowances for minimum quality of life. Thus, the food cost should be enough for purchasing proper kinds and amount of foods which can supply sufficient nutrient to maintain health and which should reflect current food consumption patterns. To estimate the food cost, the Korean Recommended Dietary Allowances was used to calculate the amount of nutrients which should be supplied. The National nutrition survey and the Food balance sheet, were used to estimate the current consumption patterns for the kind and amount of food. To estimate price for each food item, the market survey was executed in six large cities. Also, to verify the estimated food cost, actual food costs were surveyed. For 5 kinds of model household, dietary allowances were calculated for the each nutrient. Using the Korean food guides, the number of serving for each food group were decided for the model households. In each food group, the amount and kind of foods were decided by the current food consumption pattern. The kind and amount of food were adjusted by the amount of calculated nutrient. When the amount of nutrient was between 90% and 110% of the recommended dietary intake, it was accepted. With these amount and kinds of foods, the food cost were calculated using the market survey. Considering extra expenses for the eating-out and processed foods, extra expenses are added. As a results, for single person family, the estimated food cost was 149,210won per month. For two, three, four and five person family, the estimated food costs were 245,179won, 381,182won, 501,669won and 687,980won per month, respectively. The estimated food cost were lower in the single and two person family than the actual food cost by the survey. The cost for eating-out gave major differences. In the future, to estimate food cost, the food consumption patterns for the different kind of household, sex and age should be studied carefully. Also, the pattern of eating-out should by analyzed.

• Journal of Distribution Research
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• v.2 no.2
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• pp.153-172
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• 1997

The distribution sector is affected by a wide range of regulations. Many of these are related to health and safety, others are related to urban planning and environmental issues, whereas some mainly have an economic basis. But, regulations many be unduly restrictive, in which case they can drive up costs and ultimately prices, or they may, in some cases, reduce consumer choice. Unduly restrictive regulations could also increase costs indirectly, by reducing competition and thus lead to lower productivity growth. In the past few years, distribution sector has gone through drastic changes due to deregulation and market opening. Implementation of regulatory reforms served as an opportunity to change laws and systems which had been an obstacle to development of distribution sector. Market opening of distribution sector became a turning point to promote competition among domestic and foreign firms. However, for small and medium scale of the typical retail enterprises which were in no position to compete in terms of prices, additional facilities, and services, faced a threat of diminished trading area, and even of their existence. Because, large firms may have greater market power than small firms, as they can more easily extract favorable terms when procuring goods, and may also be able to deter entry by advertising outlays or access to the best sites. In addition, larger chain stores armied with sufficient capital dominated trading area and reduced customer's welfare by abusing their monopoly power when competing with other shops, and are often cited as an example of adverse effects of local monopoly. In order to minimize such adverse effects and to foster competition, regulatory reforms in distribution sector should set its goal to promote sound and stable distribution activities through market principle and restoring competition principle, and ultimately to boost customers welfare. Therefore, deregulation in distribution sector should be implemented in a way to promote customers welfare, eliminate entry barriers, and expand competition principle such as productivity and efficiency competition. However, it should be also recognized that deregulation of system alone is not enough to develop the distribution sector. To compete in a increasingly concentrated industry, small enterprises increasingly engage in co-operative arrangements, such as buying groups, strategic alliances or franchise agreements.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.41-59
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• 1999

Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

• Journal of the Korean Institute of Landscape Architecture
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• v.15 no.3
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• pp.11-19
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• 1988

The purpose of this study is to investigate ways to control the wind dispersal of contton-wrapped seeds of such poplars and willows as Poplus alba, P. tomentiglandulosa, P. euramericana, P. deltoides, and Salix pseudo-lasiogyne. These trees are hated by many people because of their seeds blowing all over the place during May. These cottony seeds can be nuisance to various types of outdoor activities, pose safely threat to drivers, become fire hazards during prolonged spring dry spells, and cause many types of health hazards of allergy such as sneezing. rhinitis, asthma, and skin rashes. Four control methods can be used to resolve the problem. First, pruning can be a solution, but it is unsatisfactory in terms of costs and outcome. Second, planting of male trees only can be a solution, but it is hard to identify sexes of saplings. Third, female trees can he replaced with other species. But it requires high costs and takes at least ten years to functionally replace the removed ones. As an alternative to such unsatisfactory control methods, the possibility of applying plant growth regulators has been investigated since 1983. During the pre-test, various concentrations and mixtures of them were either sprayed or injected, but failed to achieve any promising results. But the injection of a mixture made up of 0.75g of 2-chloroethane phosphonic acid with 0.2 mg of GA in 300cc water in the end of March produced premature falling of almost all aments and capsules of treated poplars and willows. It was found that the effect of the injection lasts two years. The results of the main experiment of 1987 can be summarized as follows ; First, the injection of the mixture of 2-chloroethane phosphonic acid and GA increases the premature abscisin of aments and capsules, thus reducing the wind dispersal of the cottony seeds of S. pseudolasiogyne, P. tomentiglandulosa, and P. euramericana 1644.09, 1200.61, and 1485.11 times, respectively, than that of the naural abscisin, It is estimated that the average number of wind-blown seeds reduced are approximatively 6,185,100, 4062,900, and 2,830,670 per tree, respectively. Second, the treatment causes no observable side effects on the growth of the samples tested.

• The Korean Journal of Pain
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• v.34 no.4
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• pp.417-426
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• 2021

Background: Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients. Methods: The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression). Results: Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47-4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients. Conclusions: Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.