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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.

영국의 공공도서관법연구

  • 최달현
    • Journal of Korean Library and Information Science Society
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    • v.7
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    • pp.177-206
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    • 1980
  • Public library legislation is the essential means of providing for all the citizen in modern society with a standard public library service. We can trace the origin of that back to the Public Libraries Act 1850 in England. This paper is reviewing all the measures concerning public libraries of England since then in order to find out some guidelines for revision of the Korean Library Law enacted in 1963. Although Public Libraries Act 1850 was an output of a series of social reform movement in the 19th century, it established first the provision of public library service su n.0, pported by public funds. However the Act had several restrictions hindering public library service from making progress. These are: 1. Adoptive legislation in nature 2. Limitation of the size of population and rate income 3. Small library authorities 4. Procedure for adoption by public meeting 5. Restrictions on the ways in which rate income might be spent 6. No governmental organization to direct or control for a standardized public library service 7. No cooperative schemes among libraries. Subsequent development was directed largely to removal of those limitations. The present Public Libraries Act 1964 as a model of public library legislation was enacted on the basis of such reports as Kenyon, McColvin, Roberts, and Bourdillon. All but the problem of small library authorities were removed with this new Act. The final object could be achieved by the Local Government Act 1974 which reorganized existing 383 small authorities into new 115 ones the average population of which was 280, 000. Now, McColvin's dream of 30 years could be fulfilled in the late 70's. He argued that the minimum size of population of a viable authority should be 300, 000. Although the effect of the 1964 Act on the development of public library services in England was great, there must be some considerations as to the provisions of public library objective, government funding for library services, free use of library materials to all regardless of residence, and placement of library committee within the authority.

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Gas Hydrate BSR-derived Heat Flow Variations on the South Shetland Continental Margin, Antarctic Peninsula (가스수화물 BSR을 이용한 남극반도 남쉐틀랜드 대륙주변부의 지열류량 변화)

  • Jin, Young-Keun;Nam, Sang-Heon;Kim, Yea-Dong;Kim, Kyu-Jung;Lee, Joo-Han
    • Ocean and Polar Research
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    • v.25 no.2
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    • pp.201-211
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    • 2003
  • Bottom simulating reflectors (BSR), representing the base of the gas hydrate stability field, are widespread on the South Shetland continental margin (SSM), Antarctic Peninsula. With the phase diagram fur the gas hydrate stability field, heat flow can be derived from the BSR depth beneath the seafloor determined on multichannel seismic profiles. The heat flow values in the study area range from $50mW/m^2$ to $85mW/m^2$, averaging to $65mW/m^2$. Small deviation from the average heat flow values suggests that heat flow regime of the study area is relatively stable. The landward decrease of heat flow from the South Shetland Trench to the continental shelf would be attributed to the landward thickening of the accretionary prism and the upward advection of heat associated with fluid expulsion. The continental slope 1500m to 3000m deep, where BSRs are most distinguished in the SSM, shows relatively large variation of heat flow possibly due to complex tectonic activities in the study area. The local high heat flow anomalies observed along the slope may be caused by heat transport mechanisms along a NW-SE trending large-scale fault.

A Study on Eco-Efficiency in Public Sector Using Decision Tree and DEA Analysis (의사결정나무와 자료포락 분석을 이용한 공공기관 유형별 환경효율성에 대한 연구)

  • Lim, Mi Sun;Kim, Jinhwa;Choi, Soon Jae
    • Journal of the Korean Operations Research and Management Science Society
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    • v.40 no.1
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    • pp.91-116
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    • 2015
  • This study aims to provide public sectors with eco-efficiency information. To implement the purposes of the study, environmental and economic variables of Eco-Efficiency were identified through decision tree model, then the relative Eco-Efficiencies of 243 public sectors were evaluated through input-oriented DEA (Data Envelopment Analysis) model. Specifically, the amount of public purchasing per a staff and the amount of energy use per a staff were considered as input factors. Sales per a staff was considered as output factor. The result shows that most of the public sectors (94.2%) were evaluated as "inefficient" taking into consideration of average value, 0.501 from market-based public corporations, 0.288 from local public corporations, 0.28 from quasi-market-based public corporations, 0.269 from fund-management-based quasi-governmental institutions, 0.09 from non-classified public institutions, and 0.078 from commissioned-service-based quasi-governmental institutions. Furthermore, it is possible to establish a plan for internal Eco-Efficiency improvement based on information of the reference set. In order to improve the Eco-Efficiency in the public sectors in the long term, environmental impacts of the overall public sectors' operations (e.g., energy saving, water saving, waste reduction, and purchasing of green products) needs to be properly proposed in consideration of BSC (Balanced Scorecard) indicators of public sectors.

Effects of Replacing Ground Corn with Cassava Chip in Concentrate on Feed Intake, Nutrient Utilization, Rumen Fermentation Characteristics and Microbial Populations in Goats

  • Chanjula, P.;Ngampongsai, W.;Wanapat, M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.10
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    • pp.1557-1566
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    • 2007
  • Ten male crossbred (Thai $Native{\times}Anglo$ Nubian) goats with average live weight of $27{\pm}2$ kg were randomly assigned according to a $5{\times}5$ replicated Latin square design to receive five diets, $T_1$ = concentrate with 0% cassava chip (CC), $T_2$ = 25% CC, $T_3$ = 50% CC, $T_4$ = 75% CC and $T_5$ = 100% CC. Fresh elephant grass (FEG) was offered ad libitum as the roughage. A metabolism trial lasted for 21 days during which liveweight changes and feed intakes were measured. Based on this experiment, there were no significant differences (p>0.05) among treatment groups regarding DM intake and digestion coefficients of nutrients (DM, OM, NDF and ADF), except for $T_5$ (100% CC) which was lowest (p<0.05) in digestion coefficient of CP than $T_1$ and $T_3$. Rumen parameters (ruminal pH, $NH_3$-N and volatile fatty acids), blood urea nitrogen, blood glucose and packed cell volume were similar among treatments. Moreover, rumen microorganism populations were not affected (p>0.05) by cassava inclusion. The amount of N absorption and retention were similar among treatments, except for $T_5$ which tended to be slightly lower. Based on this experiment, it could be concluded that the optimal level of cassava inclusion to replace corn in goat diets was in the range of 25-75% of CC when fed with FEG and it was a good approach in exploiting the use of local feed resources for goat production.

The Effects of Rural Living Community Characteristics on the Elderly's Life Satisfaction (농촌지역 생활공동체의 특성이 노인들의 생활만족도에 미치는 영향)

  • Lee, Sang-Rok;Do, You-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.5
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    • pp.171-180
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    • 2020
  • The purpose of this study is to examine the effects of the characteristics of the elderly living community in rural areas on the life satisfaction of the elderly. The subjects of study were 670 elderly people living at the living communities in Jeollabuk-do. In order to achieve the research purpose, multiple regression analysis model was applied using community characteristics as independent variables and life satisfaction as dependent variable. Among community variables, programs, mutual support, pysical space satisfaction, community consciousness and conflict, household labor burden are significant variables for life satisfaction. Among the personal characteristics, subjective health, monthly average income, marriage status(bereavement) are found to have a significant effect on life satisfaction. These results suggest that the influence of community characteristics as well as individual characteristics are important on the life satisfaction of the elderly living in the group life. The results of this study suggest such as policy implications that living community features such as interactions among seniors, programs, and their relationship with local residents are the important intervention points for improving life satisfactions of the elderly living community in rural area.

Low Computational Adaptive Expanded Block Search Motion Estimation Method (저연산 적응형 확장 블록 탐색 움직임 추정 기법)

  • Choi, Su-Woo;Yun, Jong-Ho;Cho, Tae-Kyung;Choi, Myung-Ryul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1254-1259
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    • 2010
  • In this paper, Low Computational Adaptive Expanded Block Search Motion Estimation Method is proposed. Proposed method classifies ME blocks as Average Motion Block(AMB) and Local Motion Block(LMB) according to correlation of reference frame. It could reduce the computational complexity with performing Modified Fast Search(MFS). And accuracy of MV is also increased by 4 sub-blocks on LMB and Block Expansion(BE). The experimental results show that the proposed method has better performance that increased 1.8dB than Diamond Search and 0.6dB than Full Search with 7.5 % computation of Full Search. The proposed method could be applied to video compression and Frame Rate Conversion(FRC).

Influence of bi-directional seismic pounding on the inelastic demand distribution of three adjacent multi-storey R/C buildings

  • Skrekas, Paschalis;Sextos, Anastasios;Giaralis, Agathoklis
    • Earthquakes and Structures
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    • v.6 no.1
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    • pp.71-87
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    • 2014
  • Interaction between closely-spaced buildings subject to earthquake induced strong ground motions, termed in the literature as "seismic pounding", occurs commonly during major seismic events in contemporary congested urban environments. Seismic pounding is not taken into account by current codes of practice and is rarely considered in practice at the design stage of new buildings constructed "in contact" with existing ones. Thus far, limited research work has been devoted to quantify the influence of slab-to-slab pounding on the inelastic seismic demands at critical locations of structural members in adjacent structures that are not aligned in series. In this respect, this paper considers a typical case study of a "new" reinforced concrete (R/C) EC8-compliant, torsionally sensitive, 7-story corner building constructed within a block, in bi-lateral contact with two existing R/C 5-story structures with same height floors. A non-linear local plasticity numerical model is developed and a series of non-linear time-history analyses is undertaken considering the corner building "in isolation" from the existing ones (no-pounding case), and in combination with the existing ones (pounding case). Numerical results are reported in terms of averages of ratios of peak inelastic rotation demands at all structural elements (beams, columns, shear walls) at each storey. It is shown that seismic pounding reduces on average the inelastic demands of the structural members at the lower floors of the 7-story building. However, the discrepancy in structural response of the entire block due to torsion-induced, bi-directionally seismic pounding is substantial as a result of the complex nonlinear dynamics of the coupled building block system.

Assessment of Nicotine Dependence among Smokers in a Selected Rural Population in Kerala, India

  • Jayakrishnan, R.;Mathew, Aleyamma;Lekshmi, Kamala;Sebastian, Paul;Finne, Patrik;Uutela, Antti
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2663-2667
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    • 2012
  • Objectives: An attempt was made to understand the nicotine dependence of smokers selected for an ongoing smoking cessation intervention programme in rural Kerala, India. Methods: Data were collected from resident males in the age group of 18 to 60 years from 4 randomly allocated community development blocks of rural Thiruvananthapuram district (2 intervention and 2 control groups). Trained accredited social health activist workers were utilised to collect data from all groups through face to face interview. Nicotine dependence among participants was assessed by means of the six-item Fagerstrom Test for Nicotine Dependence (FTND) translated into the local language. The internal consistency of FTND was computed using Cronbach's alpha coefficient. Criterion validity (concurrent) was assessed by correlations of nicotine dependence scores with age at initiation of smoking and cumulative smoking volume in pack-years. Results: Among the 928 smokers identified, 474 subjects were in the intervention area (mean age = 44.6 years, SD = 9.66 years) and 454 in the control area (mean age = 44.5 years, SD = 10.30 years). The overall FTND score among current daily smokers was 5.04 (SD: 5.05). FTND scores in the control and intervention areas were 4.75 (SD: 2.57) and 4.92 (SD: 2.51) respectively. The FTND scores increased with age and decreased with higher literacy and socioeconomic status. The average FTND score was high among smokers using both bidi and cigarettes (mean 6.10, SD 2.17). Internal consistency analysis yielded a Cronbach's alpha coefficient of 0.70 in a subsample of 150 subjects, a moderate result. The association of the scale was strongest, with the number of pack-years smoked (rho = 0.677, p < 0.001). Conclusion: A moderate level of nicotine dependence was observed among smokers in the current study. Tobacco cessation strategies could be made more cost effective and productive if a baseline assessment of nicotine dependence is completed before any intervention.

Kinetic and Thermodynamic Features of Combustion of Superfine Aluminum Powders in Air

  • Kwon, Young-Soon;Park, Pyuck-Pa;Kim, Ji-Soon;Gromov, Alexander;Rhee, Chang-Kyu
    • Journal of Powder Materials
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    • v.11 no.4
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    • pp.308-313
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    • 2004
  • An experimental study on the combustion of superfine aluminum powders (average particle diameter, a$_{s}$: ∼0.1 ${\mu}{\textrm}{m}$) in air is reported. The formation of aluminum nitride during the combustion of aluminum in air and the influence of the combustion scenario on the structures and compositions of the final products are in the focus of this study. The experiments were conducted in an air (pressure: 1 atm). Superfine aluminum powders were produced by the wire electrical explosion method. Such superfine aluminum powder is stable in air but once ignited it can burn in a self-sustaining way due to its low bulk: density (∼0.1 g/㎤) and a low thermal conductivity. During combustion, the temperature and radiation were measured and the actual burning process was recorded by a video camera. Scanning electron microscopy (SEM), X-ray diffraction (XRD) and chemical analysis were performed on the both initial powders and final products. It was found that the powders, ignited by local heating, burned in a two-stage self-propagating regime. The products of the first stage consisted of unreacted aluminum (-70 mass %) and amorphous oxides with traces of AlN. After the second stage the AlN content exceeded 50 mass % and the residual Al content decreased to ∼10 mass %. A qualitative discussion is given on the kinetic limitation for AlN oxidation due to rapid condensation and encapsulation of gaseous AlN.N.