• 제목/요약/키워드: outcome measure

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자궁적출술 환자를 위한 critical pathway 개발과 적용효과 (Critical Pathway Development for the Hysterectomy Patients and its applied Effect)

  • 노기옥;박경숙
    • 여성건강간호학회지
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    • 제6권2호
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    • pp.234-257
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    • 2000
  • At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

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참여자관점에서 공급사슬관리 시스템의 성공에 영향을 미치는 요인에 관한 실증연구 (An Empirical Study on the Determinants of Supply Chain Management Systems Success from Vendor's Perspective)

  • 강성배;문태수;정윤
    • Asia pacific journal of information systems
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    • 제20권3호
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    • pp.139-166
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    • 2010
  • The supply chain management (SCM) systems have emerged as strong managerial tools for manufacturing firms in enhancing competitive strength. Despite of large investments in the SCM systems, many companies are not fully realizing the promised benefits from the systems. A review of literature on adoption, implementation and success factor of IOS (inter-organization systems), EDI (electronic data interchange) systems, shows that this issue has been examined from multiple theoretic perspectives. And many researchers have attempted to identify the factors which influence the success of system implementation. However, the existing studies have two drawbacks in revealing the determinants of systems implementation success. First, previous researches raise questions as to the appropriateness of research subjects selected. Most SCM systems are operating in the form of private industrial networks, where the participants of the systems consist of two distinct groups: focus companies and vendors. The focus companies are the primary actors in developing and operating the systems, while vendors are passive participants which are connected to the system in order to supply raw materials and parts to the focus companies. Under the circumstance, there are three ways in selecting the research subjects; focus companies only, vendors only, or two parties grouped together. It is hard to find researches that use the focus companies exclusively as the subjects probably due to the insufficient sample size for statistic analysis. Most researches have been conducted using the data collected from both groups. We argue that the SCM success factors cannot be correctly indentified in this case. The focus companies and the vendors are in different positions in many areas regarding the system implementation: firm size, managerial resources, bargaining power, organizational maturity, and etc. There are no obvious reasons to believe that the success factors of the two groups are identical. Grouping the two groups also raises questions on measuring the system success. The benefits from utilizing the systems may not be commonly distributed to the two groups. One group's benefits might be realized at the expenses of the other group considering the situation where vendors participating in SCM systems are under continuous pressures from the focus companies with respect to prices, quality, and delivery time. Therefore, by combining the system outcomes of both groups we cannot measure the system benefits obtained by each group correctly. Second, the measures of system success adopted in the previous researches have shortcoming in measuring the SCM success. User satisfaction, system utilization, and user attitudes toward the systems are most commonly used success measures in the existing studies. These measures have been developed as proxy variables in the studies of decision support systems (DSS) where the contribution of the systems to the organization performance is very difficult to measure. Unlike the DSS, the SCM systems have more specific goals, such as cost saving, inventory reduction, quality improvement, rapid time, and higher customer service. We maintain that more specific measures can be developed instead of proxy variables in order to measure the system benefits correctly. The purpose of this study is to find the determinants of SCM systems success in the perspective of vendor companies. In developing the research model, we have focused on selecting the success factors appropriate for the vendors through reviewing past researches and on developing more accurate success measures. The variables can be classified into following: technological, organizational, and environmental factors on the basis of TOE (Technology-Organization-Environment) framework. The model consists of three independent variables (competition intensity, top management support, and information system maturity), one mediating variable (collaboration), one moderating variable (government support), and a dependent variable (system success). The systems success measures have been developed to reflect the operational benefits of the SCM systems; improvement in planning and analysis capabilities, faster throughput, cost reduction, task integration, and improved product and customer service. The model has been validated using the survey data collected from 122 vendors participating in the SCM systems in Korea. To test for mediation, one should estimate the hierarchical regression analysis on the collaboration. And moderating effect analysis should estimate the moderated multiple regression, examines the effect of the government support. The result shows that information system maturity and top management support are the most important determinants of SCM system success. Supply chain technologies that standardize data formats and enhance information sharing may be adopted by supply chain leader organization because of the influence of focal company in the private industrial networks in order to streamline transactions and improve inter-organization communication. Specially, the need to develop and sustain an information system maturity will provide the focus and purpose to successfully overcome information system obstacles and resistance to innovation diffusion within the supply chain network organization. The support of top management will help focus efforts toward the realization of inter-organizational benefits and lend credibility to functional managers responsible for its implementation. The active involvement, vision, and direction of high level executives provide the impetus needed to sustain the implementation of SCM. The quality of collaboration relationships also is positively related to outcome variable. Collaboration variable is found to have a mediation effect between on influencing factors and implementation success. Higher levels of inter-organizational collaboration behaviors such as shared planning and flexibility in coordinating activities were found to be strongly linked to the vendors trust in the supply chain network. Government support moderates the effect of the IS maturity, competitive intensity, top management support on collaboration and implementation success of SCM. In general, the vendor companies face substantially greater risks in SCM implementation than the larger companies do because of severe constraints on financial and human resources and limited education on SCM systems. Besides resources, Vendors generally lack computer experience and do not have sufficient internal SCM expertise. For these reasons, government supports may establish requirements for firms doing business with the government or provide incentives to adopt, implementation SCM or practices. Government support provides significant improvements in implementation success of SCM when IS maturity, competitive intensity, top management support and collaboration are low. The environmental characteristic of competition intensity has no direct effect on vendor perspective of SCM system success. But, vendors facing above average competition intensity will have a greater need for changing technology. This suggests that companies trying to implement SCM systems should set up compatible supply chain networks and a high-quality collaboration relationship for implementation and performance.

기업사회책임활동적인지인지동기류형대고객충성도적영향(企业社会责任活动的认知认知动机类型对顾客忠诚度的影响) (The Effects of the Perceived Motivation Type toward Corporate Social Responsibility Activities on Customer Loyalty)

  • Kim, Kyung-Jin;Park, Jong-Chul
    • 마케팅과학연구
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    • 제19권3호
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    • pp.5-16
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    • 2009
  • 企业社会责任活动已被认为是提高企业形象和企业竞争力的一个潜在因素. 然而, 先前大部分关于企业社会责任活动的研究是主要针对的是这些活动如何影响影响对产品, 企业以及企业形象的评价的评价. 另外, 一些学者将消费者对企业动机的感知作为企业社会责任和消费者反应之间直接关系中的调解变量. 然而, 动机理论和相关的研究存在一些缺点. 对消费者, 企业社会责任活动只有两个动机, 但最近, Vlachos等人(2008) 认为这些动机应该细分. 因此, 它有可能从原有理论发展为修正理论模型(说服, 个人知识管理(PKM). Vlachos等人(2008) 将企业社会责任动机细分为四种类型, 并尝试发现这些动机在影响顾客种程度方面的作用以及不同. 以前的研究已经证明具有积极动机会对的社会责任活动会有积极的影响. 但并没有实证地解释其心理原因. 因此本研究的目的是双重的. 第一, 本研究试图发现顾客为什么会在他们感受到企业社会活动的积极动机的情况下表达他们的感激. 第二, 本研究试图测试当社会从企业社会责任活动中获得利益时与消费者的回报的效果. 以下是本研究的假设: H1: 企业社会责任活动的价值驱使的动机积极影响认知的对等对于互惠的期待. H2: 企业社会责任活动的参股者驱使的动机消极影响于互惠的期待认知的对等. H3: 企业社会责任活动的利己驱使的动机消极影响于互惠的期待认知的对等. H4: 企业社会责任活动的战略驱使的动机消极影响对于互惠的期待认知的对等. H5: 对企业社会责任活动的互惠的期待认知的对等积极影响消费者忠诚度. 我们选择了一个公司作为研究对象来理解企业社会责任活动的动机是如何影响消费者于互惠的期待认知的对等和顾客忠诚度. 总样本为100名受访者被选为试验测试. 此外, 为了获得一致的回复, 我们保证所有的受访者都超过20岁. 本调查中. 在排除了28份无效问卷以后, 总受访者是172名(82名男性, 90名女性). 基于截至标准, 数据和模型的适配度良好. 在观察结果以后, 企业社会责任活动的价值驱使的动机对于互惠的期待认知的对等有积极的影响(t=6.75, p<.001),假设1被证明. Morales (2005) 也指出消费者的确感激企业对社会所做出的努力以及对社会所给予的利益. 而且企业社会责任活动的参股者驱使的动机对于互惠的期待认知的对等没有影响(t = ‐.049, p > .05). 因此, 假设2被拒绝. 我们可以用符合论来解释这个结果. 利己驱使动机(t = ‐3.11, p < .05)和战略驱使的动机(t = ‐4.65, p < .05) 对认知的对等有消极影响. 因此H3和H4被证明. 而且认知的对等积极影响消费者的忠诚度(t = 4.24, p < .05),H5被证明. 从结果中看, 与大众群体相比,大学生更容易受利己驱动动机的影响. 以下是本研究的结论:首先, 数据分析结果显示价值驱使的动机积极影响于互惠的期待认知的对等. 但是参股者驱动的动机对互惠的期待认知的对等没有显著影响. 另外, 利己驱使的动机和战略驱使的动机消极影响互惠的期待认知的对等. 第二, 当企业社会责任活动与消费者的回报关联时, 社会责任活动积极影响顾客忠诚度. 本研究测试了动机的种类是否影响消费者对企业社会责任的反应, 尤其是企业社会责任如何能影响关键的内在因素(认知的对等) 和消费者行为的结果(顾客忠诚度). 而且, 本研究阐述了认知对等在企业社会责任动机和顾客忠诚度的关系中起到媒介的作用. 我们的研究扩展了有关消费者企业社会责任动机方面的研究, 将他们定位为消费者反应的一个直接指标. 另外一个贡献是, 我们成功地鉴定了认知的对等作为一个次级过程在归因于顾客忠诚度的企业社会责任的影响中的中介作用. 今后在研究企业社会责任的最终行为和财务影响时应该考虑源于互惠的期待认知对等的影响. 本研究的结果具有重要的管理意义. 第一, 本研究发现的对等的中心作用表明经理人应该经常考虑这些行为将创造出多少的互惠的期待认知对等. 第二, 理解消费者对企业社会责任的动机, 的认知是如何与互惠的期待认知对等和顾客忠诚度相关, 可以帮助经理人通过营销活动和管理企业社会责任‐感应归因过程来监控和提高这些消费者的结果. 本研究的结果将帮助企业去理解影响互惠的期待认知对等的四个不同的动机的相对重要性.

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천식 환아와 보호자를 대상으로 한 집중 교육 프로그램의 효과 (Effects of an intensive asthma education program on asthmatic children and their caregivers)

  • 서강진;김건하;유병근;여윤구;김종훈;심으뜸;윤미리;유영;정지태
    • Clinical and Experimental Pediatrics
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    • 제51권2호
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    • pp.188-203
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    • 2008
  • 목 적 : 천식은 만성적인 질환으로 일상생활에서 적절한 치료와 관리를 수행하는 것이 매우 중요하며 이를 위해서는 천식 환아와 보호자 모두의 노력이 필요하다. 이에 천식 환아와 보호자를 대상으로 천식 교육 프로그램을 실시하여 그 효과를 평가해 보고자 하였다. 방 법 : 고려대학교 안암병원 소아 알레르기 클리닉에서 천식으로 진단 받은 환아들 중 천식 집중 교육 프로그램에 참가한 15가족을 교육 참가군으로 선정하였고, 교육 프로그램에 참가하지 않은 천식 환아 15가족을 대조군으로 하였다. 교육 참가군은 프로그램 시작 직전과 3개월 후, 대조군은 같은 기간에 3개월의 간격을 두고 각각 2회씩 설문조사를 시행하여 천식 환아와 보호자의 천식관리 이행 정도와 천식 인식도, 천식 환아의 자기 효능감 및 삶의 질의 변화를 측정하였다. 결 과 : 교육 참가군에서 교육 프로그램 참가 후 천식 환아의 자가관리 이행 정도(교육 전; 27.1점 vs. 교육 후; 32.2점, P=0.011), 천식 인식도(14.2점 vs. 17.9점, P<0.001), 자기 효능감 평가 항목(42.2점 vs. 45.0점, P=0.091) 중 문제 해결 능력(12.5점 vs. 14.2점, P=0.012), 삶의 질(79.6점 vs. 88.6점, P<0.001)에서 통계적으로 유의하게 점수가 높아졌으며 보호자의 천식관리 이행 정도(39.9점 vs. 42.1점, P=0.199)와 천식 인식도(15.8점 vs. 16.9점, P=0.178)는 약간 높아졌으나 통계적으로 유의한 변화를 보이지 않았다. 대조군에서는 천식 환아의 천식 인식도 중 천식의 급성 증상과 만성질환으로서의 천식에 대한 이해(4.1점 vs. 5.2점, P=0.025)와 삶의 질 중 정서적 활동(77.7점 vs. 84.3점, P=0.023)에 대한 영역에서 유의하게 점수가 증가하였으나 다른 항목에서는 유의한 차이가 없었으며 보호자의 천식관리 이행 정도와 천식 인식도에서는 변화가 없었다. 결 론 : 천식 집중 교육 프로그램을 통하여 천식 환아들의 삶의 질, 자가 관리 이행 정도, 자기 효능감, 천식 인식도 등을 향상 시킬 수 있었으며, 이러한 프로그램을 더욱 많이 개발하고 시행하여 천식 환아들의 천식 관리가 잘 이루어 질 수 있도록 해야 할 것이다.

개인의 업무 네트워크 특성에 따른 동시적 CMC의 영향 : 매체 동시성 이론 관점 (The Effect of Synchronous CMC Technology by Task Network: A Perspective of Media Synchronicity Theory)

  • 김민수;박철우;양희동
    • Asia pacific journal of information systems
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    • 제18권3호
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    • pp.21-43
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    • 2008
  • The task network which is formed of different individuals can be recognized as a social network. Therefore, the way to communicate with people inside or outside the network has considerable influence on their outcome. Moreover, the position on which a member stands in a network shows the different effects of the information systems supporting communication with others. In this paper, it is to be studied how personal CMC (computer-mediated communication) tools affect the mission that those who work for a network perform through diverse task networks. Especially, we focused on synchronicity of CMC. On this score, the perspective of Media Synchronicity Theory was taken that had been suggested by criticizing Media Richness Theory. It is the objective, from this perspective, to find which characteristics of networks make the value of IT supporting synchronicity high. In the research trends of social networks, there have been two traditional perspectives to explain the effect of network: embeddedness and diversity ones. These differ from the aspect which type of social network can provide much more economic benefits. As similar studies have been reported by various researchers, these are also divided into the bonding and bridging views which are based on internal and external tie, respectively, Size, density, and centrality were measured as the characteristics of personal task networks. Size means the level of relationship between members. It is the total number of other colleagues who work with a specific member for a certain project. It means, the larger the size of task network, the more the number of coworkers who interact each other through the job. Density is the ratio of the number of relationships arranged actually to the total number of available ones. In an ego-centered network, it is defined as the ratio of the number of relationship made really to the total number of possible ones between members who are actually involved each other. The higher the level of density, the larger the number of projects on which the members collaborate. Centrality means that his/her position is on the exact center of whole network. There are several methods to measure it. In this research, betweenness centrality was adopted among them. It is measured by the position on which one member stands between others in a network. The determinant to raise its level is the shortest geodesic that represents the shortest distance between members. Centrality also indicates the level of role as a broker among others. To verify the hypotheses, we interviewed and surveyed a group of employees of a nationwide financial organization in which a groupware system is used. They were questioned about two CMC applications: MSN with a higher level of synchronicity and email with a lower one. As a result, the larger the size of his/her own task network, the smaller its density and the higher the level of his/her centrality, the higher the level of the effect using the task network with CMC tools. Above all, this positive effect is verified to be much more produced while using CMC applications with higher-level synchronicity. Among the a variety of situations under which the use of CMC gives more benefits, this research is considered as one of rare cases regarding the characteristics of task network as moderators by focusing ITs for the operation of his/her own task network. It is another contribution of this research to prove empirically that the values of information system depend on the social, or comparative, characteristic of time. Though the same amount of time is shared, the social characteristics of users change its value. In addition, it is significant to examine empirically that the ITs with higher-level synchronicity have the positive effect on productivity. Many businesses are worried about the negative effect of synchronous ITs, for their employees are likely to use them for personal social activities. However. this research can help to dismiss the concern against CMC tools.

모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구 (A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System)

  • 이광옥
    • 대한간호학회지
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    • 제13권1호
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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만성 기침에서 스테로이드 흡입제의 역할 (The Role of Inhaled Corticosteroid in the Management of Chronic Cough)

  • 이경훈;장승훈;이정화;엄광석;반준우;김동규;신태림;박상면;이명구;김철홍;현인규;정기석
    • Tuberculosis and Respiratory Diseases
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    • 제60권2호
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    • pp.221-227
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    • 2006
  • 연구배경 : 만성 기침은 정밀 검사를 추가하여도 진단율을 향상시키는데 한계가 있고, 확진은 특이적 치료에 반응할 때에만 가능하다. 스테로이드는 비특이적 항염증 작용을 가지므로 만성 기침에 효과적일 수 있다. 본 연구에서는 원인 진단에 대한 진료 한계를 극복하기 위한 방법으로서, 만성 기침에 대한 흡입 스테로이드의 반응률을 알아보기 위하여 시행되었다. 방 법 : 3주 이상의 만성 기침 환자를 대상으로 처음 내원하였을 때 객담 호산구, 메타콜린 기관지 유발검사, 부비동 방사선촬영 등의 기본적인 객관적 검사를 시행하고, 동시에 budesonide turbuhaler $800{\mu}g/day$를 10일간 투여하고 추적 방문토록 하였다. 추적 방문일에 환자 증상의 개선도에 따라 흡입 스테로이드 반응군과 불응군으로 분류하였고 검사의 진단 성적을 조사하였으며, 각 진단에 따른 스테로이드 반응률을 알아보았다. 결 과 : 총 69명의 만성 기침 환자가 최종 분석되었고, 흡입 스테로이드의 투여로 증상의 호전이 있었던 경우는 79.7%였다. 진단된 질환에 따른 흡입 스테로이드의 반응률은 차이가 없었다. 투여 기간 동안 부작용은 거의 관찰되지 않아서 우수한 내약성을 보였다. 결 론 : 만성 기침 환자를 진료할 때 기본 검사를 시행하는 동시에 흡입 스테로이드를 단기간 투여하는 것은 매우 안전하며, 검사의 진단적 한계를 극복하고 초기에 진료 지침을 세우는 방법이 될 수 있다.

기술적(技術的) 효율성(效率性)의 결정요인(決定要因)과 동태적(動態的) 변화(變化) (Technical Efficiency in Korea: Interindustry Determinants and Dynamic Stability)

  • 유승민
    • KDI Journal of Economic Policy
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    • 제12권4호
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    • pp.21-46
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    • 1990
  • 본 논문은 유승민(劉承旻) 이인찬(李仁燦)(1990)이 추정한 우리나라 제조업(製造業)의 기술적(技術的) 효율성(效率性)을 토대로 기술적(技術的) 효율성(效率性)의 산업적(産業的) 격차(隔差)를 설명하는 경험적 증거를 구하고 효율성 추정치의 동태적(動態的) 안정성(安定性)을 분석하였다. 분석결과 산업(産業)의 생산규모(生産規模)가 클수록, 생산특화도(生産特化度)가 높을수록, 자본(資本)-노동비율(勞動比率)의 이질성(異質性)이 낮을수록 높은 기술적(技術的) 효율성(效率性)을 나타내었다. 이러한 결과는 미국(美國) 일본(日本)의 경우에 대한 연구결과와 공통되는 것으로서 기술적(技術的) 효율성(效率性)과 산업조직특성간(産業組織特性間)의 관계가 경제규모나 발전단계의 차이에도 불구하고 가설(假說)의 일반성(一般性)을 지지한다는 점에서 중요한 의미를 지닌다. 기업집중률(企業集中率) 또한 기술적 효율성에 대하여 선형(線型)보다는 이차형(二次型)의 관계를 가지고 있으나 우리나라의 경우 기술적 효율성이 극대화되는 집중률(集中率)은 매우 높은 것으로 나타났다. 또한 본 논문은 효율성(效率性) 척도간(尺度間)의 선택문제에 대한 경험적 기준을 제시하였는데 부가가치액기준(附加價値額基準)보다는 생산액기준(生産額基準)으로 추정된 기술적(技術的) 효율성(效率性)이 제가설(諸假說)들과 잘 부합되는 결과를 나타내었다. 효율성의 동태적(動態的) 안정성(安定性)에 관한 시론적(試論的) 분석(分析)에 의하면 시간변화에 따른 효율성 추청치의 안정성은 효율성 척도간에 다소의 차이는 있으나 기대한 만큼 높지 않았다. 따라서 기술적 효율성의 동태적(動態的) 불안전요인(不安全要因)에 관한 설명은 연구과제로 남는다.

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국내 매스미디어 기업의 사업다각화와 경영성과에 관한 연구 (A Study on Business Diversification and Business Performance of Korean Mass Media Enterprises)

  • 장윤희
    • 한국언론정보학보
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    • 제43권
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    • pp.173-208
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    • 2008
  • 본 연구는 2003년부터 2006년까지의 국내 전통미디어 기업집단들의 사업다각화 현황에 따른 기업성과에 대하여 실증 분석하였다. 분석결과는 다음과 같다. 첫째, 미디어 기업집단중, 신문사는 생존을 위해 다양한 영역으로부터 수익창출을 하려는 경향으로, 비관련 다각화의 비중이 높은 반면, 방송사는 고유의 사업영역인 콘텐츠의 제작과 공급을 중심으로 한관련 다각화의 비중이 높다. 둘째, 국내 미디어 기업들의 주력업종 매출비중은 해가 갈수록 감소되고 있어 다각화에 자원과 노력을 투입하고 있는 것으로 사료된다. 셋째, 조사 대상미디어 기업집단의 사업다각화 수준을 3개의 그룹으로 분류해본 결과, 다각화 수준이 가장높은 그룹에서 ROE가 가장 높았으며, ROE 변동성은 낮고, 위험대비 수익성 또한 높게 나타나 다각화를 적극적으로 진행하는 것이 안정적인 경영성과를 성취할 수 있었다. 넷째, 조사대상 미디어 기업들을 군집분석하고 몇 개의 조직속성 변수들과의 관계성을 살펴본 결과, 매출액 규모, 부채비율, 조직년수, 대주주 지분율에서 중간수준을 유지하고 ROE가 높은 군집에서 다각화 수준이 높았다. 다각화 수준과 조직속성 변수들로 인과분석을 해본결과, 미디어 기업집단의 다각화 수준에 영향을 미치는 조직속성으로는 매출액 규모가정의 방향으로, 대주주 지분율이 부의 방향으로 나타났다. 마지막으로 다각화 수준은 경영성과에 대해 정의 방향으로 의미 있게 영향을 미치는 것으로 파악되었다. 본 연구는 미디어 기업을 대상으로 하여 탐색적으로 수행되었는데, 지금까지 국내 미디어 기업의 경영성과에 대한 주제는 활발히 다루어지지 못했기 때문이다. 이에 선행연구가 부족하여 이론적 바탕에 기초하여 연구모델 및 가설을 수립하고 실증분석하는 연구방법을 선택하기보다는 조사대상 기업 경영지원 담당자들과의 수차례 인터뷰와 패널토론을 통하여 실무적인 관점의 주요 관심대상이 되는 경영지표들을 선정하고, 사업다각화와 경영성과 간의 관계를 각종 통계분석방법들을 이용하여 다각도로 조명하는 분석방법을 선택하였다. 본 연구는 수집된 자료가 최근 4개년에 한정되어 있고, 다각화와 경영성과 값 간의 시차를 두지 못한 한계를 가지고 있으므로 향후 연구에서는 미디어 기업의 특성을 보다 반영하여 미디어 기업 유형을 분류하거나, 다각화와 그에 따른 경영성과들 간의 시차도 반영한 연구들로 발전시켜야 한다.

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감각통합기능장애를 가진 청소년의 작업수행에 초점을 맞춘 작업치료 사례 (Occupation-based Occupational Therapy for an Youth With Sensory Integrative Dysfunction - A Single Case Study)

  • 지석연;이경민;김미선
    • 대한감각통합치료학회지
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    • 제6권1호
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    • pp.47-62
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    • 2008
  • 서론: 감각통합은 작업치료의 치료적 중재 근거이론(frames of reference)들에서 가장 중요하고 널리 사용되는 것 중 하나이다. 이는 작업치료사인 Jean Ayres가 클라이언트의 적응행동을 향상하기 위한 목적을 두고 발전된 이론이며, 시작된 이래로 많은 작업치료사들이 같은 목표를 가지고 적용해 왔기 때문이다. 감각통합이론을 적용하는 작업치료사로써, 임상에서 감각통합과 그 목표가 되는 적응행동인 작업수행을 치료의 결과로써 증명해 내는 것은 작업치료의 목표가 작업수행의 향상을 전제로 하는 것이기에 매우 중요하며 도전이 되는 것이다. 본론: 본 연구는 작업치료중재과정모델인 OTIPM(Occupational Therapy Intervention Process Model)이라고 하는 하향식(Top-down) 접근의 중재모델을 감각통합의 기능장애를 가지면서 일상의 작업수행에 어려움을 보이는 16세의 청소년에게 적용하여, 감각통합이론의 적용이 작업수행향상에 어떠한 의미를 가지는지 살펴보고자 하였다. 결론: 본 연구에서 적용한 OTIPM의 적용 사례를 통해, 감각통합적인 접근은 클라이언트가 일상에서 수행하기 어려웠던 작업수행에 대한 원인을 추론하는 데 유용하였다. 본 연구의 사례에서 감각통합적인 관점과 접근은 작업수행(Top)에 영향을 주는 기본적인 요소적 문제(Bottom)를 연결하는 첫단계의 중재로써 큰 의미를 가졌고, OTIPM의 적용과정은 클라이언트에게 의미 있는 작업수행을 발견하고 이에 초점을 두어 가장 우선되는 중재를 단계적으로 전개하여, 감각통합치료 이후 실제 작업수행에 초점을 둔 접근을 전개하는 데 유용하였다.

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