• Title/Summary/Keyword: quality improvement measures

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Analysis and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Compost (음식물쓰레기 퇴비화시설의 설치 및 운영 현황분석 및 개선방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.95-111
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    • 2004
  • This research sought to determine the status of the installation and operation of composting facilities of domestic public resource-making facilities and come up with corresponding improvement measures. The composting facilities were the most extensively installed of related facilities with over a 0.5 ton treated volume per day. The monthly and yearly carry-in volume of food waste were found to stand at 1,101.7 tons per day and 930.9 tons per day, thus falling short of the average planned volume of 1,270.9 tons. Many composting facilities, which were installed in areas for which factory registration were not approved, did not get approvals. Composting facilities underwent operation stoppage mainly due to faulty fermentation and crushing equipment. Mainly metals contained in food waste caused faults to the crushing equipment, thus requiring a facility designing against faults and corrosion. The initial water content was found to stand at 50-60%, thus complying with the requirement. However, since the composting food waste had an appropriate mixture of sawdust, food waste, and returned compost, it should meet the initial conditions. For fermentation facilities, the duration time for fermentation was 15 days, and post-fermentation tanks required 21 days of duration time, thus establishing the minimum criteria. However, some facilities did not meet the requirements, taking more time in decomposition, thus suggesting a need to determine the duration time according to facilities. In composting food waste, microorganism-based thermal oxidizer-operated fermentation tanks should be used to ensure an economic operation. On the contrary, 14 out of 25 survey targets heated fermentation tanks in any form. These thermal facilities contain the growth of bacteria, lowering chemical reaction in composting; thus composting facilities should be basically designed to use microorganism-based thermal oxidizers in drying water. An average daily volume of food waste and supplementary materials that was injected in producing compost was 22.8 tons. This volume produced 7.3 tons of compost per day, decreasing 68%. Properties of produced compost were analyzed by its color, absence or presence of remaining decomposition heat, and smell, to assess the quality. As a result, the composting process was not properly installed nor operated in about 50% of composting facilities. Compost should be produced to be soil-friendly.

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A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement (한방건강보험 약제 투약 실태 및 활성화 방안 연구)

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

A Function and Weight Selection of Ecosystem Service Function for the Eco-friendly Protected Horticulture Complex in Agricultural Landscape (시설원예단지의 친환경적 조성을 위한 생태계서비스 기능 및 가중치 산정)

  • SON, Jinkwan;KONG, Minjae;SHIN, Yukung;YUN, Sungwook;KANG, Donghyeon;Park, Minjung;LEE, Siyoung
    • Journal of Wetlands Research
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    • v.19 no.4
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    • pp.533-541
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    • 2017
  • Agricultural landscape has many ecosystem service functions. However, the development of the horticulture complex has no consideration for environmental conservation. Therefore, we analyzed the priorities of ecosystem service functions required for the composition. The study was conducted in three stages. As a result of the first survey, 17 functions were selected to be improved. In the second survey, 12 functions were selected excluding 5 functions. Finally, 1. Measures for water purification, 2. Groundwater recharge plan, 3. Surface water storage space, 4. Flood control measures, 5. Vegetation diversity space, 6. Carbon emission reduction plan, 7. Aquatic insect habitat space, 8. Amphibian reptiles 9. Landscape and Waste Management, 10. Bird Species Space, 11. Heat Island Mitigation Plan, 12. Experience / Ecological Education Plan. We proposed the structure, capacity, flow rate, arrangement and form of the water treatment facility to improve water quality by improving the function. We proposed a reservoir space of 7-10% for groundwater recharge. The development of reservoir and storage facilities suitable for the Korean situation is suggested for the surface water storage and flood control measures. And proposed to secure a green space for the climate cycle. Proposed habitat and nutrient discharge management for biodiversity. We propose green area development and wetland development to improve the landscape, and put into the facilities for experiential education. The results of the research can be utilized for the development and improvement of the horticultural complex.

A Sustainable Operation Plan for School Gardens - Based on a Survey of Elementary School Gardens in Seoul (학교 텃밭의 지속적인 운영방안에 관한 연구 - 서울특별시 초등학교의 학교 텃밭 실태조사를 바탕으로 -)

  • Choi, I-Jin;Lee, Jae Jung;Cho, Sang Tae;Jang, Yoon Ah;Heo, Joo Nyung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.4
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    • pp.36-48
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    • 2018
  • This study surveyed 599 elementary schools in Seoul to provide measures for the quantitative expansion and sustainable operation of environmentally-friendly school garden. Of all schools, 161 schools had formed and were operating school gardens. The total area of school gardens was $166,901m^2$ and the mean area was $131.2m^2$ in elementary, junior high and high schools in Seoul. Meanwhile, the total area of school gardens was $65,493m^2$ and the mean area was $363m^2$ in 161 schools that participated in the survey, indicating $1.15m^2$ per student. Of these schools, 11.8% were operating gardens themselves, while 50.3% were operating gardens that had been newly renovated or environmentally improved by institutional support projects after initially managing gardens themselves. According to the locations of school gardens, mixed-type gardening (a combination of school gardening and container vegetable gardening) accounted for 34.8%, followed by school gardening at 32.9%, container vegetable gardening at 29.2%, and suburb community gardening at 3.1%. Those in charge of garden operations were teachers at 51.6%, comprising the largest percentage. Facilities built when forming the garden included storage facilities for small-scale greenhouses and farming equipment at 26.1%, accounting for the largest percentage. No additional facilities constructed accounted for 21.7%. The greatest difficulty in operating gardens was garden management at 34.2%. The most needed elements for the sustainable operation of gardens were improvement in physical environment and the need for hiring a paid garden, each accounting for 32%. The most important purpose for school gardening was creating educational environments (81.6%). The major source for gaining information on garden management was consultation from acquaintances (67.8%). Schools that utilize plant waste from gardens as natural fertilizers accounted for 45.8% of all schools. Responses to the impact of operating school gardens for educational purpose were positive in all schools as 'very effective' in 63.2% and 'effective' in 36.8%. This study was meaningful in that it intended to identify the current status of the operation of school gardens in elementary schools in Seoul, support the formation of school gardens appropriate for each school with sustainable operation measures, implement a high-quality education program, develop teaching materials, expand job training opportunities for teachers in charge, devise measures to support specialized instructors, and propose the need for a garden management organization.

Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

Valuation of the Water Pollution Reduction: An Application of the Imaginary Emission Market Concept (수질오염물질 감소의 편익 추정 -수질총량제하 가상배출권시장 개념의 적용-)

  • Han, Tak-Whan;Lee, Hyo Chang
    • Environmental and Resource Economics Review
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    • v.23 no.4
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    • pp.719-746
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    • 2014
  • This study attempts to estimate the value of the water quality improvement by deriving the equilibrium price of the water pollutant emission permit for the imaginary water pollutant emission trading market. It is reasonable to say that there is already an implicit social agreement for the unit value of water pollutant, when the government set the Total Water Pollutant Loading System for the major river basin as a part of the Comprehensive Measures for Water Management, particularly for the Nakdong River Basin. Therefore, we can derive the unit value of water pollutant emission, which is already implied in the pollution allowance for each city or county by the Total Water Pollutant Loading System. Once estimated, it will be useful to the economic assessment of the water quality related projects. An imaginary water pollutant emission trading system for the Nakdong River Basin, where Total Water Pollutant Loading System is already effective, is constructed for the estimation of the equilibrium price of water pollutant permit. By estimating marginal abatement cost curve or each city or county, we can compute the equilibrium price of the permit and then it is regarded as the economic value of the water pollutant. The marginal net benefit function results from the relationship between the emission and the benefit, and then the equilibrium price of permit comes from constructing the excess demand function of the permit by using the total allowable permit of the local government entity. The equilibrium price of the permit would be estimated to be $1,409.3won/kg{\cdot}BOD$. This is within reasonable boundary compared for the permit price compared to foreign example. This permit price would be applied to calculate for the economic value of the water quality pollutants, and also be expected to use directly for the B/C analysis of the business involved with water quality change.

Comparative Analysis of the Use of Leisure Resources and Leisure Activity According to the Execution of Forty-hour-a-week Working System: Based on 2012 Survey on National Leisure Activity (근로자의 주 40시간 근무제 시행 유무에 따른 여가자원 이용 및 여가활동 비교분석: 2012년 국민여가활동 조사 결과를 기초로)

  • Bark, Min-Jeng;Yoon, So-Young
    • Journal of Family Resource Management and Policy Review
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    • v.17 no.4
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    • pp.19-37
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    • 2013
  • From the perspective of labor welfare, forty-hour-a-week working system:(FWS) has been an important goal throughout world, and in fact, advanced countries implemented this a long time ago. However, there are differences in opinions concerning FWS; some people emphasizes the improvement in life quality, while others point out that this measure increases the cost of wages and has limited effectiveness. Thus, discussions about the success of FWS have emerged from diverse perspectives; One thing that should be made clear before debating FWS is that reducing laborers' working hours is already a global trend, and Korea, also intends to extend it. Therefore, in order to maximize the benefits resulting from the execution of the system and to identify measures that can be used to solve the problems related to FWS, it is necessary to consider actual laborers' use of leisure resources and whether they have increased or decreased as a result of FWS. It is also necessary to look at the differences in workers' leisure activity with and without the system. To evaluate and diagnose FWS's political effect from the perspective of laborers' leisure satisfaction and improvements in life quality, this study examines differences in leisure expenses, leisure hours, use of and demand for leisure resources such as leisure space, and types of leisure activity, according to the execution of FWS, This research is based on the "2012 Survey on National Leisure Activity" conducted by the Ministry of Culture, Sports and Tourism. In addition, through analysis of the differences in leisure satisfaction and happiness levels, the study intends to confirm the necessity of executing FWS and ensuring that the system is in use. The study results can be briefly summed up as followa:: First, regarding the general findings of the study, a significant result was shown in terms of the execution of FWS according to income level. The finding that the execution of FWS works differently according to the working environment or life quality reassures us of the common notion in society that working environment or life quality may differ in relation to social characteristics. The utility of weekday leisure hours did not indicate a statistically significant difference, but in terms of weekend leisure hours, laborers practicing FWS had an additional 30 minutes of leisure time than those who did not. Furthermore, regarding leisure expenses, laborers practicing FWS indicated more monthly average leisure expenses or expected leisure expenses. In relation to leisure activity, those working at a company executing FWS engaged in culture and art activities more frequently than those working at the companies that did not. On the other hand, those working at companies without FWS indicated more hobbies, amusement activities, rest, and other activities than those working at the companies with FWS. In terms of vacation experience, those working at companies with FWS had more vacation time than those working at companies without it; on average, they had longer vacations by 1.64 days. Regarding their leisure life satisfaction and happiness level, those working at companies with FWS indicated higher satisfaction and greater happiness than those working at companies without it. The findings mentioned above represent the preliminary results of this paper, and the remainder of the research will provide more detailed analysis results and suggestions corresponding to them.

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Calculation of Human Resources for Medical Technologist in Diagnostic Testing (진단검사분야의 임상병리사 인력산정에 관한 연구)

  • Yang, Byoung Seon;Lim, Yong;Kim, Yoon Sik;Oh, Yeon Suk;Bae, Do Hee;Choi, Se Mook
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.2
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    • pp.158-163
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    • 2020
  • This study examines and presents reasonable improvement measures for the operation and revision of the relative value scoring system, and the basis for performance of a medical technologist. Seven hospitals were enrolled in the study, and included 5 resident laboratory medicine specialists and 53 medical technologists, giving a ratio of 10.6 technologists per laboratory medicine specialist. The average of professional manpower scores was 18, and the average of each medical institution's total score was 78. Ratings and additional rates were in the range 2~3%, and quality-added ratios were 2~3%, with no significance. Excluding pathological testing and assessing physiological functions, the average number of diagnostic tests for health insurance claims were 9,618,062, including 4,378,146 points for 5% of the total relative value scores. According to the DEA, the appropriate number of medical technologist is one person per 49,974 points of relative value. In conclusion, our study results indicate that it would be desirable to set the appropriate workforce for medical technologist to one person per 50,000 points of relative value. Our data could be used as a basis for enhancing productivity of the workforce and balancing health care resources.

Effects of Mindfulness Based Stress Reduction Program on Depression, Anxiety and Stress in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Joo, Hye-Myung;Lee, Sung-Jae;Chung, Yong-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.345-351
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    • 2010
  • Objective : In this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed. Methods : The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment. Results : The BDI value was decreased from 18.5 ${\pm}$ 10.9 to 9.5 ${\pm}$ 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 ${\pm}$ 13.9 to 42.3 ${\pm}$ 15.2; the trait anxiety was reduced from 50.9 ${\pm}$ 12.3 to 41.3 ${\pm}$ 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween. Conclusion : The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.

A Monitoring and Evaluation on the Project for Utilization of Cultural Property - Focused on the Project "Living and Breathing Hyanggyo·Seowon" in 2016 - (문화재 활용 사업 모니터링 및 평가 - 2016년 살아 숨 쉬는 향교·서원 만들기 사업을 중심으로 -)

  • Park, Dong-Seok
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.35 no.3
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    • pp.94-104
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    • 2017
  • This study carried out field evaluation by experts, monitoring by the public, and visitor satisfaction survey for 77 cases of utilization of cultural property projects that received support from "Living and Breathing Hyanggyo and Seowon" in 2016. The result was 'normal' for the comprehensive evaluation, and by section, 'good' for planning, operating, performance, outcome and annual special index. The field evaluation by experts was rated as 'good', monitoring by the public was 'good', and also 'good' for visitor satisfaction survey. The advantages of the project were as follows; increased chance for enjoyment of local cultural heritage, expansion of human network for utilization of local cultural heritage, utilization of cultural heritage as community place, diversification of educational contents by using cultural heritage. On the other hand, the disadvantages were as follows; decline of program's quality, shortage of putting plan in practice, insufficient interest and participation of local government, insufficient promoting, shortage of educational contents for free semester system. At last, we suggested measures to develop the project as follows; develop program by using local characteristics, develop programs for foreigner, training experts, increasing on-line promotion, develop new lecture technique, utilization of cultural heritage as a local community place, utilization planning by each space, improvement of evaluation system, tightening up reflection of visitor's opinions, consulting for each programs.