• 제목/요약/키워드: social relationships

검색결과 3,004건 처리시간 0.038초

창의적인 UCC 제작에 영향을 미치는 동기 및 보상 체계에 대한 연구: 몰입에 매개 효과를 중심으로 (An Empirical Study on Motivation Factors and Reward Structure for User's Createve Contents Generation: Focusing on the Mediating Effect of Commitment)

  • 김진우;양승화;임성택;이인성
    • Asia pacific journal of information systems
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    • 제20권1호
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    • pp.141-170
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    • 2010
  • User created content (UCC) is created and shared by common users on line. From the user's perspective, the increase of UCCs has led to an expansion of alternative means of communications, while from the business perspective UCCs have formed an environment in which an abundant amount of new contents can be produced. Despite outward quantitative growth, however, many aspects of UCCs do not meet the expectations of general users in terms of quality, and this can be observed through pirated contents and user-copied contents. The purpose of this research is to investigate effective methods for fostering production of creative user-generated content. This study proposes two core elements, namely, reward and motivation, which are believed to enhance content creativity as well as the mediating factor and users' committement, which will be effective for bridging the increasing motivation and content creativity. Based on this perspective, this research takes an in-depth look at issues related to constructing the dimensions of reward and motivation in UCC services for creative content product, which are identified in three phases. First, three dimensions of rewards have been proposed: task dimension, social dimension, and organizational dimention. The task dimension rewards are related to the inherent characteristics of a task such as writing blog articles and pasting photos. Four concrete ways of providing task-related rewards in UCC environments are suggested in this study, which include skill variety, task significance, task identity, and autonomy. The social dimensioni rewards are related to the connected relationships among users. The organizational dimension consists of monetary payoff and recognition from others. Second, the two types of motivations are suggested to be affected by the diverse rewards schemes: intrinsic motivation and extrinsic motivation. Intrinsic motivation occurs when people create new UCC contents for its' own sake, whereas extrinsic motivation occurs when people create new contents for other purposes such as fame and money. Third, commitments are suggested to work as important mediating variables between motivation and content creativity. We believe commitments are especially important in online environments because they have been found to exert stronger impacts on the Internet users than other relevant factors do. Two types of commitments are suggested in this study: emotional commitment and continuity commitment. Finally, content creativity is proposed as the final dependent variable in this study. We provide a systematic method to measure the creativity of UCC content based on the prior studies in creativity measurement. The method includes expert evaluation of blog pages posted by the Internet users. In order to test the theoretical model of our study, 133 active blog users were recruited to participate in a group discussion as well as a survey. They were asked to fill out a questionnaire on their commitment, motivation and rewards of creating UCC contents. At the same time, their creativity was measured by independent experts using Torrance Tests of Creative Thinking. Finally, two independent users visited the study participants' blog pages and evaluated their content creativity using the Creative Products Semantic Scale. All the data were compiled and analyzed through structural equation modeling. We first conducted a confirmatory factor analysis to validate the measurement model of our research. It was found that measures used in our study satisfied the requirement of reliability, convergent validity as well as discriminant validity. Given the fact that our measurement model is valid and reliable, we proceeded to conduct a structural model analysis. The results indicated that all the variables in our model had higher than necessary explanatory powers in terms of R-square values. The study results identified several important reward shemes. First of all, skill variety, task importance, task identity, and automony were all found to have significant influences on the intrinsic motivation of creating UCC contents. Also, the relationship with other users was found to have strong influences upon both intrinsic and extrinsic motivation. Finally, the opportunity to get recognition for their UCC work was found to have a significant impact on the extrinsic motivation of UCC users. However, different from our expectation, monetary compensation was found not to have a significant impact on the extrinsic motivation. It was also found that commitment was an important mediating factor in UCC environment between motivation and content creativity. A more fully mediating model was found to have the highest explanation power compared to no-mediation or partially mediated models. This paper ends with implications of the study results. First, from the theoretical perspective this study proposes and empirically validates the commitment as an important mediating factor between motivation and content creativity. This result reflects the characteristics of online environment in which the UCC creation activities occur voluntarily. Second, from the practical perspective this study proposes several concrete reward factors that are germane to the UCC environment, and their effectiveness to the content creativity is estimated. In addition to the quantitive results of relative importance of the reward factrs, this study also proposes concrete ways to provide the rewards in the UCC environment based on the FGI data that are collected after our participants finish asnwering survey questions. Finally, from the methodological perspective, this study suggests and implements a way to measure the UCC content creativity independently from the content generators' creativity, which can be used later by future research on UCC creativity. In sum, this study proposes and validates important reward features and their relations to the motivation, commitment, and the content creativity in UCC environment, which is believed to be one of the most important factors for the success of UCC and Web 2.0. As such, this study can provide significant theoretical as well as practical bases for fostering creativity in UCC contents.

관우한국생태학적일개예설(关于韩国生态学的一个预设): 기우복장탑배적행위(基于服装搭配的行为) (Typology of Korean Eco-sumers: Based on Clothing Disposal Behaviors)

  • Sung, Hee-Won;Kincade, Doris H.
    • 마케팅과학연구
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    • 제20권1호
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    • pp.59-69
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    • 2010
  • 绿色环保或者环境意识已经成为商业、政府机关, 以及消费者和世界关注的重要问题. 针对这一情况, 韩国政府宣布, 在本世纪初, "环保建设" 将被作为一种用以鼓励与环保相关的商业活动的方式. 不同层次的韩国服装业, 提出了不同的产品环保的绿色计划. 这些服装产品包括有机产品和回收的衣服. 要想使这些公司成功, 他们需要那些, 在做产品购买,使用, 处置时, 将绿色问题(如环境的可持续性发展)作为一个人判断的一个组成部分的顾客的信息. 这些消费者可以被看成是生态学的关注者. 过去的研究已经对消费者对于环保产品的购买意愿进行了检测. 此外, 还研究了影响生态保护者或绿色消费者的因素. 但是, 只是关注生态保护者在处置或者回收利用衣服上与采购绿色产品相比较是不够的. 服装处置行为有多种途径, 消费者可以用淘汰, 传承(例如: 把它送给一个年幼的弟弟), 赠与, 交换, 出售或者简单的把他扔掉等多种方式来暂时或者永久的摆脱闲置的衣服或贷款项目. 因此, 购买环保产品的行为应该结合服装处置的行为, 从而进一步了解消费者的消费行为与对环境的态度. 本项研究的目的在于提供韩国生态保护者从有利于生态学的角度出发来购买和处理衣服的生活方式的相关信息. 本研究的目标有: 1, 基于韩国对服装处置行为进行分类; 2, 调查人 们人口统计数据, 生活方式和服装消费价值观赏的差异; 3, 在环保的时尚物品的购买意愿和影响因素之间进行比较. 自填式的调查问卷是基于以往的研究设置出来的. 问卷包括10项处置衣服的条款, 22项可持续并且健康的生活方式的条款, 以及19项消费观念的条款. 根据利克特模板的五分量表设置. 此外, 购买两个时尚物品的意愿和每个物品属性的11项特征都是根据利克特模板的七分量表而来, 两种制成羊毛套衫的可以从PET识别代码的回收瓶子中创造出来的涤纶织物这两种套衫选自一个韩国和一个美国的户外运动服装的品牌. 我们对每一种产品的简介和颜色都进行了调查, 人口统计学(即性别, 年龄, 婚姻状况, 教育程度, 收入, 职业)也被包括在内. 在2009年5月份, 研究数据通过一个专业网站的调查机构进行采集, 最后有600份调查问卷可供分析, 这个调查的受访者年龄从20到49岁不等, 平均年龄为34岁. 百分之50的调查者为男性, 大约58%的受访者是已婚者, 其中62%的受访者有大学学位. 主要成分分析和因素最大方法差的方法用以识别衣服处理规模的潜在尺度. 共有三个因素生成(比如: 倒卖行为, 捐赠行为, 不回收利用行为). 基于他们处置衣服的方式对受访者进行了分类, 群类分析被使用, 最终得到了三个部分. 不同的消费者, 被分别贴上 "转售集团", "捐资团体" 以及 "不回收组织" 的标签加以分类, 其中98%是正确的分类. 从人口统计学角度来看, 这三个类别的人在性别, 婚姻状况, 职业和年龄上有显著的差异. 健康可持续的生活方式被缩减为以下5个因素: 自我满意度, 家庭定位, 健康问题, 环境问题和自愿的服务. 这是三个群体中健康可持续的生活方式的最显著的差异. 转售集团和捐赠组表现出在健康可持续的生活方式上的相同倾向, 同时, 不回收集团在生活方式方面呈现最低的平均值. 转售和捐赠团体自称享受和满意这种生活和消费方式, 并且能够利用空余的时间陪伴家人. 另外, 这两组的人关心健康和有机食品, 并试图保护能源和资源. 对服装消费的价值观产生主要影响的三个因素是: 个人价值, 社会价值和实用价值. 因素的方差测试表明转售集团和其他两组之间的因素差异最大. 转售集团相比其他价值更关注个人价值和社会价值. 相比之下, 非回收集团比捐赠集团更关注高层次的社会价值. 比较购买环保产品的意愿上, 转售集团表现出最高的购买A类产品的意愿. 另一方面, 捐赠集团则在小市场中表现出购买B类产品的最高意愿. 此外, 平均分数表明, 购买韩国的产品(B类产品)相比购买美国的产品(A类产品)更合韩国人的心意. 多元线性回归分析法确定了对环保产品的购买的意愿对制造业产品属性的影响. 产品的设计, 价格, 贡献, 对环境的保护, 价格, 兼容性是影响转售集团的显著因素, 另外, 以及对自身形象的影响是捐赠团体的重要因素. 对于非回收集团来说, 设计, 价格等因素是相同的, 自我的形象,对环保运动的贡献, 和环境保护也是很重要的. 而价格因素具有显著性的共通性. 对于B类产品来说, 设计, 合理的价格, 形象等因素是同等的重要, 但是不同的组对购买的特征和意愿有不同的倾向. 健康可持续的生活方式以及服装消费的意向对购买A类产品和B类产品的影响同样被我们所关注. 实际操作者的健康状况和个人价值都是影响购买意愿的重要因素; 然而, 在这三个群体中说服的力度都很低. 结果表明, 分类出来的每组处理服装的行为, 显示着不同服装产品的属性, 个人价值, 和实践者的特点, 这些都影响了他们的购买环保产品的意愿, 结果会使生态保护者提出并组织更合理的生态设计的战略决策.

UCC(user-created-contents) 웹 사이트에서 사용자의 인성이 감정적, 인지적 평가와 UCC 활용에 미치는 영향 (The Effect of Users' Personality on Emotional and Cognitive Evaluation in UCC Web Site Usage)

  • 문윤지;강소라;김우곤
    • Asia pacific journal of information systems
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    • 제20권3호
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    • pp.167-190
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    • 2010
  • The research conducted here focuses on the effect of factors that affect the behavior of UCC (User Created Content) website users, other than user's rational recognition of how useful a UCC website can be. Most discussions in the existing literature on information systems have focused on users' evaluation how a UCC website can help to attain the users' own goals. However, there are other factors and this research pays attention to an individual's 'personality,' which is stable and biological in nature. Specifically, I have noted here that 'extroversion' and 'neuroticism,' the two common personality factors presented in Eysenck's most representative 'EPQ Model' and 'Big Five Model,' are the two personality factors that affect a site's 'usefulness,' by this I mean how useful does the user consider the website and its content. How useful a site is considered by the user is the other factor that has been regarded as the antecedent factor that influences the adoption of information systems in the existing MIS (Management Information System) research. Secondly, as using or creating a UCC website does not guarantee the user's or the creator's extrinsic motivation, unlike when using the information system within an organization, there is a greater likelihood that the increase in user's activities in relation to a UCC website is motivated by emotional factors rather than rational factors. Thus, I have decided to include the relationship between an individual's personality and what they find pleasurable in the research model. Thirdly, when based on the S-O-R Paradigm of Mehrabian and Russell, the two cognitive factors and emotional factors are finally affected by stimulus, and thus these factors ultimately have an effect on an individual's respondent behavior. Therefore, this research has presented an assumption that the recognition of how useful the site and content is and what emotional pleasure it provides will finally affect the behavior of the UCC website users. Finally, the relationship between the recognition of how useful a site is and how pleasurable it is to useand UCC usage may differ depending on certain situational conditions. In other words, the relationship between the three factors may vary according to how much users are involved in the creation of the website content. Creation thus emerges as the keyword of UCC. I analyzed the above relationships through the moderating variable of the user's involvement in the creation of the site. The research result shows the following: When it comes to the relationship between an individual's personality and what they find pleasurable it is extroverted users who have a greater likelihood to feel pleasure when using a UCC website, as was expected in this research. This in turn leads to a more active usage of the UCC web site because a person who is an extrovert likes to spend time on activities with other people, is sensitive to new experiences and stimuli and thus actively responds to these. An extroverted person accepts new UCC activities as part of his/her social life, rather than getting away from this new UCC environment. This is represented by the term 'Foxonomy' where the users meet a variety of users from all over the world and contact new types of content created by these users. However, neuroticism creates the opposite situation to that created by extroversion. The representative symptoms of neuroticism are instability, stress, and tension. These dispositions are more closely related to stress caused by a new environment rather than this creatingcuriosity or pleasure. Thus, neurotic persons have an uneasy feeling and will eventually avoid the situation where their own or others' daily lives are frequently exposed to the open web environment, this eventually makes them have a negative attitude towards the web environment. When it comes to an individual's personality and how useful site is, the two personality factors of extroversion and neuroticism both have a positive relationship with the recognition of how useful the site and its content is. The positive, curious, and social dispositions of extroverted persons tend to make them consider the future usefulness and possibilities of a new type of information system, or website, based on their positive attitude, which has a significant influence on the recognition of how useful these UCC sites are. Neuroticism also favorably affects how useful a UCC website can be through a different mechanism from that of extroversion. As the neurotic persons tend to feel uneasy and have much doubt about a new type of information system, they actively explore its usefulness in order to relieve their uncomfortable feelings. In other words, neurotic persons seek out how useful a site can be in order to secure their own stable feelings. Meanwhile, extroverted persons explore how useful a site can be because of their positive attitude and curiosity. As a lot of MIS research has revealed that the recognition of how useful a site can be and how pleasurable it can be to use have been proven to have a significant effect on UCC activity. However, the relationship between these factors reveals different aspects based on the user's involvement in creation. This factor of creationgauges the interest of users in the creation of UCC contents. Involvement is a variable that shows the level of an individual's mental effort in creating UCC contents. When a user is highly involved in the creation process and makes an enormous effort to create UCC content (classed a part of a high-involvement group), their own pleasure and recognition of how useful the site is have a significantly higher effect on the future usage of the UCC contents, more significantly than the users who sit back and just retrieve the UCC content created by others. The cognitive and emotional response of those in the low-involvement group is unlikely to last long,even if they recognize the contents of a UCC website is pleasurable and useful to them. However, the high-involvement group tends to participate in the creation and the usage of UCC more favorably, connecting the experience with their own goals. In this respect, this research presents an answer to the question; why so many people are participating in the usage of UCC, the representative form of the Web 2.0 that has drastically involved more and more people in the creation of UCC, even if they cannot gain any monetary or social compensation. Neither information system nor a website can succeed unless it secures a certain level of user base. Moreover, it cannot be further developed when the reasons, or problems, for people's participation are not suitably explored, even if it has a certain user base. Thus, what is significant in this research is that it has studied users' respondent behavior based on an individual's innate personality, emotion, and cognitive interaction, unlike the existing research that has focused on 'compensation' to explain users' participation with the UCC website. There are also limitations in this research. Firstly, I divided an individual's personality into extroversion and neuroticism; however, there are many other personal factors such as neuro-psychiatricism, which also needs to be analyzed for its influence on UCC activities. Secondly, as a UCC website comes in many types such as multimedia, Wikis, and podcasting, these types need to be included as a sub-category of the UCC websites and their relationship with personality, emotion, cognition, and behavior also needs to be analyzed.

소비자의 제품 지각 위험에 대한 기업연상과 효과: 지식과 관여의 조절적 역활을 중심으로 (The Effect of Corporate Association on the Perceived Risk of the Product)

  • 조현철;강석후;김진용
    • 마케팅과학연구
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    • 제18권4호
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    • pp.1-32
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    • 2008
  • 기업연상(corporate association)이 제품 평가(product responses)에 어떻게 영향을 미치는 가에 대한 연구가 부진하다는 Brown and Dacin(1997)의 문제 제기가 있은 후, 기업연상이 제품 판단에 미치는 영향과 과정에 대한 조절변수와 매개변수들을 파악하려는 연구가 진행되어 왔다. 본 연구에서는 기업연상의 두가지 유형인 CA(corporate ability) 연상과 CSR(corporate social responsibility) 연상이 성능과 재무위험에 미치는 영향력과 그 영향력을 조절하는 변수들을 조사하였다. 분석 결과에 의하면, 주효과(main effects)에 있어서는, 가설에서 기대한 바와 같이 CA 연상이 성능위험과 재무위험에 유의한 영향력을 갖는 것으로 나타난 반면, CSR 연상은 성능위험과 재무위험에 대해 유의한 영향력을 갖지 않는 것으로 나타났다. 조절변수로 인한 상호작용효과와 관련해서는, CA 연상이 성능위험과 재무위험에 미치는 주효과에 대해 제품범주 지식과 관여는 각각 유의한 조절효과를 나타내었다. 하지만, CSR 연상이 성능위험과 재무위험에 미치는 주효과에 대해서는 제품범주 지식과 관여의 조절효과는 나타나지 않았다. 이러한 연구 결과를 통하여 제품의 기능적인 속성에 대한 정보가 부족한 제품에 대해 소비자가 지각하는 위험을 감소시키기 위하여, 기업은 CSR 연상보다는 CA 연상에 대해 강조할 필요가 있다는 결론을 내리게 되었다.

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지역사회개발(地域社會開發)과 기생충(寄生虫) (Community development and parasite control)

  • 임한종
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.10-21
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    • 1976
  • The traditional application of night soil to vegetable gardens and rice paddies results in a most wide spread condition of parasitism, with a variety of helminths found in Korea. In addition to the above fact, the peculiar habit of the consumption of raw vegetables, fish, crustaceans and mammals provides a means of infestations of helminths. During the last sixty years numerous reports were found on the prevalence of helminths amongst the Korean population in different parts of the country, and it was generally recognized that ascariasis, hookworm disease, filariasis, clonorchiasis and paragonimiasis constitute the important helminthic disease in Korea. In practical measures of parasite control activities the main measures are summarized as mass-treatment, night-soil disposal and transmission control. Among the three, the mass-treatment has been commonly applied, however, no reduction of transmission has been obtained by treatment of a population. Therefore, the ultimate eradication of parasites will depend upon the application of comprehensive environmental sanitation measures. The basic environmental measures will be concerned with (a) the safe disposal of human excreta, (b) the provision of adequate and safe water supplies in such a way as to promote a higher standard of personal hygiene in the population, and (c) the prevention of food contamination by faecal material. Additional environmental measures will deal with the improvement of housing and housing hygiene and with general community development. Community development means social and cultural as well as economic development. The control measures on the parasitic endemic diseases, such as clonorchiasis and paragonimiasis are the good examples for community health development in Korea. The control of Clonorchis and Paragonimus infections are theoretically very simple, as the infection can only invade the human body by way of encysted metacercaria which are taken into the body when eating passive intermediate hosts(fishes, crabs and crayfishes). Although prophylactic measures in the case of the infections deal with above merely consist the fishes in cooking or submerging in hot water before eating them, it is exceedingly difficult to carry out such simple measures in face of century old traditions, to which the relatively primitive population clings with great tenacity. There is no one universally applicable method of control. The choice of methods must be dictated by the nature of the environment. the habit and custom of the people. the pattern of transmission and the resources of the country. There must exist a well organized public health infrastructure. Since a control programme is of necessity on a longterm basis and continuity in its implementation is essential. An investigation should be made on the prevalence of the diseases and its relationships to irrigation engineering, freshwater ecology, agricultural methods, hydro-electric schemes, and the development of communities in affected areas. In conclusion, however. the control of clonorchiasis and paragonimiasis in Korea is not an impossible task. A combination of efforts with major emphasis on health education and mass chemotherapy coupled with governmental aid in enforcing legislative public health measures could reduce the diseases. Health education in particular attempts following four things: (a) It supplies a person with enough general knowledge about a disease to make the preventive measures. (b) It makes a person feel sufficiently about the importance of his own health to make him alter his behavior and adopt these preventive measure. (c) It makes him concerned for the health others. (d) It tries to make him feel so strongly about the first three that be supports and even initiates preventive action by the community. Educational efforts should be directed primarily toward school children because it is during the early years that most persons become infected, and also because children are less entrenched in their food habits so that, the educational process should be involved at various levels in successive changes of knowledge, attitude, beha viour, habit and custom of their lives. The most parasitic endemic diseases are related to community diseases. In caring for a sick community. the first stage is to gather epidemiological data, the next is to make inferences from it-to make the community diagnosis. The third is to prescribe community treatment or community health action part of a community health action programme. The community health action is the sum of the steps decided upon to remedy the critical features revealed by the community diagnosis. Action takes various forms; health education is the most important.

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치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석 (A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services)

  • 홍여신;박현애;조남옥
    • 대한간호학회지
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    • 제26권4호
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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북한 여성들의 탈북동기와 생활실태 - 중국 연변지역의 탈북 여성들을 중심으로 - (A Study on the Motive of Escape from the North Korea and the Life Situation of Female Fugitives in China - based on the Interview with North Korean Female Refugees in Yenben Province -)

  • 문숙재;김지희;이명근
    • 대한가정학회지
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    • 제38권5호
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    • pp.137-152
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    • 2000
  • North Korean fugitives is one of various nominations referring to the North Koreans who have secretly crossed the territorial border of their country. It is a new terminology that huts gained wider usage in our society as we entered the 1990s. North Koreans list various motives for escaping their county, such as food shortage and disillusionment of belief in the system. Most of the forced repatriation of North Korean escapees takes place in China. The purpose of this study examines the family knife of female fugitives from North Korea in order to provide pertinent alterntives which are needed to secure basic human right of the female fugitives and enable them to keep stability of their family lives and to adapt themselves into new socio-cultural circumstances in China. For this, the preliminary survey performed to examine the demographic characteristics on the female fugitives; to find out the incentives and channels of their escape out of North Korea; to investigate what types of family life and family relationship they manage in China; to grasp their problems and need of family life in adaptation into Chinese society. The specific questions for grasping the general characteristics of the female fugitives are composed of age, education level residential district in North Korea. In order to find out main causes and influential factors of their escape from North Korea, the following questions are included: what the most important incentives and motives are; the frequency of escape; and whether they discuss their escape with their family or not. The questions to find out their present actual life situations in China are about difficult things to adjust in China, family life, relationship with husband, and their conversational diction, the degree of their mastering the chinese language, the degree of their adaptation to chinese way of living, and so forth, which reveal to what extent they are adapted themselves to new cultural situation in China. This study collected the data through face-to-face personal interview from July to October, 1999 Yenben province along the China-North Korea border. Data from 202 female fugitives were used in final analysis. This study uses the SAS PC program for windows, Ver, 6.12 to analyze the data such as the distribution of frequency, percentage, mean and so on. The results from this analysis are follows; the most principal motive of North Korean women's escape to china is to eat to live because of famine. Concerning the year when the fugitives escape from North Korea, all of the interviewees haute escaped since 1990. After escape their continual contact with their family in North Korea, 81.7% of the respondent have not been in touch with their family. The main reasons for their not contacting with their family in North Korea are that it is not helpful although they contacts with their family. Female fugitives from North Korea have difficulties in life. They have rather stable relationship to their husband, but they have experienced difficulties in other aspects of family life. Their main difficulties are largely from their relationships to husbands'family members, and from the problems relate to their family in North Korea, and their children. Based on this study, further research has to present supportive policies that help North Korean female escapees live without being deprived and protect their human rights. And the development of practical program to help their efficient social adaptation has to be continued without stop together.

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개원의의 대도시 개원 이유 : 대구시 개원의를 중심으로 (Medical Practitioners' Reasons for Practice in Great Gity(Taegu))

  • 감신;천병렬;박재용;예민해;송달효
    • 보건행정학회지
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    • 제2권1호
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    • pp.17-41
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    • 1992
  • During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

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주의력결핍 과잉행동장애 환아 보호자의 삶의 질과 관련요인 (Quality of Life and Related Factors in Caregivers of Attention Deficit Hyperactivity Disorder Patients)

  • 정종현;홍승철;한진희;이성필
    • 정신신체의학
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    • 제13권2호
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    • pp.102-111
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    • 2005
  • 목적: 질병이 환자에 끼치는 주관적인 영향을 반영하고, 환자의 전반적인 경과와 예후를 나타내는 지표로써 삶의 질 개념이 널리 사용되고 있다. 이때 질병은 환자 자신뿐만 아니라 가족들의 삶에도 상당한 영향을 미치게 되고, 특히 아동이 질병에 이환 되었을 경우 이러한 영향은 더욱 커지리라고 생각된다. 이에 주의력결핍 과잉 행동장애 환아의 보호자를 대상으로 삶의 질의 정도를 알아보고, 삶의 질에 영향을 주는 다른 요인은 무엇인지를 알아보고자 하였다. 방법: DSM-IV 진단기준에 의해 주의력결핍 과잉행동장애로 진단된 아동 38명의 보호자를 대상으로 하였고, 나이와 성별을 맞춘 정상아동 16명의 보호자를 건강대조군으로 하였다. 환아 보호자군과 건강대조군에 대하여 자체 제작한 사회인구학적인 변인에 대한 설문지, 한국판 세계보건기구 삶의 질 간편형 척도(WHOQOL-BREF)를 사용하여 각각 변인의 차이를 비교하였다. 결과: 1) 한국판 WHOQOL-BREF 척도에서 전체 삶의 질 총점과 전반적인 삶의 질, 척도내의 4개의 영역인 신체적 건강 영역, 심리적 영역, 사회적 관계 영역, 환경영역에서 환아 보호자군과 대조군에서 의미 있는 차이는 없었으나, 신체적 건강 영역의 하부척도인 일상생활수행능력 척도$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$와 심리적 영역에 해당되는 자존감척도$(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$에서 유의하게 감소되어 있었다. 2) 전체 삶의 질 총점은 교육년수가 길수록 높았다(r=0.437, p=0.007). 3) 신체적 건강 영역 (영역 1)은 교육년수가 길수록 높은 점수를 보였고(r=0.370, p=0.024), 하부 척도 중에서는 수면과 휴식 척도가 교육연수와 양의 상관관계를 보였다(r=0.429, p=0.008). 4) 심리적 영역(영역 2)과 관련 있는 요인은 없었으나, 하부 척도인 긍정적사고 척도는 교육년수가 길수록 점수가 높았으며 (r=0.346, p=0.036), 자존감 척도(r=-0.337, p=0.039)와 사고 학습 기억능력 척도(r=-.341, p=0.036)는 보호자의 나이가 많을수록 점수가 낮았다. 5) 사회적 관계 영역(영역 3)과 관련 있는 요인은 없었으나, 하부척도 중 성적활동 척도는 교육년수가 길수록 높은 점수를 보이고 있었다(r=0.344, p=0.037). 6) 환경 영역(영역 4)은 교육년수가 길수록 점수가 높았지만(r=0.482, p=0.003), 환아의 나이가 많을수록 낮은 삶의 질 수준을 보고하였다(r=0.328, p=0.044). 한편 하부 척도 중에서는 신체적 안전 척도(r=-0.414, p=0.010), 거주환경 척도(r=-0.429, p=0.007), 새로운 정보나 기술의 취득 척도(r=-0.382, p=0.018), 의료서비스 및 사회보장서비스 척도(r=-0.351, p=0.031)가 환아의 나이와 음의 상관관계를 보였으며, 신체적 안전척도는 보호자의 나이가 많을수록 삶의 질이 낮음을 보고하였다(r=-403, p=0.012). 한편, 새로운 정보나 기술의 취득척도(r=0.406, p=0.013), 여가활동 척도(r=0.464, p=0.004), 교통 척도(r=0.363, p=0.027)은 교육연수가 길수록 높은 점수를 보고하였다. 결론: 주의력결핍 과잉행동장애 환아의 보호자가 느끼는 주관적인 삶의 질은 건강대조군에 비해 나쁘지 않았다. 그러나 환아의 나이가 많을수록, 보호자의 교육연수가 낮을수록 스스로 느끼는 삶의 질의정도가 낮았으므로 이에 대한 관심이 필요할 것이다.

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