• Journal of Preventive Medicine and Public Health
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• 제23권4호
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• pp.451-464
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• 1990

The variation in resource utilization for hospitalized patients who had a group of similar diseases -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utillization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs : o the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs ; o the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs : o the ratio of the maximum and the minimum among the mom LOS of hospitals was greater than 2 in 82 KDRGs ; o the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.

• Journal of Forest and Environmental Science
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• 제38권2호
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• pp.110-121
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• 2022

Leaf functional traits widely have been used to understand the environmental controls of resource utilization strategy of plants along the environmental gradients. By using key leaf functional traits, we quantified the relationships between leaf traits and local climate throughout the distributional range of Rhododendron caucasicum Pall. in eastern and western Georgian mountains (the South Caucasus). Our results revealed, that all traits showed high levels of intraspecific variability across study locations and confirmed a strong phenotypic differentiation of leaf functional variation along the east-west longitudinal gradient in response to the local climate; out of the explored climatic variables, the moisture factors related to precipitation and number of precipitation and dry days for winter and growth seasons were more strongly related to leaf trait variation than the elevation and air temperature. Among studied leaf traits, the leaf specific area (SLA) showed the highest level of variability indicating the different resource utilization strategies of eastern and western-central Rh. caucasicum individuals. High SLA leaves for western-central Caucasian individuals work in relatively resource-rich environments (more humid in terms of precipitation amount and the number of precipitation days in winter) and could be explained by preferential allocation to photosynthesis and growth, while eastern Caucasian samples work in resource-poor environments (less humid in terms of precipitation amount and the number of precipitation days in winter) and the retention of captured resources is a higher priority appearing in a low SLA leaves. However, more evidence from a broader study of the species throughout its distribution range by including additional environmental factors and molecular markers are needed for firmer conclusions of intraspecific variability of Rh. caucasicum.

• 한국지열·수열에너지학회논문집
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• 제6권1호
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• pp.29-35
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• 2010

Long-term temperature monitoring has been performed for ground heat exchanger at the Earthquake Research Center (ERC) building in Korea Institute of Geoscience and Mineral Resources (KIGAM). For the 3 years of monitoring, overall temperature increases are observed at various depths within a borehole heat exchanger. But monitoring of ground temperature variation at the monitoring well beforehand showed that geothermal utilization is not the only source for the temperature increase, Because various kinds of sources can cause the ground temperature change, more thorough investigation should be followed.

• Asian-Australasian Journal of Animal Sciences
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• 제16권7호
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• pp.939-945
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• 2003

Seventeen Chinese indigenous pig breeds and three introduced pig breeds had been carried out by means of vertical polyacrylamide gel electrophoresis (PAGE). According to the results, eight serum protein loci were highly polymorphic except Pi-2 and Cp. The polymorphism information content (PIC) of Hpx was the highest (0.5268), while that of Cp was the lowest (0.0257). The population genetic variation index showed that about 84% genetic variation existed in the population, and the rest of 16% distributed between the populations. The genetic variation of Yimeng black pig and Duroc were the highest and the lowest, respectively. The genetic variation of Chinese indigenous pig breeds was much more than that of exotic groups. Genetic distance results showed that Chinese indigenous pig breeds were classified into four groups with the three introduced pig breeds clustered into another group. The results also supported the geographic distribution of Chinese indigenous pig breeds in certain extent.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 대한간호학회지
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• 제34권2호
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• pp.278-289
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• 2004

Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.

• Molecules and Cells
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• 제26권6호
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• pp.566-575
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• 2008

Twenty-five chipmunk species occur in the world, of which only the Siberian chipmunk, Tamias sibiricus, inhabits Asia. To investigate mitochondrial cytochrome b sequence variations and population structure of the Siberian chipmunk in northeastern Asia, we examined mitochondrial cytochrome b sequences (1140 bp) from 3 countries. Analyses of 41 individuals from South Korea and 33 individuals from Russia and northeast China resulted in 37 haplotypes and 27 haplotypes, respectively. There were no shared haplotypes between South Korea and Russia - northeast China. Phylogenetic trees and network analysis showed 2 major maternal lineages for haplotypes, referred to as the S and R lineages. Haplotype grouping in each cluster was nearly coincident with its geographic affinity. In particular, 3 distinct groups were found that mostly clustered in the northern, central and southern parts of South Korea. Nucleotide diversity of the S lineage was twice that of lineage R. The divergence between S and R lineages was estimated to be 2.98-0.98 Myr. During the ice age, there may have been at least 2 refuges in South Korea and Russia - northeast China. The sequence variation between the S and R lineages was 11.3% (K2P), which is indicative of specific recognition in rodents. These results suggest that T. sibiricus from South Korea could be considered a separate species. However, additional information, such as details of distribution, nuclear genes data or morphology, is required to strengthen this hypothesis.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제9권1호
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• pp.34-49
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• 2015

Market means of spectrum trading have been utilized as a vital method of spectrum sharing and access in future cognitive radio system. In this paper, we consider the spectrum trading with multiple primary carrier providers (PCP) leasing the spectrum to multiple secondary carrier providers (SCP) for a short period of time. Several factors including the price of the resource, duration of leasing, and the spectrum quality guides the proposed model. We formulate three trading policies based on the game theory for dynamic spectrum access in a LTE based cognitive radio system (CRS). In the first, we consider utility function based resource sharing (UFRS) without any knowledge of past transaction. In the second policy, each SCP deals with PCP using a non-cooperative resource sharing (NCRS) method which employs optimal strategy based on reinforcement learning. In variation of second policy, third policy adopts a Nash bargaining while incorporating a recommendation entity in resource sharing (RERS). The simulation results suggest overall increase in throughput while maintaining higher spectrum efficiency and fairness.

• 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.