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An Analysis of Determinants of Medical Cost Inflation using both Deterministic and Stochastic Models (의료비 상승 요인 분석)

  • Kim, Han-Joong;Chun, Ki-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.542-554
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    • 1989
  • The skyrocketing inflation of medical costs has become a major health problem among most developed countries. Korea, which recently covered the entire population with National Health Insurance, is facing the same problem. The proportion of health expenditure to GNP has increased from 3% to 4.8% during the last decade. This was remarkable, if we consider the rapid economic growth during that time. A few policy analysts began to raise cost containment as an agenda, after recognizing the importance of medical cost inflation. In order to Prepare an appropriate alternative for the agenda, it is necessary to find out reasons for the cost inflation. Then, we should focus on the reasons which are controllable, and those whose control are socially desirable. This study is designed to articulate the theory of medical cost inflation through literature reviews, to find out reasons for cost inflation, by analyzing aggregated data with a deterministic model. Finally to identify determinants of changes in both medical demand and service intensity which are major reasons for cost inflation. The reasons for cost inflation are classified into cost push inflation and demand pull inflation, The former consists of increases in price and intensity of services, while the latter is made of consumer derived demand and supplier induced demand. We used a time series (1983-1987), and cross sectional (over regions) data of health insurance. The deterministic model reveals, that an increase in service intensity is a major cause of inflation in the case of inpatient care, while, more utilization, is a primary attribute in the case of physician visits. Multiple regression analysis shows that an increase in hospital beds is a leading explanatory variable for the increase in hospital care. It also reveals, that an introduction of a deductible clause, an increase in hospital beds and degree of urbanization, are statistically significant variables explaining physician visits. The results are consistent with the existing theory, The magnitude of service intensity is influenced by the level of co-payment, the proportion of old age and an increase in co-payment. In short, an increase in co-payment reduced the utilization, but it induced more intensities or services. We can conclude that the strict fee regulation or increase in the level of co-payment can not be an effective measure for cost containment under the fee for service system. Because the provider can react against the regulation by inducing more services.

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Proteomic Analyses of Chinese Cabbage(Brassica campestris L. pekinensis) Affected by High Temperature Stresses in Highland Cultivation During Summer in Korea (Proteomics를 이용한 고랭지 배추의 고온장해 해석)

  • Shin, Pyung-Gyun;Hong, Sung-Chang;Chang, An-Cheol;Kim, Sang-Hyo;Lee, Ki-Sang
    • Journal of Life Science
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    • v.17 no.12
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    • pp.1649-1653
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    • 2007
  • High temperature stresses have caused growth inhibition and delayed heading in highland cultivation Chinese cabbage during summer in Korea. We have studied high temperature stress responses in the terms of changes of inorganic components and proteins by proteomic analyses. Insufficiencies of nitrogen and phosphorus have affected growth rate and calcium deficiency has caused blunted heading. Proteins extracted from Brassica seedling grown at the altitude of 600m and 900m in the Mount Jilun were extracted and analysed by 2-dimentional polyacrylamide gel electrophoresis. Profiles of protein expression was then analyzed by 2-dimentional gel analyses. Protein spots showing different expression level were picked using the spot handling workstation and subjected to MALDI-TOF MS. Total 48 protein spots were analyzed by MALDI-TOF MS and 30 proteins spots out of 48 were identified by peptide mass fingerprinting analyses. Fourteen proteins were up-regulated in extracts from the altitude of 900m and they were identified as oxygen-evolving proteins, rubisco activase and ATPase etc. Sixteen proteins were up-regulated in extracts from the altitude of 600m and they were identified as glutathione S-transferase(1, 28kD cold induced- and 24 kD auxin-binding proteins) and salt-stress induced protein etc. These stress-induced proteins were related to the mediated protective mechanism against oxidative damage during various stresses. The results indicated that physiological phenomenon in response to high temperature stresses might be resulted by complex and multiple array of responses with drought, heat, oxidative, salt, and cold by high temperature.

Identification of Brassinosteroid-Related Protein, BAK1 from Nutrition Deficient Tomato Cultivated by Soilless Cultivation System (수경재배 영양결핍토마토에서 브레시노스테로이드관련 신호전달 단백질 BAK1의 동정)

  • Shin, Pyung-Gyun;Chang, An-Cheol;Hong, Sung-Chang;Lee, Ki-Sang
    • Journal of Life Science
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    • v.17 no.12
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    • pp.1729-1733
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    • 2007
  • Brassinolide insensitive associated receptor kinase 1(BAK1) is a critical component that play an important roles in signaling of brassinosteroid biosynthesis. Brassinosteroid-deficient and -insensitive mutants showed the characteristic of dwarf symptom. The nutrient deficient tomato showing stunt phenomenon was selected from soiless cultivation system using modified Sonneveld hydroponic solution. Twenty eight protein spots showing different expression levels compared to the control were isolated from extracts of stunted tomato leaves by 2D PAGE analyses. Significantly down-regulated 6 protein spots out of 28 protein spots were analyzed and sequenced by MALDI-TOF mass spectrometry. The protein spot having pI=4.5 and MW=24 kDa was identified as a signal protein, BAK1, which is directly related to brassinosteroid biosynthesis. In addition, five other protein spots were identified as BCK1, cystein proteinase, sulfutase, peroxidase and zinc finger factor respectively, and they were also signal proteins related to brassinosteroid biosynthesis. Furthermore, amplification of 500bp of BAK1 mRNA by RT-PCR using a primer set of peptide matched regions was inhibited conpared to that of the wild type. The results sugested that the BAK1 might be regulated at the transcription level in response to nutrition applications.

RCCA End-Tip Examination by ECT (원자로 제어봉 End-Tip 원주방향균열 와전류검사)

  • Lee, H.J.;Nam, M.W.;Jung, G.J.
    • Journal of the Korean Society for Nondestructive Testing
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    • v.18 no.6
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    • pp.455-463
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    • 1998
  • RCCA(rod cluster control assembly) End-Tip suffers from neutron irradiation and constant vibration due to high-speed internal flow of primary coolant during plant operation. Such operating conditions cause the RCCA end-tip crackings around tile circumferential weldment of the end-tip, and in some cases, the defective end-tips were completly broken loose. However, no reliable inspection techniques for end-tip crackings were developed in the past, although some techniques exist for inspecting RCCA control rod wears. Therefore, NDE group at KEPRI has developed an ECT technique for the detection and the sizing of the end-tip crackings. The technique uses a specially designed surface-riding probe that can detect size of circumferential crackings with an accuracy of ${\pm}5.31%$ RMS error. This paper describes the ECT instrumentation including the ECT probes, calibration bars, as well as technical approaches.

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A Study on the Measurement of Ultrasound Velocity to Evaluate Degradation of Low Voltage Cables for Nuclear Power Plants (원전 저압케이블 열화도 평가를 위한 초음파 음속계측에 관한 연구)

  • Kim, Kyung-Cho;Kang, Suk-Chull;Goo, Charles;Kim, Jin-Ho;Park, Jae-Seok;Joo, Geum-Jong;Park, Chi-Seung
    • Journal of the Korean Society for Nondestructive Testing
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    • v.24 no.4
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    • pp.325-330
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    • 2004
  • Several kinds of low voltage cables have been used in nuclear power plants for the supply of electric power, supervision, and the propagation of control signals. These low voltage tables must be inspected for safe and stable operation of nuclear power plants. In particular, the degradation diagnosis to estimate the integrity of low voltage rabies has recently been emphasized according to the long use of nuclear power plants. In order to evaluate their degradation, the surrounding temperature, hardness of insulation material, elongation at breaking point (EAB), etc. have been used. However, the measurement of temperature or hardness is not useful because of the absence of quantitative criteria; the inspection of a sample requires turning off of the power plant power; and, the electrical inspection method is not sufficiently sensitive from the initial through the middle stage of degradation. In this research, based on the theory that the ultrasonic velocity changes with relation to the degradation of the material, we measured the ultrasonic velocity as low voltage cables were degraded. To this end, an ultrasonic degradation diagnosis device was developed and used to measure the ultrasonic velocity with the clothing on the cable, and it was confirmed that the ultrasonic velocity changes according to the degradation of low voltage cables. The low voltage cables used in nuclear power plants were degraded at an accelerated rate, and EAB was measured in a tensile test conducted after the measurement of ultrasonic velocity. With the increasing degradation degree, the ultrasonic velocity decreased, whose potential as a useful parameter for the quantitative degradation evaluation was thus confirmed.

Development of Remote Reld Testing Technique for Moisture Separator & Reheater Tubes in Nuclear Power Plants (원자력발전소 습분분리재열기 튜브 원격장검사 기술 개발)

  • Nam, Min-Woo;Lee, Hee-Jong;Kim, Cheol-Gi
    • Journal of the Korean Society for Nondestructive Testing
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    • v.28 no.4
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    • pp.339-345
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    • 2008
  • The heat exchanger tube in nuclear power plants is mainly fabricated from nonferromagnetic material such as a copper, titanium, and inconel alloy, but the moisture separator & reheater tube in the turbine system is fabricated from ferromagnetic material such as a carbon steel or ferrite stainless steel which has a good mechanical properties in harsh environments of high pressure and temperature. Especially, the moisture separator & reheater tubes, which use steam as a heat transfer media, typically employ a tubing with integral fins to furnish higher heat transfer rates. The ferromagnetic tube typically shows superior properties in high pressure and temperature environments than a nonferromagnetic material, but can make a trouble during the normal operation of power plants because the ferrous tube has service-induced damage forms including a steam cutting, erosion, mechanical wear, stress corrosion cracking, etc. Therefore, nondestructive examination is periodically performed to evaluate the tube integrity. Now, the remote field testing(RFT) technique is one of the solution for examination of ferromagnetic tube because the conventional eddy current technique typically can not be applied to ferromagnetic tube such as a ferrite stainless steel due to the high electrical permeability of ferrous tube. In this study, we have designed RFT probes, calibration standards, artificial flaw specimen, and probe pusher-puller necessary for field application, and have successfully carry out RFT examination of the moisture separator & reheater tube of nuclear power plants.

Geochemical characteristics of light yellow brown surface sediments and dark brown colored subsurface sediments in KODOS-89 area, western part of Clarion-Clipperton fracture zone (KODOS-89 지역 표층의 황색 퇴적물과 그 하부 갈색 퇴적물의 지구화학적 특성)

  • 정회수;강정극
    • 한국해양학회지
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    • v.26 no.3
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    • pp.193-203
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    • 1991
  • KODOS (Korea Deep ocean Study)-89 sediments, recovered from western part of Clarion-Clipperton fracture zone in north Pacific, show two distinctly colored layer zones: surface yellow brown layer (unit A) and subsurface dark brown layer (unit B), and roughly recognized as Quaternary and Tertiary in age, respectively. Geochemical characteristics are also different in those two units. Smectite, water, micronodule, and heavy metal contents are higher in unit B, while POC content is higher in unit A. High smectite and low POC contents in unit B are due to the longer formation period of smectite, almost decomposition of labile organic matter in unit B relative to unit A. High water content in unit B is caused by coarse fabric which results from higher content of spicules and spines. Additionally, stronger electrostatic repulsion force caused by high smectite content also supports high water content in unit B relative to unit A. Variations in heavy metal contents are closely related to the amount of micronodule, which has higher metal contents than that of sediment. Therefore, we conclude that the differences of geochemical characteristics in unit A and unit B are resulted from the different diagenetic durations of unit A and unit B.

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Formation of Si Nanodot by Using SiNx Thin Films (SiNx 박막을 이용한 Si Nanodot의 형성)

  • Lee, Jang Woo;Park, Ik Hyun;Shin, Byul;Chung, Chee Won
    • Applied Chemistry for Engineering
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    • v.16 no.6
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    • pp.768-771
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    • 2005
  • The deposition of silicon nitride ($SiN_x$) thin films was carried out on $SiO_2/Si$ substrate at room temperature by reactive dc magnetron sputtering. The analysis of deposited $SiN_x$ films using x-ray photoelectron spectroscopy indicated that the composition of $SiN_x$ films was Si-rich. The deposited $SiN_x$ thin films were annealed by varying annealing temperature and time. X-ray diffraction (XRD) analysis was performed in order to examine the crystallization of Si in $SiN_x$ thin films. The optical and electrical properties of $SiN_x$ thin films were measured for the observation of Si nanodot. As a result, we observed the XRD peaks that might be the Si crystals. As the annealing time and annealing temperature increased, the photoluminescence intensity of $SiN_x$ films gradually increased. The capacitance-voltage characteristics of $SiN_x$ film measured before and after annealing indicated that the trap effect of electrons or holes occurred due to the existence Si nanodots in the $SiN_x$ thin films.

Stabilization of LiMn2O4 Electrode for Lithium Secondary Battery(I) - Electrode Characteristics on the Substitution of Metal Oxides in LiMn2O4 Cathode Material - (리튬이차전지용 정극활물질 LiMn2O4의 안정화(I) - LiMn2O4에 대한 금속산화물의 치환에 따른 전극 특성 -)

  • Lee, Jin-Sik;Lee, Chul-Tae
    • Applied Chemistry for Engineering
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    • v.9 no.5
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    • pp.774-780
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    • 1998
  • For the stabilization of the spinel structured $LiMn_2O_4$, a fraction of manganese was substituted with various metals such as Mg, Fe, V, W, Cr, Mo with Mn that had a similar ionic radii ($LiM_xMn_{2-x}O_4(0.05{\leq}x{\leq}0.02)$). The $LiM_xMn_{2-x}O_4$ showed a substantial improvement as lower capacity loss than that of the spinel structured $LiMn_2O_4$ when it was used as a cathode material. And with the partial substitution, the chemical diffusion coefficient for $LiMg_{0.05}Mn_{1.9}O_4$ and $LiCr_{0.1}Mn_{1.9}O_4$ was increased by and order of magnitude compared to that of the $LiMn_2O_4$ with spinel structure. The results showed that significant improvement can be made on the electrochemical characteristics as the structure of the $LiMn_2O_4$ electrode material was stabilized by the partial substitution.

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Hydrogen Electrode Performance with PTFE Bonded Raney Nickel Catalyst for Alkaline Fuel Cell (라니 니켈 촉매에 대한 알칼리형 연료전지용 수소극의 전극특성)

  • Lee, Hong-Ki;Lee, Ju-Seong
    • Applied Chemistry for Engineering
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    • v.3 no.3
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    • pp.527-534
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    • 1992
  • Raney nickel was used as catalyst in the hydrogen electrode for an alkaline fuel cell. The hydrogen electrode manufactured with the Raney nickel catalyst which was sintered at $700^{\circ}C$ was found to have the highest electrode performance. Using the Raney nickel powder of average particle size $90{\AA}$ for the electrode, the current density which had been measured was $450mA/cm^2$ at $80^{\circ}C$ using 6N KOH solution as an electrolyte. The effects of PTFE addition were investigated with CO-chemisorption, polarization curves and Tafel slope. CO-chemisorption had shown the optimum value when the Raney nickel was mixed with 5wt% of PTFE, but from the current density and Tafel slope at porous Raney nickel electrode, the appropriate value of PTFE addition was 10wt%. Recommendable Ni and Al portion for Raney nickel was 60 : 40 and loading amount was $0.25g/cm^2$. Also the influence of pressing pressure for manufacturing catalytic layer and for junction with gas diffusion layer was examined. The morphology of catalyst surface was investigated with SEM. The influence of reactivation time and heat-treatment temperature were also studied.

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