• Title/Summary/Keyword: 급여 계산

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Analysis of the Payment Rates and Classification of Services on Radiation Oncology (치료방사선과 의료서비스에 대한 원가산정)

  • Shin Kyung Hwan;Shin Hyun Soo;Pyo Hong Ryull;Lee Kyu Chan;Lee Yoon Tae;Myoung Hee Bong;Yeom Yong Kwon
    • Radiation Oncology Journal
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    • v.15 no.2
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    • pp.167-174
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    • 1997
  • Purpose : The main Purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. Material and Methods : A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as Payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current Payment rates of individual services. Results : The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12-2.55 times lower in total body irradiation. Conclusion : We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.

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Effects of Coriandrum sativum L. on Lipid Contents in Streptozotocin-Induced Diabetic Rats (식이내 고수(Coriandrum sativum L.)의 첨가가 당뇨성 흰쥐의 혈장과 간의 지질함량에 미치는 영향)

  • 황금희;윤연희;최인선;최옥자;강성구
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.4
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    • pp.684-691
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    • 2001
  • This study was designed to investigate the effects of Coriandrum sativum L. on lipid metabolism in nondiaetic and stretozotocin-induced diabetic.Thirty two mael Sprague-Dawley rats weighting 108$\pm$13 g were divided into four groups as follow: control (C), leaf(L), seed (S) and root (R) groups. For four weeks of experimental periods, the C group were fed basal diet and the L, S and R groups were fed Coriandru sativum L. diets containing 5% dried leaf, seed and root of Coriandrum sativum L, respectively. diet intakes, weight gain and food efficiency were not significantly different among the four groups. The liver and heart weights of L, s and R groups were significantly different amount the control group. The levels of plasma insulin was significantly increased but the plasma glucose levels was not decreased in all Coriandrum group. The levels of plasma lipids was not significantly different among the four groups. the levels of plasma total cholesterol was significantly decreased in R groups. The levels of plasma and liver TBARS values were significantly decreased in R groups. The levels of plasma vitamin E were tendency to decrease in all coriandum groups. These results indicate feeding diet with coriander did not show the hypolipidemic effect but show the antioxidative effect.

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Analysis of the 2015 reform plan of government employees pension system (GEPS) through monte carlo simulations (모의실험을 통한 2015년 공무원 연금제도 개정안의 효과분석)

  • Lee, Jieun;Song, Seongjoo
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.1
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    • pp.19-32
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    • 2016
  • Due to the increasing fiscal burden and structural unbalanced premium/benefit costs, the new reform on the government employees pension system (GEPS) was considered even after the recent reform in 2009. This article examines the various effects of recent amendment in 2015 on GEPS using a simple probabilistic model. We consider effects on both sides, the pensioners and the government. First of all, the expected net value of pension payment for an individual employee was calculated based on the supposed survival distribution. The fairness of individual pension holders was compared using the benefit-cost ratio. Secondly, from pension system users' point of view, the default probability and the government subsidy were examined by Monte-carlo simulation. From the simulation experiment, we could see that the 2015 reform plan indeed reduces the default probability and the size of the fiscal burden of government by increasing the premium and decreasing the benefit. However, the size of the effect is not very standout at this moment because the number of new employees who are fully subject to the reform will be much smaller than the number of previous employees for a while. Thus, the effect of the reform is expected to appear in a slow manner.

Survey of CT Practice and Collective Effective Dose Estimation (CT검사건수 및 CT검사에 의한 집단 실효선량의 추정)

  • Lee, Man-Koo;Lim, Cheong-Hwan
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.231-237
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    • 2010
  • Computed tomography (CT) has been established as an important diagnostic tool in clinical medicine and has become a major source of medical exposure. A nationwide survey regarding CT examinations was carried out in 2007. Thanks to the appeasement policy regulating the import of CT scanners, there are 1,825 CT scanners across the country as of the end of March 2010, which means that we have 36.8 CT scanners per one million people. The annual number of examinations was 3.29 million, the number of examinations per 1000 population was 68. The most part of examinations was abdomen and pelvis. and the collective effective dose was in these parts. The effective dose per one population was evaluated as 0.952 mSv.

Growth Efficiency, Carcass Quality Characteristics and Profitability of Finishing Pigs Slaughtered at 130 vs. 110Kg (110kg 대비 130kg에 도축된 비육돈의 성장효율, 도체 품질 특성 및 수익성)

  • 이철영;권오천;하덕민;신호원;이제룡;하영주;이진희;하승호;김원기;김광위;김두환
    • Journal of Animal Science and Technology
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    • v.48 no.4
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    • pp.493-502
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    • 2006
  • The slaughter weight (wt) is a most important economic factor in swine roduction. The present study was undertaken to determine if it is feasible to increase the slaughter wt of finishing pigs to 130kg without significantly affecting the growth efficiency and carcass quality. One hundred and sixty gilts and 160 barrows born from lean-type Yorkshire×Landrace (YL)-dam and Duroc (D)-sire lines, which are most widely used for terminal breeding for pork production in Gyeongsangnam-do, were randomly allocated into 16 pens under a 2 (sex)×2 (slaughter wt; 110 vs. 130kg) factorial arrangement of treatments. The animals were fed ad libitum a diet containing 3,200kcal DE/kg and 15.5% crude protein. After slaughter at the predetermined wt, yields of trimmed primal cuts and physicochemical characteristics of the longissimus dorsi muscle (LD) were measured or analyzed. Average daily gain was greater (P<0.01) in barrows than in gilts (0.86 vs. 0.79kg), but it was not different between the 110- and 130-kg slaughter wt groups (P>0.05). Backfat thickness was greater in the 130- vs. 110-kg group in both sexes (gilts: 21.6 vs. 17.6 mm, barrows: 25.1 vs. 20.8 mm). The yield percentage of belly was greater in barrows than in gilts (21.2 vs. 20.5%) and also in the 130-kg vs. 110-kg group (21.4 vs. 20.2%). Major physicochemical characteristics of LD including the color, percentage of 48-h drip loss, 24-h pH and percentages of crude protein and fat were not influenced by slaughter wt. Marginal profit of the 130-kg vs. 110-kg market pig was approximately 󰠏20,000 won/head, which resulted primarily from the heavy carcass weight of the former exceeding the upper limit of the A- or B-grade. However, if it had not been for the carcass weight limit of the current grading system, a 130-kg market pig would have had a potential marginal profit greater than 20,000 won. Results suggest that slaughter wt of lean-line finishing pigs can be increased to 130kg without significantly compromising the growth efficiency and carcass quality and accordingly, the upper weight limit of the ‘good-grade’ carcass needs to be increased or abolished to accommodate the larger market pigs.

Nutrients and Energy Digestibilities of Various Feedstuffs Fed to Israeli Strain of Growing Common Carp (Cyprinus carpio) (육성용 이스라엘 잉어에 의한 원료사료의 영양소 및 에너지 소화율)

  • 김정대;김광석;이승복;정관식
    • Journal of Aquaculture
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    • v.10 no.3
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    • pp.327-334
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    • 1997
  • This study was conducted with Israeli strain of common carp to determine apparent protein, lipid and gross energy digestibility coefficients and apparent calcium and phosphorus availabilities of the following feedstuffs : steam-dried white fish meal (WFM-S), flame-dried white fish meal (WFM-F), brown fish meal (BFM), soybean meal (SBM), corn gluten meal (CGM), sesame meal (SSM), wheat flour (WFL), brewer's yeast (BY) and monocalcium phosphate (MCP). Test diets consisting of a 70:30 mixture of refoernce diet to test ingredient were utilized with chromic oxide as an external indicator. Fecal collection was made during 10 days before the end of feeding trial lasted for 27 days. The best weight gain and feed utilization were found in fish fed MCP containing test diet. Protein digestibility was high for most ingredients, ranging from 81.2% for BY to 91.9% for SBM, with the exception of SSM which was 77.6%. Lipid digestibility coefficients ranged 74% for CGM to 85.8% for two kinds of white fish meal. Digestible energy coefficients were generally high for fish meals, ranging from 77.4% for WFM-S to 81.3% for WFM-F, whereas those for plant feedstuffs were significantly (P<0.05) lower, from 64.5% for CGM to 70.6% for BY. Phosphorus availability from fish meals was variable with a low of 6.6% for WFM-F and a high of 13.6% for WFM-S. Phosphorus availability from SBM and BY was 7.3% and 57.2%, respectively. Calcium and phosphorus availabilities from MCP were 84.6% and 80.6%, respectively. These results provide more precise information concerning nutrients and energy utilization of Israeli strain of common carp and will allow ingredient substitutions in practical diet formulations based on levels of availabile protein and phosphorus.

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A Study on the Effects of Dietary Fat Sources on the Plasma and Liver Cholesterol Levels in Young Chicks (지방공급원이 병아리의 혈액 및 간 Cholesterol 함량에 미치는 영향)

  • 최인숙;지규만;오미향
    • Korean Journal of Poultry Science
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    • v.13 no.2
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    • pp.209-219
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    • 1986
  • This study was designed to investigate the effects of various sources of dietary fats on the blood and liver cholesterol(CHOL) levels in young Single Comb White Leghorn male chicks, In experiment 1, corn oil, palm gil, tallow and fish oil were added individually at a level of 4% to semipurified type diets composed of isolated soyprotein and glucose as major components. The diets were fed ad libitum for a period of 15 days. In experiment 2, various fats such as corn oil, soybean oil, repeseed oil, palm oil, tallow, fish oil and hydrogenated fish oil(HFO) were added individually at a level of 11.4% to practical type diets primarily based on corn and soybean meal. Control diet contained 3% of corn oil. All these diets were formulated to contain equivalent amount of nutrients such as protein, vitamins and minerals on a basis of unit kcal of metabolizable energy. The third Experiment was to compare the effects of different levels of calorie/protein(C/P ratio) of diets on the performances and various biological parameters in the chicks. Control diet was the same as in experiment 2. Another diet was added with 11.14% corn oil(C/P ratio=146) and the other diet with 10% corn oil(C/P ratio=164), The diets in experiment 2 and 3 were fed ad libitum for 26 days. In the first experiment, the chicks fed the diet containing vegetable oils tended to grow faster and show better feed efficiency without significance than those fed diets added with animal fats. However, this tendency was not observed in the experiment 2. Birds consumed the diets added with fish oil appeared to have heavier liver weight and higher liver CHOL than the others(p〈0.05), No significant differences in the levels of blood CHOL and triacylglycerol(TG) were observed among the chicks of various dietary groups(Exp. 1). Weights of liver or heart were significantly heavier in the chicks consumed the diets added with HFO or fish oil, respectively(Exp. 2). However, chicks ingested diet containing fish oil appeared to have significantly lower plasma CHOL. No significant differences were observed in the levels of liver CHOL and plasma TG among the dietary groups. Birds consumed the diet with a wider C/P ratio resulted in higher liver TG levels in experiment 3(p〈0.05). Although no statistical differences were observed among the various dietary groups, chicks fed the diet with a wider C/P ratio tended to show higher levels of plasma CHOL, TG, liver CHOL and total liver lipids compared to those of the control group.

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The Comparison of Efficacy of Glutathione S-transeferase Placental Form Positive and Iron-Resistant Lesions in the Detection of Hepatocarcinogens (간발암성 물질 검색에 있어서 Glutathione S-transeferase Placental Form 양성 병소와 철 저항 병소의 유효성 비교 연구)

  • 강경선;김형진;이영순
    • Journal of Food Hygiene and Safety
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    • v.6 no.1
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    • pp.1-12
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    • 1991
  • Fischer 344 rats aged six weeks were diYided into four groups and group 1, 2, and 3 of rats were given an intraperitoneal injection of diethylnitrosamine at 200 mg/kg body weight and group 4 was given saline alone. Two weeks after beginning of the experiment, group 1 and 2 of rats were begun to feed on diets containing 0.02% 2-acetylaminofluorene as a promoter for four weeks. Three weeks after beginning of the experiment, all groups were performed partial hepatectomy. During the last two weeks, group 1 and 3 of rats were received subcutaneously 3 consecutive weekly doses of iron dextran at 0.125 ml/100 g body weight. Subcutaneous injection of iron dextran resulted in hepatic siderosis in group 1 and 3 of rats. Pre neoplastic nodules were identified histopathologically by two markers, resistance to exogenous iron accumulation and glutathione S-transeferase placental form (GST-P) activity, while early carcinogen induced foci were hardly resistant to iron accumulation and though a few lesions were identified, it could hardly be distincted from normal hepatocytes of surroundings. However, GST-P positive nodules as well as foci were clearly distincted from normal hepatic cells of surroundings. In the quantitative analysis of carcinogen-induced nodules and foci, more lesions were detected by immunohistochemical method for GST-P than by prussian blue staining for resistant to iron accumulation. It is concluded that immunohistochemical marker for GST-P is more sensitive and reliable than iron-resistance marker, and that iron-resistance is not useful marker for early detection of carcinogen-induced hepatic lesions.

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연금충당부채 및 연금비용 회계정보 공시에 관한 연구 : 사학연기금을 중심으로

  • Seong, Ju-Ho
    • Journal of Teachers' Pension
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    • v.3
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    • pp.69-105
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    • 2018
  • 저출산과 고령화 이슈는 우리사회의 경제적 문제뿐만 아니라 공적연금의 재정지속가능성 여부와도 맞물려 있다. 실제로 우리나라 모든 공적연금은 사회보험역설(social insurance paradox)이 지속되기 힘든 새로운 도전에 직면하였다. 즉, 재정지속가능성은 제도 내적 연금개혁 혹은 제도 외적 재정지원이 없다면 항시적 수지불균형 상태가 누적될 것으로 예측된다. 이에 정부는 직접 고용과 관련된 공무원연금과 군인연금에 대해서만 연금충당부채를 산출하도록 규정하고 있다. 발생주의회계를 채택한 국제회계기준(종업원급여)을 참조하여 연금충당부채 산출을 위한 연금회계준칙(2011.8.3. 제정; 2011.1.1. 시행) 그리고 '연금회계 평가 및 공시 지침(2011.8.3. 고시 : 이하 편의상 연금회계지침이라 함)'을 신설하였다. 사학연금에 적용성 여부 논의에 앞서, 이들의 산출방법상의 문제점을 먼저 살펴보았다. 첫째, 공적연금은 공통적으로 세대 간 합의에 의해 운영되는 사회계약에 해당하므로 제도의 연속성을 전제로 한다. 하지만 연금회계준칙 및 지침은 제도의 청산을 전제로 현재 가입자(연금 미수령자, 연금 수령자)에 대해서 연금충당부채를 산출하는 폐쇄형측정(closed group valuation)을 채택하고 있다. 즉, 폐쇄형은 제도의 연속성 속성을 반영하고 있지 못하고 있어 기본 전제와 모순된다. 둘째, 공무원연금과 군인연금은 이미 기금 소진(최소한의 유동성기금만 보유함)이 되었고 정부의 보전금에 의해 수지 균형이 유지되는 순수부과방식 체계로 전환되었다. 따라서 연금충당부채는 해당 적립기금의 과소 여부를 판정하는 재정상태 기준 값에 해당하므로 기금소진이 진행된 현 상황에서는 산출의 목적, 필요성을 찾기가 힘들다. 부언하면, 제도 외적 재정지원(보전금)에 의한 수지균형방식이라면 발생주의회계보다는 현금주의회계가 회계의 목적적합성이 높다. 마지막으로 연금충당부채 산출에 있어 가장 민감한 할인율 설정 권한을 기재부장관에게 위임한 내용은 산출의 객관성, 일관성을 확보하기 힘들다고 판단된다. 이를 해소하기 위한 방안으로 본 연구에서는 5년마다 실시하고 있는 장기재정계산에서 예측된 명목 기금투자수익률을 연도별로 적용할 것을 권고하고 있다. 현행 정부회계기준을 사학연금제도에 그대로 적용하기에는 상당한 무리가 있다. 그 이유와 공시방안에 대해 살펴본다. 현재 사학연금은 기금소진 이슈로부터 상당부분 벗어나기 위해 2015년 연금개혁을 단행한 바가 있고 이를 통해 상당기간 부분적립방식 체계가 유지될 것이다. 물론 제도 외적 재정지원은 사학연금법 제53조의7에서 정부지원의 가능성만을 열어 놓은 상태이므로 미래기금소진의 가능성은 상존한다고 볼 수 있다. 먼 미래에는 순수부과방식 체계로 전환될 개연성이 높다. 이러한 재정의 양면성을 본 연구에서는 이중재정방식(dual financing system)이라고 한다. 이러한 속성을 고려하여 연금충당부채(연금채무라는 표현이 적합할 것으로 사료됨)를 산출하고 공시하여야 한다. 그 주요 연구 결과는 다음과 같이 요약된다. 먼저 현행 부분적립방식의 재정상태 검증을 위해 연금채무를 산정할 필요성이 있다. 이를 위해 본 연구에서는 기발생주의(예측단위방식 적용)에 근거한 폐쇄형 측정I(제도 종료를 전제로 현 가입자의 잠재연금채무(IPD) 산출에 초점을 둠) 그리고 미래발생주의(가입연령방식 적용)에 근거한 폐쇄형 측정II(추가적으로 현 가입자의 일정기간 급여 및 기여 발생 허용)을 제안하고 있다. 이를 통해 미적립채무의 규모 그리고 이를 해소하기 위한 상각부담률을 산출할 수 있다. 최종적으로 미래 가입자들까지 포함하고 기금소진 가능성까지 고려하는 개방형측정(open group valuation)을 다루고 있다. 단, 본 연구에서는 공무원연금처럼 기금부족분에 대해서 향후 정부보전금이 있다는 가정 하에 공시 방법을 제시하고 있다. 요약하면, 현행 사학연금제도는 현재와 미래의 재정 양면성을 모두 고려하여 연금채무 및 미적립채무를 공시하여야 한다. 부언하면, 현재 부분적립방식 재정상태를 반영하는 연금채무는 발생주의회계를 적용하고 미래에 도래할 순수부과방식 재정상태는 현금주의회계를 적용할 것을 최종 결론으로 도출하고 있다. 마지막으로 본 연구의 한계는 정부보전금의 가능성에 대한 법률적 해석과 병행하여 책임준비금 범위의 안정적 확대를 전제로 한 공시 논의 그리고 보전금의 책임한도 범위에 따른 공시 논의 등은 다루고 있지 않다는 점이다. 이러한 논의 사항은 향후 연구과제로 두고자 한다.