• Title/Summary/Keyword: 비용부담

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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Development of a Device for Estimating the Optimal Artificial Insemination Time of Individually Stalled Sows Using Image Processing (영상처리기법을 이용한 스톨 사육 모돈의 인공수정적기 예측 장치 개발)

  • Kim, D.J.;Yeon, S.C.;Chang, H.H.
    • Journal of Animal Science and Technology
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    • v.49 no.5
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    • pp.677-688
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    • 2007
  • 돼지를 포함한 대부분의 동물은 일정한 발정주기를 가지고 일정한 시기에 배란을 하는 자연배란동물이지만, 토끼, 고양이, 밍크 등의 암놈은 교미자극에 의해 배란이 일어나는 유기배란동물이다. 또한 1년에 한 번만 발정하는 단발정동물과 1년에 수차례 발정하는 다발정동물이 있다. 이 중에서 모돈은 1년에 수차례 발정하는 다발정 동물로서 발정기에 들면 비발정기와는 다른 행동을 나타낸다(Diehl 등, 2001). 양돈가의 수익을 최대화하기 위해서는 비생산일수를 최소로 줄여야 한다. 모돈의 비생산일수를 줄일 수 있는 한 가지 방법은 성공적으로 교배를 시키는 것이다. 이처럼 성공적으로 교배를 시키기 위해서는 수정적기를 정확히 예측해야 한다. 만약 수정적기를 정확히 판단하지 못하여 수태가 되지 않으면, 비생산일수가 늘어나 손실을 입게 된다. 따라서 수정적기를 정확히 판단하는 것은 모돈의 성공적인 인공수정에 있어서 중요한 요소이다. 수정적기는 배란이 일어나기 전 10시간에서 12시간 사이이며, 발정이 시작되는 시점을 기준으로 하였을 때 경산돈의 경우 26시간에서 34시간 사이이고 미경산돈의 경우는 18시간에서 26시간 사이이다(Evans 등, 2001). 현재 하루에 두 번 모돈의 발정을 확인하는 것이 일반화되어 있으며, 이 때 웅돈을 접촉시키거나 육안관찰을 통하여 발정 유무를 판단한다. 이러한 방법에는 숙련된 기술과 풍부한 경험이 요구될 뿐만 아니라 총 소요노동력의 30% 정도가 요구된다(Perez 등, 1986). 하루에 두 번밖에 발정을 감지하지 않기 때문에 발정이 언제 시작되었는지를 정확히 알 수 없으며, 또한 발정의 대부분이 새벽에 시작되므로 수정적기를 정확히 판단하기란 매우 어렵다. 만약 발정을 감지했더라도 적기에 인공수정을 하지 못한다면, 수태율이 낮아지므로 경제적 손실이 초래된다. 현재 이러한 문제점 때문에 2회에서 3회에 걸쳐 인공수정을 하고 있으나 이에 따른 소요비용과 소요노동력 등은 양돈가의 부담을 가중시키는 요인이 되고 있다. 돼지는 발정기가 되면 비발정기에 나타내지 않던 외음부의 냄새를 맡는 행동, 귀를 세우는 행동 및 승가허용 행동 등을 나타낸다(Diehl 등, 2001). 또한 돼지는 비발정기에 비하여 발정기에 더 많은 활동량을 나타낸다(Altman, 1941; Erez and Hartsock, 1990). Freson 등(1998)은 스톨에서 개별적으로 사육되고 있는 모돈의 활동량을 적외선센서를 이용하여 측정함으로써 발정을 86%까지 감지하였다고 보고하였다. 그러나 이 연구는 단지 모돈의 발정을 감지하였을 뿐 번식관리에 있어서 가장 중요한 수정적기의 판단 기준을 제시하지 못하였다. 따라서, 본 연구는 스톨에서 사육되는 모돈의 활동량을 측정함으로써 발정시작시각을 감지하고 이를 기준으로 인공수정적기를 예측할 수 있는 인공수정적기 예측 장치를 개발한 후 이의 성능을 농장실증실험을 통하여 시험하고자 수행되었다.

A Study on the Legal Explanation and Cases of the Buyer's Obligation to Pay the Price for the Goods under CISG (CISG하에서 매수인의 물품대금지급 의무에 관한 법적 기준과 판결례에 관한 고찰)

  • Shim, Chong-Seok
    • International Commerce and Information Review
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    • v.15 no.3
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    • pp.199-224
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    • 2013
  • Section I of Chapter III ('Obligations of the Buyer') in Part III ('Sale of Goods') of the CISG consists of six articles addressing one of the fundamental buyer obligations described in article 53 of the CISG: the obligation to pay the price. Although the amount of the price that the buyer must pay is usually specified in the contract, two articles in Section I contain rules governing the amount of the price in particular special circumstances: article 55 specifies a price when one is not fixed or provided for in the contract, and article 56 specifies the way to determine the price when it is 'fixed according to the weight of the goods'. The remaining four provisions in Section I relate to the manner of paying the price: they include rules on the buyer's obligation to take steps preparatory to and to comply with formalities required for paying the price (article 54); provisions on the place of payment (article 57) and the time for payment (article 58); and an article dispensing with the need for a formal demand for payment by the seller (article 59). Especially article 53 states the principal obligations of the buyer, and serves as an introduction to the provisions of Chapter III. As the CISG does not define what constitutes a 'sale of goods', article 53, in combination with article 30, also sheds light on this matter. The principal obligations of the buyer are to pay the price for and take delivery of the goods 'as required by the contract and this CISG'. From this phrase, as well as from article six of the CISG, it follows that, where the contract provides for the performance to take place in a manner that differs from that set forth in the CISG, the parties' agreement prevails.

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A Study on Awareness of the Dental Health Insurance Coverage (치과 건강보험에 관한 인식 조사)

  • Han, Ji-Hyoung;Kim, Yoon-Sin
    • Journal of dental hygiene science
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    • v.8 no.2
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    • pp.65-71
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    • 2008
  • The purpose of this study was to examine people's awareness of health insurance in a bid to help improve the management of dental health insurance coverage. The subjects in this study were 1,036 people who included experts in that field and medical consumers. The findings of the study were as follows: 1. In regard to the demographic characteristics of the expert group including gender and age, the female experts outnumbered the males, as the former accounted for 84.7 percent. And the experts in their 20s made up the largest age group, followed by the 30-39 age group and those in their 40s. As to the demographic characteristics of the medical consumers, the rates of the men and women stood at 49.8 percent and 50.2 percent respectively, which were similar. By age, the largest number of the medical consumers were in their 20s, followed by in their 30s and in their 40s. 2. Concerning opinions on the procurement of finance for health insurance, many respondents in both groups agreed that the health insurance coverage should be enlarged by securing more finance, and that items involved in the coverage should be prioritized again. Regarding a means of securing financial resources, the experts placed the most emphasis on extended budgetary support from the government, followed by establishing a social security system and budget compilation by local governments. The medical consumers attached the most importance to extended budgetary backing from the government, followed by budget compilation by local governments and determining contribution according to income level. 3. As for general view of the dental health insurance, the experts believed that the amounts of copayment and self-payment by the insured were appropriate(2.47), and they found the number of benefitted items to be proper(2.29) as well. The medical consumers thought that the benefit percentage of the dental health insurance in the overall health insurance budget was appropriate(2.26), and they also considered the number of benefitted items adequate(2.16). But this group didn't give a lot of marks to the appropriateness of those things. 4. As to perception about the dental health insurance, both groups took a similar view of it. Specifically, they felt the strong need for a dental health insurance system. In terms of satisfaction level, both groups were dissatisfied with it, and there was a strong tendency for them to be discontented with the health insurance coverage.

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The Influence of Phase Feeding Methods on Growth Performance, Meat Quality, and Production Cost in Growing-Finishing Pigs (성장단계별 사료급여 방법이 육성-비육돈의 성장과 육질 그리고 생산비에 미치는 영향)

  • Jeong, Tae-Sam;Heo, Pil-Seung;Lee, Geon-Young;Kim, Dong-Hyuk;Ju, Won-Seok;Kim, Yoo-Yong
    • Journal of Animal Science and Technology
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    • v.52 no.1
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    • pp.29-36
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    • 2010
  • This experiment was conducted to evaluate the influence of phase feeding methods on growth performance, carcass characteristics, pork quality, and economical efficiency in growing-finishing pigs. A total of 120 crossbred pigs ([Yorkshire ${\times}$ Landrace] ${\times}$ Duroc), average initial body weight 25.23 ${\pm}$ 2.66 kg, were allotted to 5 treatments by body weight and sex in a randomized complete block (RCB) design. Each treatment had 6 replicates with 4 pigs per pen. The treatments were 1) A (fed late weaner feed during whole phase), 2) B (fed late weaner feed in growing phase and grower feed in finishing phase), 3) C (fed grower feed during whole phase), 4) D (fed grower feed in growing phase and early finisher feed in early and late finishing phase), 5) E (fed grower feed in growing phase, early finisher feed in early finishing phase and late finisher feed in late finishing phase). Commercial diets bought from private feed company were used for this experiment. During the early growing phase (6 wks), treatments A and B showed higher growth performance than that of other treatments (P<0.05). However, growth performance tended to be similar among treatments at 10 wks after feeding and there was no difference in time of market weight (13 wks). Moreover, blood urea nitrogen (BUN) concentration was lowered in treatment E than other treatments during whole experimental period (P<0.01). Carcass characteristics and pork quality were measured when body weight of pigs reached at 110.33 ${\pm}$ 2.1 kg. Days to market weight (110 kg), quality grade, pork color, and pork pH did not show any significant difference among treatments. These results suggested that phase feeding based upon growth stages of pigs showed no detrimental effects on growth performance and the pork quality. Moreover, feed cost was saved approximately 37% by phase feeding method without delaying of days to market weight compared to general conventional feeding method (B) of swine farm in Korea.

A Study on Titanium Miniscrew as Orthodontic Anchorage : An experimental investigation in dogs (성견에서 교정적 고정원으로서의 티타늄 미니스크류에 대한 연구)

  • Yoon, Byung-Soo;Choi, Byung-Ho;Lee, Won-You;Kim, Kyoung-Nam;Shim, Hyung-Bo;Park, Jin-Hyung
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.517-523
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    • 2001
  • Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

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Effect of Mechanical Working System on Labor-Saving in Wheat Cultivation (밀 기계화 작업체계에 의한 노력 절감 효과)

  • Kim, Hag-Sin;Kim, Young-Jin;Kim, Kyeong-Hoon;Lee, Kwang-Won;Shin, Sang-Hyun;Cheong, Young-Keun;Park, Ki-Hoon
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.57 no.4
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    • pp.331-336
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    • 2012
  • This study was carried out to evaluate the wheat cultivation system to reduce costs and mechanize wheat production. A field study was conducted for 2 years (2009 to 2010) at the National institute of crop science, Iksan, Korea. We used working system I and working system II for the experiment. Working system I is used a multiple machine attached with a spreader tractor (seeding, fertilization, seed coverage, and weed control functionality) and working system II is used a multiple machine with a tractor which works for simultaneous job when seeding step (seeding, fertilization, and seed coverage). Sowing to harvesting operation time is 118 hours/ha for mechanize with conventional planting. Working system I is a multiple machine and a combine machine with a tractor, which worked 26 hours/ha lower than conventional planting. Working system II is 18 hours/ha lower than conventional planting. The reduced work efforts of working system I and II were 78% and 85% respectively. The growth and yield of wheat according to working system I and II is lower than conventional planting. Therefore, a multiple machine needs to study for appropriate seeding rate. Mechanization cost in consideration of the mechanical break-even point when the working system I is 3.7 ha and working system II is 4.2 ha. The farm income is enhanced by working system I (778,110 won/ha) and working system II (849,930 won/ha). The results showed that application of a multiple machine lowered costs of wheat production.

Usefulness of $^{18}F$-Fluoride PET/CT in Bone Metastasis of Prostate Cancer (전립선암 환자의 뼈 전이에 대한 $^{18}F$-Fluoride PET/CT의 유용성)

  • Park, Min-Soo;Kim, Jung-Yul;Park, Hoon-Hee;Kang, Chun-Goo;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.24-30
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    • 2009
  • Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

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A Study on Efficiently Designing Customer Rewards Programs (고객 보상프로그램의 효율적 구성에 관한 연구)

  • Kim, Sang-Cheol
    • Journal of Distribution Science
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    • v.10 no.1
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    • pp.5-10
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    • 2012
  • Currently, the rewards programs offered by many companies to strengthen customer relationships have been working quite well. In addition, many companies' rewards programs, designed for stabilizing revenue, are recognized to be effective. However, these rewards programs are not significantly differentiated between companies and there are no accurate conclusions currently, which can be made about their effects. Because of this, a company with a customer rewards program may not comprehend the true level of active participation. In this environment some companies' rewards programs inadvertently hinder business profitability as a side effect while attempting to increase customer loyalty. In fact, airline and oil companies pass on the financial cost of their programs to the customer, and as a result, they have been criticized publicly. The result of this is that the corporations with bad rewards programs tend to get a bad image. In this study of stores' rewards programs, we centered our focus on the design of the program. The main problem in this study is to recognize the financial value of the rewards program and whether it can create a competitive edge for the companies despite the cost issues experienced by them. Customers receiving financial rewards for their business may be just as satisfied with a particular company or store versus those who are not, and the program, perhaps, does not form a distinctive competitive advantage. When the customer is deciding between competing companies to secure their product needs with, we wanted to figure out how much of an affect a valuable reward program had on their decision making. To evaluate this, we set the first hypothesis as, "based on the level of involvement of the customers, there is a difference between customers' preferences for rewards programs." In the results of Experiment 1 we saw that in a financial compensation program for high-involvement groups and low-involvement groups, significant differences appeared and Hypothesis 1 was partially supported. As for the second hypothesis that "customers will have different preferences between a financial rewards programs (SE) and a joint rewards programs (JE)," the analysis showed that the preference for JE was significantly higher than that for other programs. In addition, through Experiment 2, we were able to find meaningful results, which revealed that consumers have shown a significant difference in their preferences between SE and JE. The purpose of these experiments was to enable the designing of a rewards program by learning how to enhance service information distribution and strengthen customer relationships. From the results, there should be a great amount of value for future service-related endeavors and academic research programs. The research is significant, because the results can be found to have a positive effect on reward program designs however, it does have the following limitations. First, this study was performed using an experiment, and all experiments have limitations. Second, although there was an individual evaluation and a joint evaluation, setting a proper evaluation criteria was difficult. In this study, 1,000 Korean won (KRW) in the individual evaluation had a value of 2 points, and, in the joint evaluation, 1,000 KRW had a value of 1 point. There may have been alternative ways to differentiate the evaluations to obtain the proper results. In this study, since there was no funding, the experiments were performed orally however, this was complementary to the study. Third, the subjects who participated in this experiment were students. Conducting this study through experimentation was unavoidable for us, and future research should be conducted using an actual program with the target customers.

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A Study on the Domestic Small Package Express Service′s Competitive Power Improvement Plan at EC Times (전자상거래 시대 국내 택배업의 경쟁력 향상 방안에 관한 연구)

  • 박영태;정종식
    • Proceedings of the Korean DIstribution Association Conference
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    • 2002.05a
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    • pp.31-59
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    • 2002
  • Recently there are many changes of logistics environment Such as integrated logistics information system, the rapid growth of the domestic and international small package express service and third party logistics with Electronic Commerce. At this time it is very important to deliver to customers the goods sold through EC speedy, accurately and safely. That is to say, the role of small package express service is very important at EC times. The bottlenecks of small package express service in the circumstances of EC are the weakness of EC operating company and small package express service provider the shortage of distribution centre and cargo terminal, the shortage of skilled man with related small package express service etc. So, I suggested that for activation of EC it is necessary to strengthen the strategic alliances, introduce GPS and use the third party logistics positively in the side of small package express service provider. And it is necessary to prepare for the settlements of traffic problems, support the introduction of integrated logistics service, logistics information system, deregulate restriction such as weight limit of vehicles in the side of the government. And to government support throughout extending nation's SOC, deregulation, support to small package express service terminal, permit to stopping & parking in downtown, abolishing a no passing zone, permit to being employed foreigner. Also this service involves ensuring that the product will arrive when wanted, and in an undamaged condition.

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