• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.337-365
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• 1994

Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

• Korean Journal of Occupational Health Nursing
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• v.4
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• pp.5-29
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• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Korean Society of Forest Science
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• v.85 no.2
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• pp.158-171
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• 1996

In Korea, 80,616 ha in 139 places have been designated as recreation forests by the end of 1994. Among these places, 64,547 ha in 76 places were designated in the national forest, 9,937 ha in 25 places were designated in the public forest, and 6,132 ha in 38 places were designated in private forest. Designs of 10 places and plans of 6 places in 14 places of recreation forest in Chonbuk province were compared and analyzed. The results are as follows: 1. Sixty four types of convenient facilities, 15 types of athletic facilities, 13 types of sanitation facilities, 22 types of education facilities were designed in 10 places of the recreation forest. 2. The material cost was the highest in construction costs in Waryong recreation forest. However, the labor cost was the highest one in construction costs in 5 places of recreation forest ; Dokyu-san, Hoimoon-san, Saesim, Seongsu, and Sokgeum-san And the total construction cost was much higher in private recreation forest than in both of national and public recreation forest. 3. Hoimoon-san was the only recreation forest which makes profit among 14 recreation forests in Chonbuk province. The uses of this recreation forest are increasing, and seasonal uses significantly fluctuate. 4. There are several problems for the public in enjoying these recreation forest places. The access to these places by public transportations is inconvenient. The time required for construction of many places are too long after they are designated as recreation forest, and the management of the established recreation forest is poor. 5. To improve the method of facility design in recreation forest, easy access to nature should be promoted such as recreation forest places and understanding of public concerning nature are needed. Recreation forest places themselves need to offer good facilities, and convenient access. And to make frequent use of recreation forest places, a system of information and excellent service to the public are strongly recommended.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Journal of Korea Technology Innovation Society
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• v.12 no.4
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• pp.788-818
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• 2009

Renewable energy refers to solar energy, biomass energy, hydrogen energy, wind power, fuel cell, coal liquefaction and vaporization, marine energy, waste energy, and liquidity fuel made out of byproduct of geothermal heat, hydrogen and coal; it excludes energy based on coal, oil, nuclear energy and natural gas. Developed countries have recognized the importance of these energies and thus have set the mid to long term plans to develop and commercialize the technology and supported them with drastic political and financial measures. Considering the growing recognition to the field, it is necessary to analysis up-to-now achievement of the government's related projects, in the standards of type of renewable energy, management of sectional goals, and its commercialization. Korean government is chiefly following suit the USA and British policies of developing and distributing renewable energy. However, unlike Japan which is in the lead role in solar rays industry, it still lacks in state-directed support, participation of enterprises and social recognition. The research regarding renewable energy has mainly examinedthe state of supply of each technology and suitability of specific region for applying the technology. The evaluation shows that the research has been focused on supply and demand of renewable as well as general energy and solution for the enhancement of supply capacity in certain area. However, in-depth study for commercialization and the increase of capacity in industry followed by development of the technology is still inadequate. 'Cost-benefit model for each energy source' is used in analysis of technology development of renewable energy and quantitative and macro economical effects of its commercialization in order to foresee following expand in related industries and increase in added value. First, Investment on the renewable energy technology development is in direct proportion both to the product and growth, but product shows slightly higher index under the same amount of R&D investment than growth. It indicates that advance in technology greatly influences the final product, the energy growth. Moreover, while R&D investment on renewable energy product as well as the government funds included in the investment have proportionate influence on the renewable energy growth, private investment in the total amount invested has reciprocal influence. This statistic shows that research and development is mainly driven by government funds rather than private investment. Finally, while R&D investment on renewable energy growth affects proportionately, government funds and private investment shows no direct relations, which indicates that the effects of research and development on renewable energy do not affect government funds or private investment. All of the results signify that although it is important to have government policy in technology development and commercialization, private investment and active participation of enterprises are the key to the success in the industry.

• International Journal of Highway Engineering
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• v.9 no.4
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• pp.33-43
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• 2007

Because usually signal controllers on the crosswalks of mid-block provide pedestrian signals every cycle based on the fixed signal plan, pedestrian signals are provided even when there is no pedestrian demand. Consequently, signal is operated inefficiently and this may cause drivels to experience useless delay or violate the signal. Even though recently pushbuttons have been installed to improve the efficiency of pedestrian signal control in the crosswalks of mid-block and the pedestrian safety. they are not spread out national-wide in Korea because of the cost of the pushbutton equipments and the lack of an acknowledgement of the efficiency of the pushbutton. In this study, the effectiveness of the pushbutton on saving the vehicle delay was verified through before and after study in 4 study sites using a traffic micro-simulation model, VISSIM. To evaluate the viability of the pushbutton, a benefit/cost analysis was also performed for 4 study sites. It was found that B/C ratio of all of 4 study sites was greater than 1. The sensitivity analysis for the traffic volume and pedestrian volume were performed to identify the impact of the both volume on the operation of pushbutton. And, a benefit/cost analysis was performed for all scenarios. It was found that when the pedestrian volume is greater than 90ped/h, the pedestrian signal was operated same as the fixed signal plan. That is, there is no benefit of pushbutton at all once the pedestrian volume is greater than 90ped/h. When the pedestrian volume is equal to or less than 90ped/h and the traffic volume is greater than 2,500veh/h, B/C ratio is greater than 1. Also it was found that as traffic volume increases and pedestrian volume decreases, the benefit increases. In this study, the criteria for installation of pushbutton on the crosswalks of mid-block are developed through the sensitivity analysis and benefit/cost analysis. The results of this study may be used as a criteria for expansion of pushbutton system.

• Journal of Korean Society of Transportation
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• v.20 no.7
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• pp.15-22
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• 2002

Transportation project appraisal should be precise in order to increase the social welfare and efficiency, and it has been evaluated by only a single criterion analysis such as benefit/cost analysis. However, this method cannot assess some qualitative items, and cannot get a proper solution for the clash of interests among various groups. Therefore, the multi-criteria analysis, which can control these problems, is needed, and then Saaty has developed one of these methods, AHP(Analytic Hierarchy Process) method. In AHP, the project is evaluated through weighted score of the criteria and the alternatives, which is surveyed by a questionnaire of specialists. It is based on some strict suppositions such as reciprocal comparison, homogeneity, expectation, independence relationship between multi-criteria, but supposing that each criterion has independence relation with others is too difficult in two reasons. First, in real situation, there cannot be perfect independence relationship between standards. Second, individuals, even though they are specialists of that area, do not feel the degree of independence relation as same as others. This paper develops a modified AHP method for solving this dependence relationship between multi-criteria. First of all. in this method, the degree of dependence relationship between multi-criteria that the specialist feels is surveyed and included to the weighted score of multi-criteria This study supposes three methods to implement this idea. The first model products the degree of dependence relationship in the first step for calculating the weighted score, and the others adjust the result of weighted score from the basic AHP method to the dependence relationship. One of the second methods distributes the cross weighted score to each standard by constant ratio, and the other splits them using Fuzzy measure such as Bel and Pl. Finally, in order to validate these methods, this paper applies them to evaluate the alternatives which can control public resentments against Korean rail path in a city area.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.20 no.2
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• pp.55-62
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• 2020

A 22-month-old girl who had taken iron supplements due to iron deficiency anemia, presented bloody mucoid stool for one month. She had a bruise at the right periorbital area due to minor trauma and hepatosplenomegaly. Laboratory studies showed anemia, thrombocytopenia, elevated alkaline phosphatase (ALP), hypophosphatemia, decreased haptoglobin, hypocomplementemia, negative direct/indirect Coomb's test, normal vitamin D3 level and high PTHi. Wrist x-ray showed no signs of rickets. The abdominal ultrasound showed only accessory spleen. Tandem mass spectrometry was normal. During follow up, bloody stool regressed after seven days of withdrawal of iron supplement and cow milk, and the total CO2 level had been within 15-20 mEq/L with normal anion gap. NGS (next generation sequencing) panel test for evaluation of renal tubular acidosis showed negative results. After low dose steroid and vitamin D supplements under the impression of hypocomplementemic vasculitis, thrombocytopenia, C3/C4, decreased haptoglobin, and elevated ALP level became normal. At 57 months of age, laboratory findings showed elevated liver enzyme, ALP and gamma-glutamyl transferase again. And liver cirrhosis with splenomegaly and diffuse renal disease were reported with abdomen CT scan. Liver biopsy reported macro- and micronodular cirrhosis. Urine organic acid profile showed elevated succinylacetone level. Whole exome sequencing revealed novel compound heterozygous mutations (NM_00137.2:c.107T>C, NM_00137, 2:c.614T>C) in FAH gene and confirmed by Sanger sequencing. Consequently, the patient was diagnosed as chronic hereditary tyrosinemia type I. She started low phenylalanine/tyrosine diet and nitisinone treatment. Our case had presented symptoms very slowly, which is the first case of chronic tyrosinemia type I in South Korea.

• Journal of Preventive Medicine and Public Health
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• v.28 no.4 s.51
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• pp.809-844
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• 1995

The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (1) Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows ; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3 parts, that is , occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was sightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of Occupational Medicine(18.2%), Several Kinds of Medical Colloge Journal(17.0%), The Korean Journal Occupational Health(15.1%), The Korean Journal of Preventive Medicine(15.1%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(18.2%), occupational organization 3(9.1%) and occupational health delivery system 1 (3.0%). Of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was 185(71.1%), followed by women worker, white coiler workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (1) Study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.