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A Study on the cost allocation method of the operating room in the hospital (수술실의 원가배부기준 설정연구)

  • Kim, Hwi-Jung;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.135-164
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    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

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Application of SP Monitoring in the Pohang Geothermal Field (포항 지열 개발지역에서의 SP 장기 관측)

  • Lim Seong Keun;Lee Tae Jong;Song Yoonho;Song Sung-Ho;Yasukawa Kasumi;Cho Byong Wook;Song Young Soo
    • Geophysics and Geophysical Exploration
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    • v.7 no.3
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    • pp.164-173
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    • 2004
  • To delineate geothermal water movement at the Pohang geothermal development site, Self-Potential (SP) survey and monitoring were carried out during pumping tests. Before drilling, background SP data have been gathered to figure out overall potential distribution of the site. The pumping test was performed in two separate periods: 24 hours in December 2003 and 72 hours in March 2004. SP monitoring started several days before the pumping tests with a 128-channel automatic recording system. The background SP survey showed a clear positive anomaly at the northern part of the boreholes, which may be interpreted as an up-flow Bone of the deep geothermal water due to electrokinetic potential generated by hydrothermal circulation. The first and second SP monitoring during the pumping tests performed to figure out the fluid flow in the geothermal reservoir but it was not easy to see clear variations of SP due to pumping and pumping stop. Since the area is covered by some 360 m-thick tertiary sediments with very low electrical resistivity (less than 10 ohm-m), the electrokinetic potential due to deep groundwater flow resulted in being seriously attenuated on the surface. However, when we compared the variation of SP with that of groundwater level and temperature of pumping water, we could identify some areas responsible to the pumping. Dominant SP changes are observed in the south-west part of the boreholes during both the preliminary and long-term pumping periods, where 3-D magnetotelluric survey showed low-resistivity anomaly at the depth of $600m\~1,000m$. Overall analysis suggests that there exist hydraulic connection through the southwestern part to the pumping well.

An Effective Block of Radioactive Gases for the Storage During the Synthesis of Radiopharmaceutical (방사성의약품 합성에서 발생하는 방사성기체의 효율적 차단)

  • Chi, Yong Gi;Kim, Dong Il;Kim, Si Hwal;Won, Moon Hee;Choe, Seong-Uk;Choi, Choon Ki;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.126-130
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    • 2012
  • Purpose : Methode an effective block was investigated to deal with volatile radioactive gas, short lived radioactive waste generated as a result of the routinely produced radiopharmaceuticals FDG (2-deoxy-2-[$^{18}F$]fluoro-D-glucose) and compound with $^{11}C$. Materials and Methods : All components of the radiation stack monitoring and data management system for continuous radioactive gas detection in the air extract system purchase from fixed noble gas monitor of Berthold company. TEDLAR gas sampling bags purchase from the Dongbanghitech company. TEDLAR gas sampling bags (volume: 10 L) connected via paraflex or PTFE tubing and Teflon 3 way stopcock. When installing TEDLAR gas sampling bags in Hot cell on the inside and not radioactive gas concentrations were compared. According to whether the Hot cell inside a activated carbon filter installed, compare the difference in concentration of the radioactive gas $^{18}F$. Comparison of radiation emission concentration difference of module a FASTlab and TRACElab. Results : Activated carbon filter are installed in the Hot cell, a measure of the concentration of radioactive gas was 8 $Bq/m^3$. Without activated carbone filter in the hot cell was 300 $Bq/m^3$. Tedlar bag prior to installation of the radioactive gases a measure of the concentration was 3,500 $Bq/m^3$, $^{11}C$ synthesis of the measured concentration was 27,000 $Bq/m^3$. After installed a Tedlar bag and a measure concentration of the radioactive gases was 300 $Bq/m^3$ and $^{11}C$ synthesis was 1,000$Bq/m^3$. Conclusion : $^{11}C$ radioactive gas that was ejected out of the Hot cell, with the use of a Tedlar gas sampling bag stored inside. A compound of 11C is not absorbed onto activated carbon filter. But can block the release out by storing in a Tedlar gas sampling bag. We was able to reduce the radiation exposure of the worker by efficient radiation protection.

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Estimation of Agricultural Water Quality Using Classification Maps of Water Chemical components in Seonakdong River Watershed (수질성분 분포도를 이용한 서낙동강 수계 농업용수 수질평가)

  • Ko, Jee-Yeon;Lee, Jae-Sang;Kim, Choon-Song;Jeong, Ki-Yeol;Choi, Young-Dae;Yun, Eul-Soo;Park, Seong-Tae;Kang, Hwang-Won;Kim, Bok-Jin
    • Korean Journal of Environmental Agriculture
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    • v.25 no.2
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    • pp.138-146
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    • 2006
  • To understand the status of water quality and work out a suitable countermeasures in Seonakdong watershed which has poor agro- environmental condition because of severe point and non-point source pollution by popularized city and near sea, we investigated the pollution sources and water quality from '03 and '05 and the result were mapped with GIS and RS for end-users's convenient comprehense and conjunction of water quality and geological data. The most degraded tributary was Hogeo stream which was affected directly by highly popularized Gimhae city, the main pollution source of the watershed. The pollution of tributaries in watershed increased the T-N of main body that reached over 4 mg/L during dry season. Pyeonggang stream and the lower part of main water way were suffered from high salt contents induced near sea and the EC value of those area were increased to 2.25 dS/m. The delivered loads of T-N and T-P were largest in Joman river as 56% and 61% of total delivered loads 1mm tributaries because of lots of stream flow. When Management mandate for irrigation water in Seonakdong river watershed was mapped for estimating integrated water quality as the basis of classification of EC and T-N contents in water, Hogeo and Shineo catchments were showed the requiring countermeasures none against nutrients hazard and Pyeonggang catchment was the vulnerable zone against nutrients and salts hazard. As the result, Seonakdong watershed had very various status of water quality by characteristics of catchments and countermeasures for improving water quality and crop productivity safely should changed depend on that.

INFLUENCE OF IRRADIATION MODES ON THE MICROHARDNESS AND THE POLYMERIZATION CONTRACTION OF COMPOSITE RESIN POLYMERIZED WITH LED CURING UNIT (LED 광중합기의 조사 mode가 복합레진의 미세경도 및 수축응력에 미치는 영향)

  • Park, In-Ho;Oh, You-Hyang;Lee, Nan-Young;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.312-320
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    • 2005
  • The purpose of this study was to evaluate the polymerization contraction and the microhardness of compostie resin($Supreme^{(R)}$, Filtek $Flow^{(R)}$, 3M-ESPE, USA) according to irradiation modes of LED curing unit(Elipar $Freelight^{(R)}$, 3M-ESPE, USA). The strain guage method was used for determination of polymerization contraction. Sample were divided by 6 groups according to curing modes and filling method. Group A: $Supreme^{(R)}$, Filtek $Flow^{(R)}$ lining, 10seconds curing, Group B: $Supreme^{(R)}$, Filtek $Flow^{(R)}$ lining, 15seconds curing, Group C: $Supreme^{(R)}$, Filtek $Flow^{(R)}$ lining, 15seconds soft start curing, Group D: $Supreme^{(R)}$ only, 10seconds curing, Group E: $Supreme^{(R)}$ only, 15seconds curing, Group F: $Supreme^{(R)}$ only, 15seconds soft start curing. Preparations of acrylic molds were followed by filling and curing. Strain guage attached to each sample were connected to a strainmeter. Measurements were recorded at each second for the total of 10 minutes including the periods of light application. And microhardness of each group after 24hours from light irradiation were measured. Obtained data were analyzed statistically using Repeated measures ANOVA and Tukey test. The results of the present study are as follows: 1. In flowable resin liner group, soft start curing group was not found decrease of polymerization contraction. But, In Supreme only filling group, the lowest polymeriation contraction was found in soft start curing group. 2. 10 seconds curing group showed statistically significant reduction of polymerization contraction compared with 15 seconds curing group(p<0.05). 3. The microhardness values of each group not revealed significant difference(p>0.05). But, lower surface microhardness was not reached 80% of upper surface microhardness.

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Effect of Chitosan-Trimer on the Prevention of Postoperative Intraperitoneal Adhesion Formation in Rats (랫트에서 Chitosan-Trimer가 복강유착에 미치는 영향)

  • Kwon, Eun-ju;Jang, Kwang-ho;Jang, In-ho
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.257-264
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    • 2001
  • This study was performed to investigate the effects of chitosan-trimer (CT) on the prevention of postoperative adhesion formation in the rate model. All animals divided into PBS (control), 1% CT, 3% CT, and chitin treated group. The mean adhesion score in 1% CT group (1.03$\pm$0.63), 3% CT group (0.64$\pm$0.53) and chitin group (1.67$\pm$0.71) was found to be lower than that in control group (2.07$\pm$0.81). More favorable adhesion prevention was achieved in 3% CT group (0.64$\pm$0.53) in comparison with the control group, 1% CT group, and chitin group without any hemorrhagic complications. A statistically significant difference was observed in adhesion formation between control group and 3% CT group (p<0.001). In control group, 44 of 45 sites (97.7%) formed adhesions between the intestine defects. In contrast, 3% CT was effective in reducing the incidence of adhesion formation to 17 to 45 sites (62.2%) (p<0.05). The locations of adhesions were observed in serosa-serosa (60%), serosa-mesentery (13.3%), serosa-connective tissue of testis (10%), omentum-liver (10%), serosa-omentum (3.3%), serosa-cecum (3.3%), and serosa-incision (0%). On the results of histological analysis, grade of inflammation and fibrosis at the sites of postoperative peritoneal adhesion formation were not significantly different in all groups. But, 3% CT showed the lowest score of inflammation and fibrosis. In 3% CT group, the rate of increase of plasma fibrinogen was significantly lower compared with that in control group from pre-operation to 10 days later (p<0.05). There were no appreciable difference in the CBC, leukocyte differential counts and total protein concentrations among four groups. In conclusion, our data suggested that CT should be effective on reducing adhesion formation in experimental rat models. The results also showed that 3% CT does not adversely affect normal wound healing and healthy recovery after operation.

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Estimating the Carrying Capacity of a Coastal Bay for Oyster Culture -II. The Carrying Capacity of Geoie-Hansan Bay- (굴 양식수역의 환경용량 산정 -II. 거제 · 한산만의 환경용량-)

  • Park Jong Soo;Kim Hyung Chul;Choi Woo Jeung;Lee Won Chan;Kim Dong Myung;Koo Jun Ho;Park Chung Kil
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.35 no.4
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    • pp.408-416
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    • 2002
  • A 3D hydrodynamic-ecological coupled model was applied to estimate carrying capacity in Geoje-Hansan Bay where is one of the most important oyster culturing grounds in Korea. We considered the carrying capacity as the difference between food supply to the oysters and food demand, considering monthly difference of the actual growth. The food supply to the system was determined from the results of the model simulation (tidal exchange and chlorophyll $\alpha$) over the culturing period from September to May of the following year. The food demand was estimated from the food concentration (chlorophyll $\alpha$) multiple the filtration rate of oysters that is considered monthly different growth rate of oysters and food concentration. The values of carrying capacity for the system varied from 6.1 ton/ha (minimum carrying capacity) in february to 14.91 ton/ha (maximum carrying capacity) in April of marketable size oysters (>4 g wet-tissue weight) depending on temporal variations in the food supply. The oyster production calculated from present facilities was 9 ton/ha in wet-tissue weight in Geoje-Hansan Bay. This value corresponded to $60\%$ of maximum carrying capacity of the system. The optimal carrying capacity without negatively affecting on oyster production was 5.5 ton/ha when calculated from annual statistic data and 6.1 ton/ha when determined by this study. These results suggest that it must be reduced $32\%$~$39\%$ of oyster facilities in the system.

Residual Consistency and Interrelationship Estimation of PCDDs, PCDFs, Dioxin-like PCBs in Colostrum of Primipara and Multipara (초산부, 경산부 초유 중 PCDDs, PCDFs, dioxin-like PCBs의 축적수준 및 상관성 평가)

  • We, Sung-Ug;Kim, Ki-Ho;Cho, Yu-Jin;Cho, Bong-Hui;Park, Sang-Ah;Baek, In-Cheon;Kang, Seong-Hoon;Yoon, Cho-Hee;Min, Byung-Yoon
    • Journal of Life Science
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    • v.20 no.7
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    • pp.1078-1085
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    • 2010
  • Polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) are bioaccumulative chemicals that are considered to be toxic contaminants based on several epidemiological studies. These chemicals in colostrum were investigated and estimated for their residual consistencies by maternal characteristics like parity and maternal ages. Test subjects were healthy primipara and multipara mothers with a mean age of 31.5 (S.D=3.6) in 2007. Seven isomers of PCDDs, 10 of PCDFs, 4 of non-orthopolychlorinated biphenyls(non-ortho PCBs) and 8 of mono-orthochlorinated polychlorinated biphenyls (mono-ortho PCBs) were analyzed by HRGC/HRMS. From the analyzed data, the mean level of total WHO-TEQs was 9.41 pg TEQ/g lipid, which is significantly lower than the level found in individuals from other countries. The main contributors to the total WHO-TEQs with increasing percentages were 2,3,4,7,8-PeCDF, 1,2,3,7,8-PeCDD and 3,3',4,4',5-PCB (#126), and they accounted for more than 60% of the total WHO-TEQs. PCDFs concentrations and total WHO-TEQs were negatively associated with parity (p<0.05), and maternal age was positively associated with total WHO-TEQs (p<0.01). However, the associations with body mass index (BMI) and fish intake during pregnancy were not significant. These results were suggested that parity and maternal age are an important factor affecting the concentrations of PCDD/DFs and dl-PCBs in these specimens.

Effects of Different Grazing Types of Hilly Pasture on Growth and Meat Quality in Organic Korean Black Goats (산지초지를 이용한 방목유형별이 유기흑염소의 발육과 육질에 미치는 영향)

  • HwangBo, S.;Choi, S.H.;Kim, S.W.;Son, D.S.;Jeon, B.S.;Lee, S.H.;Jo, I.H.
    • Korean Journal of Organic Agriculture
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    • v.16 no.3
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    • pp.309-320
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    • 2008
  • This study was conducted to determine the effects of different types of hilly pasture grazing on growth and meat quality in organic Korean black goats, and to obtain basic data for the production of organic goats. A total of 40 goats with similar age and BW were equally allocated to four dietary treatments in a randomized complete block design. Dietary treatments included grazing types of four different hilly pastures; T1: forages types, T2: organic forages types, T3: native plants types, and T4: browse types, respectively. The trial lasted for 174 days from 15th of May to 5th of November, 2007 in Livestock Genetic Resources Experiment Station, National Institute of Animal Sciences. At the end of trial, all animals were slaughtered to analyze carcass characteristics and meat quality. Average daily gain was significantly (p<0.05) higher for T1 treatments than for others. Dressing percentage was significantly (p<0.05) higher for T1 and T2 than for T3 and T4 treatments. Meat percentage of T1 treatments was significantly (p<0.05) higher than those of other treatments. For meat properties, crude fat content was highest in T3 treatments. Linoleate (18:2n6) and linolenate (18:3n3) contents tended to be higher in T1 than those of other treatments, while arachidonate (20:4n6) content tended to be higher in T3 and T4 than that of other treatments. Shear force was lower (p<0.05) for T3 than other treatments. For sensory results, juiciness and tenderness tended to be greater (p<0.05) in T2 and T3, and flavour tended to be greater (p<0.05) in T3 and T4. The results indicated that grazing in hilly pastures for organic Korean black goats was somewhat less in their performances and carcass characteristics, but not behind in the meat quality and physical characteristics as compared with the conventional regimen. Therefore, it would be expected that goats grazing in hilly pastures made it possible to produce organic animal products with a high safety and also might lead to increase of breeders income and consumers satisfaction.

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Predicting Forest Gross Primary Production Using Machine Learning Algorithms (머신러닝 기법의 산림 총일차생산성 예측 모델 비교)

  • Lee, Bora;Jang, Keunchang;Kim, Eunsook;Kang, Minseok;Chun, Jung-Hwa;Lim, Jong-Hwan
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.1
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    • pp.29-41
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    • 2019
  • Terrestrial Gross Primary Production (GPP) is the largest global carbon flux, and forest ecosystems are important because of the ability to store much more significant amounts of carbon than other terrestrial ecosystems. There have been several attempts to estimate GPP using mechanism-based models. However, mechanism-based models including biological, chemical, and physical processes are limited due to a lack of flexibility in predicting non-stationary ecological processes, which are caused by a local and global change. Instead mechanism-free methods are strongly recommended to estimate nonlinear dynamics that occur in nature like GPP. Therefore, we used the mechanism-free machine learning techniques to estimate the daily GPP. In this study, support vector machine (SVM), random forest (RF) and artificial neural network (ANN) were used and compared with the traditional multiple linear regression model (LM). MODIS products and meteorological parameters from eddy covariance data were employed to train the machine learning and LM models from 2006 to 2013. GPP prediction models were compared with daily GPP from eddy covariance measurement in a deciduous forest in South Korea in 2014 and 2015. Statistical analysis including correlation coefficient (R), root mean square error (RMSE) and mean squared error (MSE) were used to evaluate the performance of models. In general, the models from machine-learning algorithms (R = 0.85 - 0.93, MSE = 1.00 - 2.05, p < 0.001) showed better performance than linear regression model (R = 0.82 - 0.92, MSE = 1.24 - 2.45, p < 0.001). These results provide insight into high predictability and the possibility of expansion through the use of the mechanism-free machine-learning models and remote sensing for predicting non-stationary ecological processes such as seasonal GPP.