• 보건행정학회지
• /
• 제11권2호
• /
• pp.141-168
• /
• 2001

Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ￦35,880, evaluation/preventive cost was ￦72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

• 수산경영론집
• /
• 제22권2호
• /
• pp.75-99
• /
• 1991

A quantitative analysis was carried out to monitor the commercial yield level of walleye pollock Theragra chalcogramma in the east coast of Korea, based on available data on catch and fishing effort, catch per unit of effort including fish prices from 1911 to 1988, using a traditional yield model. The results from the quantitative assessment were based to estimate maximum economic yield (MEY) and optimal fishing effort (E-opt) at MEY. On the other hand, interaction aspects between danish seine fishery and trawl fishery mainly targeting walleye pollock in the east coast of Korea were studied to predict optimal situation in fishing effort level from economic point of view which gives the most benefits to the two fisheries. Total production of walleye pollock in 1911 when its catch record was begun for the first time was about 12, 000 metric tons(M/T), and then the catch trend maintained nearly at the level of 50, 000 M/T per annum, showing a decreasing trend until 1930. The highest production from historical data base on walleye pollock fishery statistics was from the years in 1939 and 1940, about 270, 000 M/T and 26, 000 M/T, respectively. No production of the fish species was recorded during the years from 1943 to 1947, and from 1949 to 1951. From 1952 onwards annual production was only available from the southern part of 38$^{\circ}$N in the east coast. During two decades from 1952 to 1970, the production had sustained about less than 30, 000 M/T every year. Annual production showed an increasing trend from 1971, reaching a maximum level of approximately 162, 000 M/T in 1981. Afterwards, it has deceased sharply year after year and amounted to 180, 000 M/T in 1988. The catch composition of walleye pollock for different fishery segments during 1970~1988 showed that more than 70% of the total catch was from danish seine fishery until 1977 but from 1978 onwards, the catch proportion did not differ from one another, accounting for the nearly same proportion. Catch per unit of effort (CPUE) for both danish seine fishery and trawl fishery maintained a decline tendency after 1977 when the values of CPUE were at level of 800 kg/haul for the former fishery and 1, 300 kg/haul for the latter fishery, respectively. CPUEs of gillnet fishery during 1980~1983 increased to about 3.5 times as high value as in the years, 1970~1979 and during 1987~1988 it decreased again to the level of the years, 1970~1978. The bottom longline fishery's CPUE wa at a very low level (20 kg/basket) through the whole study years, with exception of the value (60 kg/basket) in 1980. Fishing grounds of walleye pollock in the east coast of Korea showed a very limited distribution range. Danish seine fishery concentrated fishing around the coastal areas of Sokcho and Jumunjin during January~February and October~December. Distributions of fishing grounds of trawl fishery were the areas along the coastal regions in the central part of the east coast. Gillnet and bottom longline fisheries fished walleye pollock mainly in the areas of around Sokcho and Jumunjin during January~February and December. Relationship between CPUEs' values from danish seine fishery and trawl fishery was used to standardize fishing effort to apply to surplus production model for estimating maximum sustainable yield (MSY) and optimum fish effort (F-opt) at MSY. The results suggested a MSY of 114, 000 M/T with an estimated F-opt of 173, 000 hauls per year. Based on the estimates of MSY and F-opt, MEY was estimated to be about 94, 000 M/T with a range of 81, 000 to 103, 000 M/T and E-opt 100, 000 hauls per year with a range of 80, 000 to 120, 000 hauls. The estimated values of MEY and E-opt corresponded to 82% of MSY and 58% of F-opt, respectively. An optimal situation in the fishing effort level, which can envisage either simultaneously maximum yield or maximum benefit for both danish seine fishery and trawl fishery, was determined from relationship between revenue and cost of running the fleet : the optimal fishing effort of danish seine fishery was about 52, 000 hauls per year, corresponding to 50 danish seiners and 27, 000 hauls per year which is equal nearly to 36 trawlers, respectively. It was anticipated that the net income from sustainable yield estimated from the respective optimal fishing effort of the two fisheries will be about 3, 800 million won for danish seine fishery and 1, 000 million won for trawl fishery.

• 대한교통학회지
• /
• 제19권4호
• /
• pp.19-33
• /
• 2001

선진 외국과는 달리 우리나라의 경우 외부효과의 계측과 가치화에 대한 노력이 미미하여, 공학적 뿐만 아니라 경제학적 입장에 입각하여 교통소음 이라는 환경재에 대한 가치화를 대도시 도로주변 아파트가격과 실제 소음측정을 통해 본 논문에서 최초로 분석하였다. 그리고 본 논문의 목적은 자동차 소음이라는 환경재의 비시장적 가치를 시장가치로 환산하여 아파트 가격에 내재된 소음가치를 특성가격기법과 회귀분석에 의해 추정하는 것이었다. 즉 소음수준에 따라서 아파트 매매가격에 영향을 미치는 정도가 다르므로 소음차이로 인한 아파트 매매가격에 내재된 한계소음가격 도출이 가능하였다. 구체적으로는 평형대별 한계소음가격을 도출함으로써 소음 IdB(A)의 증가(혹은 감소)가 주택가격에 미치는 영향의 정도를 분석하였다. 본 논문에서 도출된 결과를 정리해 보면, 먼저 대도시권의 교통소음이 아파트 가격에 내재된 가치를 추정하기위해 $\ulcorner$준-특성가격기법$\lrcorner$을 이용하였으며, 자료의 한계를 극복하기 위하여 소음변수를 제외한 다른 요인에 의한 주택가격 차이를 제거할 수 있는 표본을 선정하고, 선정된 표본집단의 소음수준을 측정한 자료를 활용하여 소음에 의한 주택가격의 한계소음가치를 측정하였다. 선형, 준로그, 역준로그, 이중로그 회귀모형식을 이용하여 소음수준에 따른 주택가격 차이를 분석하였으며, 그 중에서도 이중로그 함수식이 가장 적합성이 뛰어난 모형으로 나타났다. 한계소음가격은 대상지역과 주택의 평수에 따라 상당히 다른 것으로 분석되었다 즉, 서울시 지역의 소음가격은 경기도 지역보다 높은 것으로 나타났다. 또한, 큰 평수의 주택이 적은 평수의 주택보다 소음가격이 높은 것으로 나타났다. 한편, 서울시와 경기도에 있어서 소음 IdB증가가 주택가격에 미치는 영향은 서울시 주택가격이 경기도 주택가격에 비해 거의 3배나 되기 때문에 이들 두 지역에서의 소음 IdB증가가 주택가격에 미치는 영향에는 별 차이가 없었다. 즉, 서울시와 경기도의 소음 IdB증가가 주택가격에 미치는 영향은 평균 0.3%로 추정되었으며, 평형대별로는 규모가 큰 평수일수록 소음 IdB증가가 주택가격에 미치는 영향은 높은 것으로 분석되었다. 이상의 연구결과를 통해 볼 때 본 논문에서 도출된 교통소음의 가치를 교통시설의 타당성 평가에 적용할 수 있을 것으로 판단된다.

• Radiation Oncology Journal
• /
• 제10권2호
• /
• pp.213-217
• /
• 1992

국소적으로 진행된 자궁경부암(종괴크기가 5 cm이상혹은 FIGO병기 III, IV) 환자에 있어 방사선 치료 단독으로 근치적치료를 시행한 경우 골반내에서 약 50$\%$까지의 높은 재발율이 보고되고 있다. 따라서 이들 환자에 있어서 국소관해율 및 생존율을 증가 시키기 위하여 본 연구에서는 방사선 민감제로서 가장 효과적인 약제로 알려진 cisplatin을 방사선치료와 동시에 투여하는 방사선-화학요법을 시행하였다. 1988년 5월부터 1991년 9월까지 인제대학교 부속 서울백병원치료방사선과에서 자궁경부암으로 진단된 환자중 국소적으로 진행된(FIGO병기 III, IV, 종괴크기가 5 cm이상의 IIb) 환자로서 방사선치료와 cispiatin의 동시병행요법이 시행되었던 12명을 대 상으로 후향적 임상분석을 하였다. 12명의 환자에 대한 치료는 골반부위에 5000 cGy이상 (4980-6480 cGy)의 외부방사선치료및 1회이상의 강내치료가 시행되었고 동시에 cisplatin 50 mg을 1주 간격으로 반복투여하였다. 총 투여횟수는 $3\~7$회로 평균 5회였다. 추적기간은 $3\~53$개월 (중앙값 34개월) 이며, 연령 분포는 $26\~69$세(중앙값 54세) 였다. 병기별 분포는 IIb, III, IV가 각각 5, 3, 4명 이었다. 조직학적 분류상 편평상피세포암이 11명 이었다. 11명의 관찰대상중 완전관해는 7명 ($64\%$), 부분관해는 4명 ($35\%$)에서 이루어졌다. 7명의 완전관해중 6명이 무병상태였다. 관찰종로시의 전체국소관해율은 $73\%$로서 완전관해군은 $100\%$, 부분관해군은 $25\%$,에서 국소관해를 보였다. 병기별 생존분포를 보면 FIGO병기 IIb, III, IV에서 각각 4/4, 2/3, l/3 이었으며 5년생존율은 $61\%$이었다. 사망자는 4명으로 이중 3명은 일차적인 질병으로, 1명은 패혈증으로 사망하였다. 재발환자는 3명으로 국소재발이 1명, 원격전이가 1명, 국소재발과 원격전이가 1명 이었다. 병합치료에 의한 독성을 살펴보면 오심증상이 3명, 식욕부진이 4명, 백혈구감소증이 4명, 그리고 혈소판감소증이 1명에서 관찰되었다. 다른 1명은 치료종료후 패혈증으로 사망하였다. 그 외의 혈액적독성, 신독성의 증상을 나타낸 경우는 없어 cisplatin 추가에 의한 독성은 경미한 것으로 나타났다. 국소적으로 진행된 자궁경부암 환자에서 방사선-화학요법을 동시 병행할 경우 국소관해율이 $100\%$(완전관해율이 $64\%$)이었고 골반내 재발율은 $27\%$, 이었으며 cisplatin추가로 인한 독성은 경미하였다. 이는 대조군과 비교할때 보다 나은 성적으로 예비결과이기는 하나 국소적으로 진행된 자궁경부암환자에서 방사선치료와 cisplatin 동시 병행요법이 국소관해율을 향상시킬 수 있을 것으로 기대된다.

• 한국대기환경학회지
• /
• 제33권4호
• /
• pp.377-392
• /
• 2017

A set of BFM (Brute Force Method) simulations with the CMAQ (Community Multiscale Air Quality) model were conducted in order to estimate self-contributions and conversion rates of PPM (Primary $PM_{2.5}$), $NO_x$, $SO_2$, $NH_3$, and VOC emissions to $PM_{2.5}$ concentrations over the SMA (Seoul Metropolitan Area). CAPSS (Clean Air Policy Support System) 2013 EI (emissions inventory) from the NIER (National Institute of Environmental Research) was used for the base and sensitivity simulations. SCCs (Source Classification Codes) in the EI were utilized to group the emissions into area, mobile, and point source categories. PPM and $PM_{2.5}$ precursor emissions from each source category were reduced by 50%. In turn, air quality was simulated with CMAQ during January, April, July, and October in 2014 for the BFM runs. In this study, seasonal variations of SMA $PM_{2.5}$ self-sensitivities to PPM, $SO_2$, and $NH_3$ emissions can be observed even when the seasonal emission rates are almost identical. For example, when the mobile PPM emissions from the SMA were 634 TPM (Tons Per Month) and 603 TPM in January and July, self-contributions of the emissions to monthly mean $PM_{2.5}$ were $2.7{\mu}g/m^3$ and $1.3{\mu}g/m^3$ for the months, respectively. Similarly, while $NH_3$ emissions from area sources were 4,169 TPM and 3,951 TPM in January and July, the self-contributions to monthly mean $PM_{2.5}$ for the months were $2.0{\mu}g/m^3$ and $4.4{\mu}g/m^3$, respectively. Meanwhile, emission-to-$PM_{2.5}$ conversion rates of precursors vary among source categories. For instance, the annual mean conversion rates of the SMA mobile, area, and point sources were 19.3, 10.8, and $6.6{\mu}g/m^3/10^6TPY$ for $SO_2$ emissions while those rates for PPM emissions were 268.6, 207.7, and 181.5 (${\mu}g/m^3/10^6TPY$), respectively, over the region. The results demonstrate that SMA $PM_{2.5}$ responses to the same amount of reduction in precursor emissions differ for source categories and in time (e.g. seasons), which is important when the cost-benefit analysis is conducted during air quality improvement planning. On the other hand, annual mean $PM_{2.5}$ sensitivities to the SMA $NO_x$ emissions remains still negative even after a 50% reduction in emission category which implies that more aggressive $NO_x$ reductions are required for the SMA to overcome '$NO_x$ disbenefit' under the base condition.