• Title/Summary/Keyword: Case-mix

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A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System (의료전달체계 실시 전후의 3차 진료기관 외래환자 이용양상 비교)

  • Lee, Kyeong-Soo;Kim, Chang-Yoon;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.88-100
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    • 1992
  • This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

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A Case Study on Application of the Menu Engineering Technique in Government Offices Contract Foodservice (관공서급식소의 메뉴엔지니어링기법을 적용한 메뉴분석 사례연구)

  • Rho, Sung-Yoon
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.78-96
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    • 2009
  • The purpose of this study was to analyze and evaluate the menu served in government offices foodservice by using Kasavana & Smith's Menu-Engineering. Sales and food costs were collected from the daily sales reports for a year from Jan 2 to Dec 31 in 2007. Calculation for menu analysis and customer's data were done by computer using the MS 2003 Excel spreadsheet program and SPSS 12.0 package program. Menu mix% (MM%) and unit contribution margin were used as variables by Kasavana & Smith. Four possible classifications by Menu-Engineering technique were turned out as 'STAR', 'PLOWHORSE', 'PUZZLE', 'DOG'. The main menus served during a year were 128 dishes and about 141 peoples visited this restaurant daily. The mean age of the men was $44.1\;{\pm}\;6.3$, women were $32.7\;{\pm}\;6.4$ and showed that was statistically higher than that of women (p < .0001). The rates of STAR menus were 'Western style (75.0%)', 'guk/tang-ryu (48.1%)', 'jjigae/ jeongol-ryu (23.1%)', 'bap-ryu (17.2%)' in sequence. There were no STAR menus in gui/jorim/jjim-ryu. PLOWHORSE menus were 'gui-ryu (75.0%)', 'guk/tang-ryu (29.6%)', 'bap-ryu (27.6%)' in sequence. There were no PUZZLE or DOG menus in 'jjigae/jeongol-ryu'. PUZZLE menus were 'jorim/jjim-ryu and Myeonryu (each 33.3%)', 'bap-ryu (31.0%)' in sequence. PUZZLE menus were a lots of 'Chinese food (75.0%)' and 'myeonryu (55.6%)'. This study provides the basic data based on regularly menu analysis method applied the scientific menu analysis techniques in government offices food services, I'd like to suggest that the menu management must be done based on the necessity and result of menu analysis according to the seasonal and middle, long-term plans.

Studies on Electrostatic Propensity of Fabrics (직물대전성에 관한 연구)

  • 최병희;배도규
    • Journal of Sericultural and Entomological Science
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    • v.27 no.2
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    • pp.54-63
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    • 1985
  • This studies has been carried out how to effect on electrostafic propensity of synthetic fabrics by coating with 0.5% acrylic polymer solution which was previously developed by the author to improve anticrease nature of silk. The work conditions are: (A) Applied synthetic polymer was acrylic polymer 525, developed by the author. (B) Electrostatic voltage for various fabrics were carried out by Korea standard abrasion partner with Korea standard (KS K 0905) cotton, nylon, polyester and the self sample fabric. (C) Applied fabrics for the investigations were carried out by using abrasion partner with Korea standard (KS K 0905) cotton, nylon, polyester and the self sample fabric. (D) Electrostatic propensity investigations were carried out by use of sample as silk, nylon, polyester and acrylic fabrics, seperating before finish or after finish. (E) Washing after the finish or the original fabric was carried out by Korea standard method, KS K 0465. Through the investigations, he happened to find many interesting matters and the obtained results are as followings. 1. Electrostatic voltage for the finished fabrics increased more than their original silk, nylon, acrylic fabrics except polyester fabric. (See Table 5) 2. Electrostatic voltage for the finished polyester against K.S. polyester decreased remarkably than the original fabric test. 3. In spite of no problem on electrostatic propensity of silk, it showed high electrostatic voltage between the same nature fabric abrasion, because silk is very weak against abrasion and because the test method had been developed to be useful for only synthetic fabrics. 4. Electrostatic voltage increased more in case of abrasion between different nature of fabrics than the same nature of fabrics. 5. Electrostatic voltage of each fabric increased by repeat of wash. 6. Many investigation data were followed with Contact Electrification Series Principle, another word, the farther each other located fabric on the series abrasion was, the higher electrostatic voltage. (See Fig. 6) 7. Such investigation gives warning of use on the mix fiber spinning service as far as concern with electrification. 8. It may also call attention for such increase of electrification in case any finishing of silk textile.

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Mechanical Properties of Granulated Ground Blast Furnace Slag on Blended Activator of Sulfate and Alkali (황산염 및 알칼리계의 혼합 활성화제에 대한 고로슬래그미분말의 역학적 특성)

  • Kim, Tae-Wan;Jun, Yu-Bin;Eom, Jang-Sub
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.19 no.5
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    • pp.104-111
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    • 2015
  • This study shows the mechanical properties of alkali-activated slag cement (AASC) synthesized using sulfate with NaOH solution. The used sulfates were calcium sulfate ($CaSO_4$, denoted CS) and sodium sulfate ($Na_2SO_4$, denoted SS). The replacement ratio of sulfates was 2.5, 5.0, 7.5 and 10.0% by weight of slag. NaOH solution of 2M and 4M concentration was used. A sample was activated with sulfate and activated with blended activator (blending NaOH solution with sulfate) respectively. 24 mix ratios were used and the water-binder weight ratio for the test was set 0.5. This research carried out the compressive strength, flexural strength, ultrasonic pulse velocity (UPV), absorption and X-ray diffraction (XRD). In the case of samples with CS, sample with 7.5% CS, sample with 2M NaOH+5.0% CS and sample with 4M NaOH+5.0% CS showed the good performance in the strength development. In the case of samples with SS, sample with 10.0% SS, sample with 2M NaOH+7.5% SS and sample with 4M NaOH+2.5% SS obtained good performance in strength. The results of UPV and water absorption showed a similar tendency to the strength properties. The XRD analysis of samples indicated that the hydration products formed in samples were ettringite, CSH and silicate phases. In this study, it is indicated that when compared to the use of sulfate only, the use of both sulfate and NaOH solution makes mechanical properties of AASC better.

Trend of Medical Care Utilization and Medical Expenditure of the Elderly Cohort (노인 코호트의 의료이용 및 입원진료비 변화 추이 -공.교 의료보험 대상자를 대상으로-)

  • Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.437-461
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    • 1997
  • Because of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 30 years, the life expectancy of the Korean people has lengthened considerably and as a result, the number of the elderly has markedly increased. Such an increase of the number of aged population brought about many social, economic, and medical problems which were never seriously considered before. This study was conducted to assess the trend of medical care utilization and medical expenditure of the elderly. The data of each patient in the study were taken from computer database maintained for administrative purpose by the Korea Medical Insurance Corporation. The study population was 132,670 who were 60 years old or more and registered in Korean Medical Insurance Corporation from 1989 to 1993. The study subjects were predominantly female(56.3%) and 10,000-20,000 Won premium group(50.6%). The following are summaries of findings : The total increase of the number of inpatient cases was 40.5% from 1989 through 1993. The average annual increase was 3.7% in inpatient medical expenditures per case, 4.4% in inpatient medical expenditures per day and 0.08% in length of stay per case from 1989 through 1993. Cataract was the most prevalent disease of 10 leading frequent diseases in all ages from 1989 through 1993. The case mix in 1993 compared to 1989 revealed that cataract and ischemic cerebral disease were increased whereas essential hypertension and pulmonary tuberculosis were decreased . The average annual increase of medical expenditures was 3.8% in general hospitals, 6.3% in hospitals and 2.4% in clinics. From 1989 through 1993, medical expenditures used by high-cost patients accounted for about 14% to 20% of all expenditures for inpatient care, while they represented less than 2.5% of the elderly population. Time series analysis revealed that total medical expenditures and doctor's fee for inpatient will be progressively increased whereas drug expenditures for inpatient will be decreased. And there will be no change in length of stay. Based on the above results, the factors increasing medical cost and utilization should be identified and the method of cost containment for the elderly health care should be developed systematically.

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An Ontology Model for Public Service Export Platform (공공 서비스 수출 플랫폼을 위한 온톨로지 모형)

  • Lee, Gang-Won;Park, Sei-Kwon;Ryu, Seung-Wan;Shin, Dong-Cheon
    • Journal of Intelligence and Information Systems
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    • v.20 no.1
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    • pp.149-161
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    • 2014
  • The export of domestic public services to overseas markets contains many potential obstacles, stemming from different export procedures, the target services, and socio-economic environments. In order to alleviate these problems, the business incubation platform as an open business ecosystem can be a powerful instrument to support the decisions taken by participants and stakeholders. In this paper, we propose an ontology model and its implementation processes for the business incubation platform with an open and pervasive architecture to support public service exports. For the conceptual model of platform ontology, export case studies are used for requirements analysis. The conceptual model shows the basic structure, with vocabulary and its meaning, the relationship between ontologies, and key attributes. For the implementation and test of the ontology model, the logical structure is edited using Prot$\acute{e}$g$\acute{e}$ editor. The core engine of the business incubation platform is the simulator module, where the various contexts of export businesses should be captured, defined, and shared with other modules through ontologies. It is well-known that an ontology, with which concepts and their relationships are represented using a shared vocabulary, is an efficient and effective tool for organizing meta-information to develop structural frameworks in a particular domain. The proposed model consists of five ontologies derived from a requirements survey of major stakeholders and their operational scenarios: service, requirements, environment, enterprise, and county. The service ontology contains several components that can find and categorize public services through a case analysis of the public service export. Key attributes of the service ontology are composed of categories including objective, requirements, activity, and service. The objective category, which has sub-attributes including operational body (organization) and user, acts as a reference to search and classify public services. The requirements category relates to the functional needs at a particular phase of system (service) design or operation. Sub-attributes of requirements are user, application, platform, architecture, and social overhead. The activity category represents business processes during the operation and maintenance phase. The activity category also has sub-attributes including facility, software, and project unit. The service category, with sub-attributes such as target, time, and place, acts as a reference to sort and classify the public services. The requirements ontology is derived from the basic and common components of public services and target countries. The key attributes of the requirements ontology are business, technology, and constraints. Business requirements represent the needs of processes and activities for public service export; technology represents the technological requirements for the operation of public services; and constraints represent the business law, regulations, or cultural characteristics of the target country. The environment ontology is derived from case studies of target countries for public service operation. Key attributes of the environment ontology are user, requirements, and activity. A user includes stakeholders in public services, from citizens to operators and managers; the requirements attribute represents the managerial and physical needs during operation; the activity attribute represents business processes in detail. The enterprise ontology is introduced from a previous study, and its attributes are activity, organization, strategy, marketing, and time. The country ontology is derived from the demographic and geopolitical analysis of the target country, and its key attributes are economy, social infrastructure, law, regulation, customs, population, location, and development strategies. The priority list for target services for a certain country and/or the priority list for target countries for a certain public services are generated by a matching algorithm. These lists are used as input seeds to simulate the consortium partners, and government's policies and programs. In the simulation, the environmental differences between Korea and the target country can be customized through a gap analysis and work-flow optimization process. When the process gap between Korea and the target country is too large for a single corporation to cover, a consortium is considered an alternative choice, and various alternatives are derived from the capability index of enterprises. For financial packages, a mix of various foreign aid funds can be simulated during this stage. It is expected that the proposed ontology model and the business incubation platform can be used by various participants in the public service export market. It could be especially beneficial to small and medium businesses that have relatively fewer resources and experience with public service export. We also expect that the open and pervasive service architecture in a digital business ecosystem will help stakeholders find new opportunities through information sharing and collaboration on business processes.

A Study of variables Related to Nursing Productivity (간호생산성에 관한 연구: 관련변수의 검증을 중심으로)

  • 박광옥
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.584-596
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    • 1994
  • The objective of the study is to explore the relationships between the variables of nursing productivity on the framework of system del in the tertiary university based care hospital in Korea. Productivity is basically defined as the relation-ship between inputs and outputs. Under the proposition that the nursing unit is a system that produces nursing care output using personal and material resources through the nursing intervention and nursing care management. And this major conception of nursing productivity system comproises input, process and output and feed-back. These categorized variables are essential parts to produce desirable and meaningful out-put. While nursing personnel from head nurse to staff nurses cooperate with each other, the head nurse directs her subordinates to achieve the goal of nursing care unit. In this procedure, the head nurse uses the leadership of authority and benevolence. Meantime nursing productivity will be greatly influenced by environment and surrounding organizational structures, and by also the operational objectives, the policy and standards of procedures. For the study of nursing productivity one sample hospital with 15 general nursing care units was selected. Research data were collected for 3 weeks from May 31 to June 20 in 1993. Input variables were measured in terms of both the served and the server. And patient classification scores were measured drily by degree of nursing care needs that indicated patent case-mix. And also nurses' educational period for profession and clinical experience and the score of nurses' personality were measured as producer input variables by the questionnaires. The process varialbes act necessarily on leading input resources and result in desirable nursing outputs. Thus the head nurse's leadership perceived by her followers is defined as process variable. The output variables were defined as length of stay, average nursing care hours per patient a day the score of quality of nursing care, the score of patient satisfaction, the score of nurse's job satis-faction. The nursing unit was the basis of analysis, and various statistical analyses were used : Reliability analysis(Cronbach's alpha) for 5 measurement tools and Pearson-correlation analysis, multiple regression analysis, and canonical correlation analysis for the test of the relationship among the variables. The results were as follows : 1. Significant positive relationship between the score of patient classification and length of stay was found(r=.6095, p.008). 2. Regression coefficient between the score of patient classification and length of stay was significant (β=.6245, p=.0128), and variance explained was 39%. 3. Significant positive relationship between nurses’ educational period and length of stay was found(r=-.4546, p=.044). 5. Regression coefficient between nurses' educational period and the score of quality of nursing care was significant (β=.5600, p=.029), and variance explained was 31.4%. 6. Significant positive relationship between the score of head nurse's leadership of authoritic characteristics and the length of stay was found (r=.5869, p=.011). 7. Significant negative relationship between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was found(r=-.4578, p=.043). 8. Regression coefficient between the score of head nurse's leadership of benevolent characteristics and average nursing care hours was significant(β=-.6912, p=.0043), variance explained was 47.8%. 9. Significant positive relationship between the score of the head nurse's leadership of benevolent characteristics and the score of nurses' job satis-faction was found(r=.4499, p=050). 10. A significant canonical correlation was found between the group of the independent variables consisted of the score of the nurses' personality, the score of the head nurse's leadership of authoritic characteristics and the group of the dependent variables consisted of the length of stay, average nursing care hours(Rc²=.4771, p=.041). Through these results, the assumed relationships between input variables, process variable, output variables were partly supported. In addition it is also considered necessary that-further study on the relationships between nurses' personality and nurses' educational period, between nurses' clinical experience including skill level and output variables in many research samples should be made.

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Effect of Market Basket Size on the Accuracy of Association Rule Measures (장바구니 크기가 연관규칙 척도의 정확성에 미치는 영향)

  • Kim, Nam-Gyu
    • Asia pacific journal of information systems
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    • v.18 no.2
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    • pp.95-114
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    • 2008
  • Recent interests in data mining result from the expansion of the amount of business data and the growing business needs for extracting valuable knowledge from the data and then utilizing it for decision making process. In particular, recent advances in association rule mining techniques enable us to acquire knowledge concerning sales patterns among individual items from the voluminous transactional data. Certainly, one of the major purposes of association rule mining is to utilize acquired knowledge in providing marketing strategies such as cross-selling, sales promotion, and shelf-space allocation. In spite of the potential applicability of association rule mining, unfortunately, it is not often the case that the marketing mix acquired from data mining leads to the realized profit. The main difficulty of mining-based profit realization can be found in the fact that tremendous numbers of patterns are discovered by the association rule mining. Due to the many patterns, data mining experts should perform additional mining of the results of initial mining in order to extract only actionable and profitable knowledge, which exhausts much time and costs. In the literature, a number of interestingness measures have been devised for estimating discovered patterns. Most of the measures can be directly calculated from what is known as a contingency table, which summarizes the sales frequencies of exclusive items or itemsets. A contingency table can provide brief insights into the relationship between two or more itemsets of concern. However, it is important to note that some useful information concerning sales transactions may be lost when a contingency table is constructed. For instance, information regarding the size of each market basket(i.e., the number of items in each transaction) cannot be described in a contingency table. It is natural that a larger basket has a tendency to consist of more sales patterns. Therefore, if two itemsets are sold together in a very large basket, it can be expected that the basket contains two or more patterns and that the two itemsets belong to mutually different patterns. Therefore, we should classify frequent itemset into two categories, inter-pattern co-occurrence and intra-pattern co-occurrence, and investigate the effect of the market basket size on the two categories. This notion implies that any interestingness measures for association rules should consider not only the total frequency of target itemsets but also the size of each basket. There have been many attempts on analyzing various interestingness measures in the literature. Most of them have conducted qualitative comparison among various measures. The studies proposed desirable properties of interestingness measures and then surveyed how many properties are obeyed by each measure. However, relatively few attentions have been made on evaluating how well the patterns discovered by each measure are regarded to be valuable in the real world. In this paper, attempts are made to propose two notions regarding association rule measures. First, a quantitative criterion for estimating accuracy of association rule measures is presented. According to this criterion, a measure can be considered to be accurate if it assigns high scores to meaningful patterns that actually exist and low scores to arbitrary patterns that co-occur by coincidence. Next, complementary measures are presented to improve the accuracy of traditional association rule measures. By adopting the factor of market basket size, the devised measures attempt to discriminate the co-occurrence of itemsets in a small basket from another co-occurrence in a large basket. Intensive computer simulations under various workloads were performed in order to analyze the accuracy of various interestingness measures including traditional measures and the proposed measures.

Strength Development of Sulfur-Polymer-Based Concrete Surface Protecting Agents Depending on Curing Condition and Hazard Assessment of Sulfur Polymers (유황폴리머를 활용한 콘크리트 표면보호재의 양생조건에 따른 강도 평가 및 유황폴리머의 유해성 평가)

  • Lee, Byung-Jae;Lee, Eue-Sung;Kim, Seung-Gu;Kim, Yun-Yong
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.19 no.1
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    • pp.139-146
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    • 2015
  • The amount of by-product from sulphur increases in domestic industrial facilities. However, the amount of its consumption is limited so that the amount of unused sulphur continues to increase. Therefore, in this study, the use sulfur polymer as the concrete surface protecting material was conducted. The compressive strength showed that as the substitution ratio of filler increased up to 40%, the compressive strength also increased. A high compressive strength was shown at the curing temperature of $40^{\circ}C$ (SS, FA) and $60^{\circ}C$ (OPC) according to the type of filler. The difference of compressive strength between air dry curing and water curing was insignificant so that there was no significant influence of moisture during curing process. The evaluation result of bond strength showed that the highest bond strength was shown at the air-dry condition of $40^{\circ}C$ regardless of type of filler. Bonding didn't occur properly during water curing in comparison to air dry curing. Also, in case of the specimen cured at $60^{\circ}C$, discoloration and hair cracks appeared due to the influence of temperature, and the highest bond strength was shown at the substitution ratio of 20% (SS, FA) and 30% (OPC) according to the type of filler. The releasing test result of harmful substance showed that no harmful substance was released, so there is no harmfulness in the surface protecting material using sulfur polymer. As a conclusion drawn in this study, it is most appropriate to substitute silica by approximately 20%, mix and cure at the air-dry condition of $40^{\circ}C$ in order to use sulfur polymer as the surface protecting material.

Freeze-thaw Resistance Estimation of Concrete using Surface Roughness and Image Analysis (콘크리트의 동결융해 저항성 추정을 위한 표면 거칠기 및 이미지 분석의 적용성)

  • Lee, Binna;Lee, Jong Suk
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.22 no.3
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    • pp.1-7
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    • 2018
  • As part of a research dedicated to the field evaluation of the durability of concrete subjected to freezing-thawing, this study analyzes the relationship between the surface roughness and the relative dynamic elastic modulus through image analysis. Four mix compositions with water-to-binder ratios (W/B) of 40%, 50%, 60% and 70% and without AE agent were considered to provoke early freezing. The basic physical properties of the mixes including the relative dynamic elastic modulus and the compressive strength were first evaluated experimentally according to W/B. Then, tests were performed to measure the surface roughness followed by photographs and SEM image analysis. The measured surface roughness tended to increase with larger number of freezing-thawing cycles regardless of W/B. The relative dynamic elastic modulus appeared to increase gradually with the number of cycles for the relatively denser mixes with W/B of 40% and 50%. Besides, the surface roughness increased only at rupture for the mixes with W/B of 60% and 70%. Moreover, the analysis of the photographs of the surface of the mixes with W/B of 40% and 50% revealed that the degradation progressed gradually from the surface with the freezing-thawing cycles. However, for the mixes with W/B of 60% and 70%, apparent change of the surface remained very insignificant until rupture at which damage like cracking could be observed. Consequently, the analysis of surface photograph or the measurement of the surface roughness presented some limitation in assessing the degree of freezing-thawing-induced degradation in case of relatively porous specimens. On the other hand, the photograph and surface roughness appeared to be sufficient for assessing such degradation for the mixes with W/B of 40% and 50%. Accordingly, the image of the surface and the surface roughness are potentially applicable on site for the assessment of freezing-thawing damages in relatively dense mixes.