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A Study on the Medical Costs on Last Admission in Terminal Cancer Inpatients for Hospice Care (호스피스 케어를 위해 입원한 말기 암 환자의 사망직전 의료비용 실태 조사)

  • Yoo, Sang-Yeon;Lee, Hye-Ree;Lee, Yong-Je;Ahn, Mi-Hong;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.146-154
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    • 2002
  • Purpose : Death due to cancer has been continuously increasing, therefore cancer is the first in the cause of death now. A national policy for the elevation of medical costs in cancer patients is necessary, therefore, we searched for the medical costs and its related factors in terminal cancer patients for the effective reduction of the medical costs. Methods : We reviewed the medical records of 259 hospitalized terminal cancer patients who had died during the period of July 1, 2000 to June 30, 2002. History of cancer included type of cancer, type of past treatment, existence of metastasis. Clinical manifestation was examined and medical costs on last admission was categorized based on the account of charges of the department of patient affair on the last hospitalization. For analysis of factors related with medical costs, ANOVA was used. Results : Of the 259 patients, the number of male was 135 cases (52.1%), and the female, 124 cases (47.9%). The most frequent type of cancer was stomach (21.9%) cancer. Of the clinical manifestation, anorexia (87.6%) was the most frequent manifestation. Total medical costs was 740,628,045won, the mean costs was $285,968{\pm}3,070,272won$. The frequent category of medical costs was injection (32.0%), medical accommodation (27.9%), examination (14.0%), in order. The only factor related with mean medical costs was pain (P<0.05). Conclusion : If unnecessary injection of opioid analgesics is reduced, hospice care at home is activated and excessive examination is reduced In terminal cancer inpatients, it will be possible to reduce the medical costs in terminal cancer patients more effectively.

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The effect of dietary asparagine supplementation on energy metabolism in liver of weaning pigs when challenged with lipopolysaccharide

  • Kang, Ping;Liu, Yulan;Zhu, Huiling;Zhang, Jing;Shi, Haifeng;Li, Shuang;Pi, Dinan;Leng, Weibo;Wang, Xiuying;Wu, Huanting;Hou, Yongqing
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.4
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    • pp.548-555
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    • 2018
  • Objective: This experiment was conducted to investigate whether asparagine (Asn) could improve liver energy status in weaning pigs when challenged with lipopolysaccharide. Methods: Forty-eight weaned pigs ($Duroc{\times}Large\;White{\times}Landrace$, $8.12{\pm}0.56kg$) were assigned to four treatments: i) CTRL, piglets received a control diet and injected with sterile 0.9% NaCl solution; ii) lipopolysaccharide challenged control (LPSCC), piglets received the same control diet and injected with Escherichia coli LPS; iii) lipopolysaccharide (LPS)+0.5% Asn, piglets received a 0.5% Asn diet and injected with LPS; and iv) LPS+1.0% Asn, piglets received a 1.0% Asn diet and injected with LPS. All piglets were fed the experimental diets for 19 d. On d 20, the pigs were injected intraperitoneally with Escherichia coli LPS at $100{\mu}g/kg$ body weights or the same volume of 0.9% NaCl solution based on the assigned treatments. Then the pigs were slaughtered at 4 h and 24 h after LPS or saline injection, and the liver samples were collected. Results: At 24 h after LPS challenge, dietary supplementation with 0.5% Asn increased ATP concentration (quadratic, p<0.05), and had a tendency to increase adenylate energy charges and reduce AMP/ATP ratio (quadratic, p<0.1) in liver. In addition, Asn increased the liver mRNA expression of pyruvate kinase, pyruvate dehydrogenase, citrate synthase, and isocitrate dehydrogenase ${\beta}$ (linear, p<0.05; quadratic, p<0.05), and had a tendency to increase the mRNA expression of hexokinase 2 (linear, p<0.1). Moreover, Asn increased liver phosphorylated AMP-activated protein kinase (pAMPK)/total AMP-activated protein kinase (tAMPK) ratio (linear, p<0.05; quadratic, p<0.05). However, at 4 h after LPS challenge, Asn supplementation had no effect on these parameters. Conclusion: The present study indicated that Asn could improve the energy metabolism in injured liver at the late stage of LPS challenge.

Impacts of Energy Tax Reform on Electricity Prices and Tax Revenues by Power System Simulation (전력계통 모의를 통한 에너지세제 개편의 전력가격 및 조세수입에 대한 영향 연구)

  • Kim, Yoon Kyung;Park, Kwang Soo;Cho, Sungjin
    • Environmental and Resource Economics Review
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    • v.24 no.3
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    • pp.573-605
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    • 2015
  • This study proposed scenarios of tax reform regarding taxation on bituminous coal for power generation since July 2015 and July 2014, estimated its impact on SMP, settlement price, tax revenue from year 2015 to year 2029. These scenarios are compared with those of the standard scenario. To estimate them, the power system simulation was performed based on the government plan, such as demand supply program and the customized model to fit Korea's power system and operation. Imposing a tax on bituminous coal for power generation while maintaining tax neutrality reducing tax rate on LNG, the short-term SMP is lowered than the one of the standard scenario. Because the cost of nuclear power generation is still smaller than costs of other power generation, and the nuclear power generation rarely determines SMPs, the taxation impact on SMP is almost nonexistent. Thus it is difficult to slow down the electrification of energy consumption due to taxation of power plant bituminous coal in the short term, if SMP and settlement price is closely related. However, in the mid or long term, if the capacity of coal power plant is to be big enough, the taxation of power plant bituminous coal will increase SMP. Therefore, if the tax reform is made to impose on power plant bituminous coal in the short term, and if the tax rate on LNG is to be revised after implementing big enough new power plants using bituminous coal, the energy demand would be reduced by increasing electric charges through energy tax reform. Both imposing a tax on power plant bituminous coal and reducing tax rate on LNG increase settlement price, higher than the one of the standard scenario. In the mid or long term, the utilization of LNG complex power plants would be lower due to an expansion of generating plants, and thus, the tax rate on LNG would not affect on settlement price. Unlike to the impact on SMP, the taxation on nuclear power plants has increased settlement price due to the impact of settlement adjustment factor. The net impact of energy taxation will depend upon the level of offset between settlement price decrease by the expansion of energy supply and settlement price increase by imposing a tax on energy. Among taxable items, the tax on nuclear power plants will increase the most of additional tax revenue. Considering tax revenues in accordance with energy tax scenarios, the higher the tax rate on bituminous coal and nuclear power, the bigger the tax revenues.

A Study on Sickness and the Status of Medical Care in a Rural Area (일부(一部) 농촌주민(農村住民)의 상병(傷病) 및 의료실태(醫療實態)에 관(關)한 조사연구(調査硏究))

  • Park, Jeong-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.14 no.1
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    • pp.65-74
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    • 1981
  • This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

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Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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Right of disposition of cargo and Air waybill (송하인의 운송물 처분청구권과 항공화물운송장)

  • Nam, Hyun-Sook;Choi, June-Sun
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.177-199
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    • 2015
  • Commerce enriches human life enriched and within commerce, transportation of cargo is arguably the most important in business transactions. Traditionally, marine transport has been major commercial transaction, but carriage cargo by air is on the increase. While the fare for freight in comparison with that of ocean is higher, air freight has many benefits that justify the higher shipping fee; lower insurance premium, packing charges, inventory control, cost management and especially speed. Therefore, air freight transport is accumulating gradually. An air waybill(AWB) is needed in the air transport flow. It is a nonnegotiable security, so the holder cannot transfer of a right to a third party. Some scholars suggest that a negotiable AWB is needed. However, it seems nearly impossible to do so; an e-AWB use shows a gain in numbers, even if it has not met expectations. Going forward, it would appear reasonable to conduct a follow-up study on the utility and legal problem for e-AWB. After sending goods, the consignor has the right of disposition of cargo in some cases, and more research is necessary, because it is related to change of ownership and a trade settlement. According to WATS (World Airlines Transport Statistics), the Korean Air took third place in international freight in 2014, and fifth in total, domestic and international to great acclaim. However, there is a lack of research supporting the business showing. It is hope that more studies on e-AWB, stoppage in transit, and a risk of outstanding amount, etc. connect to develop Korean air freight industry.

A Study on the Evaluation Criteria for Reconstruction Charge Allocation (재건축부담금 배분을 위한 지자체 평가기준 연구)

  • Kim, Joo-Jin;Song, Young-Hyun
    • Land and Housing Review
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    • v.2 no.1
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    • pp.35-46
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    • 2011
  • This paper aims at examining the indices and their weights for the evaluation of local government to allocate reconstruction charge and reviewing the availability of them simulating local governments' evaluation. There has been no specific evaluation criteria existed, while central government has to allocate the reconstruction charge to local governments by the provision 3 of Restitution of Housing Reconstruction Gains Act. The results as follows : According to a survey on evaluation indices weight and AHP analysis, the weight of 'the housing welfare improve effort' is the highest with 25.1% among 5 upper-classification indices. Following this, each weight of 'housing welfare conditions(22.7%)', 'housing SOC establishment(22.5%)', 'the achievement and planning on reconstruction charge use(15.8%)', and 'housing sector achievement such as Bogeumjari(13.9%)' are ranked. Meanwhile, Among 16 lower-classification indices, 'the rate of minimum housing standard households(11.5%)', 'public rental housing supply(8.9%)', 'reconstruction charge use achievement(8.3%)', 'reconstruction charge use planning submit(7.5%)', and 'rate of water and sewage(6.3%)' hold high rank. The analysis results show the weight of 'housing sector achievement such as Bogeumjari' on the existing provisions should be decreased(30%${\rightarrow}$13.9%) as others' weight has to be slightly increased. According to the result of the simulation, Jeonbuk, Gyeongbuk, Jeonnam, Jeju, Gyeonggi received higher scores in the comprehensive evaluation, while Daejeon, Seoul, Incheon, Daegu and Gwangju, where the housing conditions are relatively good, received lower scores. These results of the analysis correspond with the direction of reconstruction charges allocation and indicate that the evaluation criteria used in this simulation is acceptable.

Efficiency Estimation for Desalination System of Seawater Using Reverse Osmosis Membrane (역삼투압막 해수담수화 장치의 미네럴 분리 성능평가)

  • Moon, Deok-Soo;Jung, Dong-Ho;Kim, Hyeon-Ju;Shin, Phil-Kwon
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.8 no.2
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    • pp.60-66
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    • 2005
  • When external pressure higher than osmosis pressure is reversely derived into solution, its solvent is moved into the solution having lower concentration, which is called 'reverse osmosis'. We investigated the desalination application of deep ocean water using reverse osmosis pressure of $40-70\;kgf/cm^2$ We observed how to operational factor j like flow rate, water temperature and pressure have effect on efficiency of reverse osmosis membrane and salts rejection. Fluxes of reverse osmosis membrane are directly proportional to water temperature and pressure. However, salts rejection rates are positively correlated with pressure and inversely proportional to water temperature. Separation efficiencies of osmosis membrane for major elements such as $Mg^{2+},\;Ca^{+2},\;Na^+\;and\;K^+$ are as follows in a strong electrolysis solution like seawater; $Ca^{2+},\;Mg^{2+}>K^+>Na^+$. Rejection rates of $Mg^{2+}\;and\;Ca^{2+}$ that have high electric charges are over 99% and show positively correlation with water temperature. Rejection rates of $Na^+$ having low electric charge is observed to be 98%-99%, which rates is much lower than those of $2^+$ charged ions like $Ca^{2+}\;and\;Mg^{2+}$. Ion rejection rates of boron, B, are much low because boron is present il free state or gas phase in seawater. Boron concentration in desalination water is over criteria of Korean drinking water, 0.3 mg/L. However, we could satisfied with the criteria of drinking water under the operation condition like temperature $5^{\circ}C$ and pressure $70kgf/cm^2$, using the relationship that rejection rates of boron is proportional to pressure and is inversely proportional to water temperature

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A Study on Analysis of Investment Effects of Farm Mechanization, Korea -Mainly on the Case Study of Saemaeul Farm Mechanization Groups in Nonsan Area, Chungnam Province- (농업기계화(農業機械化)의 투자효과분석(投資效果分析)에 관(關)한 연구(硏究) -충남논산지역(忠南論山地域) 새마을 기계화영농단(機械化營農團)을 중심(中心)으로-)

  • Lim, Jae Hwan;Han, Gwan Soon
    • Korean Journal of Agricultural Science
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    • v.14 no.1
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    • pp.164-185
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    • 1987
  • The Korean economy has been developed rapidly in the course of implementing the five year economic development plans since 1962. Accordingly the industrial and employment structure have been changed from the traditional agriculture to modem industrial economy. In the course of implementing export oriented industrialization policies, rural farm economy has been encountered labour shortage owing to rural farm population drain to urban areas, rural wage hike and pressure on farm operation costs, and possibility of farm productivity decrease. To cope with the above problems the Korean government has supplied farm machinery such as power tillers, tractors, transplanters, binders, combines, dryers and etc. by means of the favorable credit support and subsidies. The main objectives of this study are to identify the investment effects of farm mechanization such as B/C and Internal Rate of Return by machinery and operation patterns, changes of labour requirement per 10a for rice culture since 1965, partial farm budget of rice with and without mechanization, and estimation labour input with full mechanization. To achieve the objectives Saemaeul farm mechanization groups, common ownership and operation, and farms with private ownership and operation were surveyed mainly in Nonsan granary area, Chungnam province. The results of this study are as follows 1. The national average of labor input per 10a of paddy has decreased from 150.1Hr in 1965 to 87.2Hr in 1985 which showes 42% decrease of labour inputs. On the other hand the hours of labour input in Nonsan area have also decreased from 150.1Hr to 92.8Hr, 38% of that in 1965, during the same periods. 2. The possible labor saving hours per 10a of Paddy was estimated at 60 hours by substituting machine power for labor forces in the works of plowing, puddling, transplanting, harvesting and threshing, transporting and drying The labor savings were derived from 92.8 hours in 1986 deducting 30 hours of labor input with full mechanization in Nonsan area. 3. Social benefits of farm mechanization were estimated at 124,734won/10a including increment of rice (10%): 34,064won,labour saving: 65,800won,savings of conventional farm implements: 18,000 won and savings of animal power: 6,870won. 4. Rental charges by works prevailing in the area were 12,000won for land preparation, 15,000won for transplanting with seedlings, 19,500won for combine works and 6,000won for drying paddy. 5. Farm income per 10a of paddy with and without mechanization were amounted to 247,278won and 224,768won respectively. 6. Social rate of return of the machinery were estimated at more than 50% in all operation patterns. On the other hand internal rate of return of the machinery except tractors were also more than 50% but IRR of tractors by operation patterns were equivalent to 0 to 9%. From the view point of farmers financial status, private owner-operation of tractors is considered uneconomical. Tractor operation by Saemaeul mechanization groups would be economical considering the government subsidy, 40% of tractor price. 7. Farmers recommendations for the government that gained through field operation of farm machinery are to train maintenance technology for rural youth, to standardize the necessary parts of machinery, to implement price tag system, to intercede spare parts and provide marketing information to farmers by rural institutions as RDA,NACF,GUN office and FLIA.

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Policy Suggestions for Korea Aviation Industry's Fair Competition (항공운송산업의 공정경쟁에 대한 이해와 정책적 제언)

  • Park, Jin-Seo;Kim, Je-Chul;Han, Ik-Hyun
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.2
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    • pp.129-153
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    • 2017
  • Fair Competition policy in aviation field has been discussed since open skies policy began in 1970s. This issue has been also the main topic in the ICAO's Worldwide Air Transport Conference, the Air Transport Symposium, etc. ICAO defines competition as the existent or potential rivalry between two or more operators, carriers or groups, striving for advantages in the same market based on different prices, qualities and services. In a broader sense, the definition includes more various meanings; reasonable, fair, effective, and unrestricted competitions. Nowadays, competition laws and regulations to air transportation have been applied more frequently and the issues varies from antitrust immunity, mergers and alliances, abuse of dominant positions, capacity dumping and predatory pricing, sales and marketing, to airport charges and fees, state aid and loan guarantees. Now, the competition among the airlines or nations in aviation industry is changing to cooperation level. A lot of airlines try to survive by various cooperation methods. Therefore the policy of Korean aviation industry should be developed, taking so-called "the viewpoint of national aviation industry ecosystem" into consideration and Korean government should prepare a policy of fair competition to cope with it. First, in the process of open skies policy with neighboring countries such as China, Japan and the Middle East, it is necessary to apply the fair competition act and prepare laws and regulations to implement it. Second, the standards of effective ownership and control of air transportation business should be reviewed. Third, in preparation for aviation agreements and liberalization, the Korean aviation industry needs to study and review competition and cooperation issues through the analysis of strict aviation market structure for airlines and airport operations. Fourth, it is necessary to create a fair air transportation environment for the development of air transportation and competitiveness through preemptive policies such as the approval of mergers, acquisitions, JV and the ripple effects analysis.

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