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Impacts of DRG Payment System on Behavior of Medical Insurance Claimants (DRG 지불제도 도입에 따른 의료보험청구 행태 변화)

  • Kang, Gil-Won;Park, Hyoung-Keun;Kim, Chang-Yup;Kim, Yong-Ik;Ha, Beom-Man
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.393-401
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    • 2000
  • Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

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A CONVERGENCE RESULTS FOR ANTIPLANE CONTACT PROBLEM WITH TOTAL SLIP RATE DEPENDENT FRICTION

  • AMMAR, DERBAZI
    • Journal of applied mathematics & informatics
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    • v.39 no.5_6
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    • pp.813-823
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    • 2021
  • In this work, we present the classical formulation for the antiplane problem of a eletro-viscoelastic materialswith total sliprate dependent friction and write the corresponding variational formulation. In the second step, we prove that the solution converges to the solution of the corresponding electro-elastic problem as the viscosity converges to zero.

NAVIER-STOKES SIMULATION OF A VISCOUS MICRO PUMP WITH A SPIRAL CHANNEL (스파이럴 채널을 가진 초소형 점성 펌프의 Navier-Stokes 해석)

  • Seo, J.H.;Kang, D.J.
    • Journal of computational fluids engineering
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    • v.16 no.1
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    • pp.90-95
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    • 2011
  • The Navier-Stokes equations are solved to study the flow characteristics of a micro viscous pump. The viscous micropump is consisted of a stationary disk with a spiral shaped channel and a rotating disk. A simple geometrical model for the tip clearance is proposed and validated by comparing computed flow rate with corresponding experimental data. Present numerical solutions show satisfactory agreement with the corresponding experimental data. The tip clearance effect is found to become significant as the rotational speed increases. As the pressure load increases, a reversed flow region is seen to form near the stationary disk. The height of the channel is shown to be optimized in terms of the flow rate for a given rotational speed and pressure load. The optimal height of the channel becomes small as the rotational speed decreases or the pressure load increases. The flow rate of the pump is found to be in proportion to the width of channel.

Nationwide Reduction of Primary Energy and Greenhouse Gas Emission by PMV Control Considering Individual Metabolic Rate Variations in Apartments (아파트 건물에서 재실자 활동량이 고려된 PMV제어에 따른 연간 국가 차원의 1차 에너지 및 온실가스 감축량 분석)

  • Hong, Sung-Hyup;Do, Sung-Lok;Lee, Kwang Ho
    • Journal of the Architectural Institute of Korea Structure & Construction
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    • v.34 no.10
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    • pp.37-44
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    • 2018
  • In this study, the effects of considering hourly metabolic rate variations for predicted mean vote (PMV) control on the heating and cooling energy and greenhouse gas emission were investigated. The case adopting PMV control taking the hourly metabolic rate into account was comparatively analyzed against the conventional dry-bulb air temperature control, using a detailed simulation technique. Under the assumption that all the apartments in Korea adopt the PMV control incorporating real-time metabolic rate measurements, nationwide reductions of primary energy and greenhouse gas emission were analyzed. As a result, PMV control considering hourly metabolic rate variations is expected to reduce national primary energy by 6.2% compared to conventional dry-bulb air temperature control, corresponding to reduction of 10,342 GWh. In addition, it turned out that 6.6% of tCO2 emission can be reduced by adopting PMV control, corresponding to nationwide reduction of greenhouse gas emission by approximately 1,720,000 tCO2.

Profit analysis of life insurance products with interest rate options (이자율 보증옵션이 내재된 생명보험의 이차익 분석)

  • Lee, Hangsuck
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.4
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    • pp.737-753
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    • 2013
  • Interest rate options embedded in life insurance products provide policyholders with minimum guaranteed rates credited to the corresponding surrender values. This paper discusses current low-interest environment and several types of interest rate options embedded in life insurance products. In addition, this paper shows profit structures of the life insurance products and calculates values of the interest rate options under stochastic interest model and the corresponding VaR (value at risk). Finally, some implications are discussed.

Relationship between follicular fluid adipocytokines and the quality of the oocyte and corresponding embryo development from a single dominant follicle in in vitro fertilization/intracytoplasmic sperm injection cycles

  • Chang, Hye Jin;Lee, Ji Hyun;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.21-28
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    • 2014
  • Objective: To investigate the association of individual follicular fluid (FF) leptin and adiponectin levels with the quality of the corresponding oocyte and embryo. Methods: We prospectively enrolled 67 women who underwent controlled ovarian hyperstimulation with 89 FF samples. FF and the corresponding oocyte was obtained from a single dominant preovulatory follicle at the time of oocyte retrieval. Concentrations of leptin and adiponectin were measured by enzyme-linked immunosorbent assay in an individual follicle. The oocyte quality, fertilization rate, and corresponding embryo development were assessed. Results: The FF level of leptin was significantly associated with body mass index (r=0.334, p<0.01). The FF adiponectin level was significantly higher in the normal fertilization group than the abnormal fertilization group (p=0.009) in the non-obese women. A lower FF leptin level was associated with a trend toward mature oocytes, normal fertilization, and good embryo quality, although these relationships were not statistically significant. The leptin:adiponectin ratio of FF did not differ significantly according to oocyte and embryo quality. The quality of the oocyte and embryo was not associated with the FF leptin level tertile. However, the normal fertilization rate was positively associated with FF adiponectin level tertile. There was a trend towards improved oocytes and normal fertilization rates with the lowest tertile of the FF leptin:adiponectin ratio, but this difference was not statistically significant. Conclusion: Our results suggest that a high FF adiponectin concentration could be a predictor of normal fertilization. However, the FF leptin concentration and leptin:adiponectin ratio is not significantly related to oocyte maturity and corresponding embryo development.

Reaction of Diisobutylaluminum Hydride-Dimethyl Sulfide Complex with Selected Organic Compounds Containing Representative Functional Groups. Comparison of the Reducing Characteristics of Diisobutylaluminum Hydride and Its Dimethyl Sulfide Complex

  • Cha, Jin-Soon;Jeong, Min-Kyu;Kwon, Oh-Oun;Lee, Keung-Dong;Lee, Hyung-Soo
    • Bulletin of the Korean Chemical Society
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    • v.15 no.10
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    • pp.873-881
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    • 1994
  • The approximate rate and stoichiometry of the reaction of excess diisobutylaluminum hydride-dimethyl sulfide complex($DIBAH-SMe_2$) with organic compounds containing representative functional group under standardized conditions (toluene, $0{\circ}C$) were examined in order to define the reducing characterstics of the reagent and to compare the reducing power with DIBAH itself. In general, the reducing action of the complex is similar to that of DIBAH. However, the reducing power of the complex is weaker than that of DIBAH. All of the active hydrogen compounds including alcohols, amines, and thiols evolve hydrogen slowly. Aldehydes and ketones are reduced readily and quantitatively to give the corresponding alcohols. However, $DIBAH-SMe_2$ reduces carboxylic acids at a faster rate than DIBAH alone to the corresponding alcohols with a partial evolution of hydrogen. Similarly, acid chlorides, esters, and epoxides are readily reduced to the corresponding alcohols, but the reduction rate is much slower than that of DIBAH alone. Both primary aliphatic and aromatic amides examined evolve 1 equiv of hydrogen rapidly and are reduced slowly to the amines. Tertiary amides readily utilize 2 equiv of hydride for reduction. Nitriles consume 1 equiv of hydride rapidly but further hydride uptake is quite slow. Nitro compounds, azobenzene, and azoxybenzene are reduced moderately. Cyclohexanone oxime liberates ca. 0.8 equiv of hydrogen rapidly and is reduced to the N-hydroxylamine stage. Phenyl isocyanate is rapidly reduced to the imine stage, but further hydride uptake is quite sluggish. Pyridine reacts at a moderate rate with an uptake of one hydride in 48 h, while pyridine N-oxide reacts rapidly with consumption of 2 equiv of hydride for reduction in 6h. Similarly, disulfides and sulfoxide are readily reduced, whereas sulfide, sulfone, and sulfonic acid are inert to this reagent under these reaction conditions.

A Study on Trend Changes for Certain Parametric Families

  • Nam, Kyung Hyun;Park, Dong Ho
    • Journal of Korean Society for Quality Management
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    • v.23 no.3
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    • pp.93-101
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    • 1995
  • We present a brief survey concerning the relations between mean residual life and failure rate. Change points of mean residual life and failure rate are known to be different in general and we explore such situations in this paper. A few parametric models which show bathtub-shaped failure rate are examined in details, including the shape of its corresponding mean residual life function. We give some graphical comparisons of trend changes of mean residual life and failure rate for various choices of parameters for each parametric model.

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Kinetics and Reaction Mechanism for Aminolysis of Benzyl 4-Pyridyl Carbonate in H2O: Effect of Modification of Nucleofuge from 2-Pyridyloxide to 4-Pyridyloxide on Reactivity and Reaction Mechanism

  • Kang, Ji-Sun;Um, Ik-Hwan
    • Bulletin of the Korean Chemical Society
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    • v.33 no.7
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    • pp.2269-2273
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    • 2012
  • Pseudo-first-order rate constants $k_{amine}$ have been measured spectrophotometrically for the reactions of benzyl 4-pyridyl carbonate 6 with a series of alicyclic secondary amines in $H_2O$ at $25.0^{\circ}C$. The plots of $k_{amine}$ vs. [amine] curve upward, indicating that the reactions proceed through a stepwise mechanism with two intermediates, a zwitterionic tetrahedral intermediate $T^{\pm}$ and its deprotonated form $T^-$. This contrasts to the report that the corresponding reactions of benzyl 2-pyridyl carbonate 5 proceed through a forced concerted pathway. The $k_{amine}$ values for the reactions of 6 have been dissected into the second-order rate constant $Kk_2$ and the thirdorder rate constant $Kk_3$. The Br${\o}$nsted-type plots are linear with ${\beta}_{nuc}=0.94$ and 1.18 for $Kk_2$ and $Kk_3$, respectively. The $Kk_2$ for the reaction of 6 is smaller than the second-order rate constant $k_N$ for the corresponding reaction of 5, although 4-pyridyloxide in 6 is less basic and a better nucleofuge than 2-pyridyloxide in 5.

Numerical and Experimental Studies on the Fluidic Characteristics and Performance of Liner-type Microtube

  • Kim, Jin Hyun;Woo, Man Ho;Kim, Dong Eok
    • Journal of Biosystems Engineering
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    • v.42 no.1
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    • pp.1-11
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    • 2017
  • Purpose: Methods: Three-dimensional CFD modeling was conducted to analyze the flow structure and discharge flow rate corresponding to the variation in the geometry of the flow channel in a microtube. Additionally, experiments were carried out, and the discharge flow rate was measured at various inlet pressures and inclination angles of the microtube. Results: The quantitative data of velocity distribution and discharge flow rate were obtained. As the width and length of the microtip increased, the discharge flow rate decreased significantly because of the increase in the loss of pressure along the microtube. As the depth of the microtip increased, the flow rate also increased because of the reduction in the flow resistance. However, in this analysis, the variation in the angle of the microtip did not influence the flow rate. From the experimental results, it was observed that the flow rate increased linearly with the increase in the inlet pressure, and the effects of the inclination angle were not clearly observed in those test cases. The values of the flow rate obtained from the experiments were significantly lower than that obtained from the CFD analysis. This is because of the distortion of the shape of the flow path inside the microtube during the fabrication process. The distortion of the flow path might decrease the flow cross-sectional area, and it would increase the flow resistance inside the microtube. The variation in the flow rate corresponding to the variation in the inlet pressure showed similar trends. Conclusions: Therefore, the results of the numerical analysis obtained from this study can be efficiently utilized for optimizing the shape of the microtip inside a microtube.