• The Journal of Korean Medicine
• /
• v.28 no.1 s.69
• /
• pp.72-86
• /
• 2007

Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

• Journal of Korean Society of Forest Science
• /
• v.102 no.3
• /
• pp.390-397
• /
• 2013

The study, utilizing a data envelopment analysis (DEA) which is one of the nonparametric estimation methods, aims to evaluate the management efficiency of chestnut tree cultivators in such provinces in Chungchungnam-do as Cheong-yang, Gong-ju, Bu-yeo and so on. The analysis data of this study is based on inputs and outputs of 20 forestry households surveyed in the 2012 survey titled 'A Study on Current Level and Condition of Chestnut Cultivation and Management', which was conducted from March 2012 to October 2012. The elements of inputs are composed of management cost, harvesting cost, material cost, non-operation expenses and cultivation area, while the element of output is a gross margin only. Then the study analyzes a technical efficiency, a puretechnical efficiency and a scale efficiency using CCR and BCC model among DEA methods. Based on that, it also provides improvement methods for forestry households that turned out to be inefficient. In order to verify the result of DEA analysis, the study additionally compares a result of this efficiency study with that of chestnuts management standard diagnostic table. According to the result, the average value of technical efficiency analyzed was 0.667, proving to be inefficient in general. Given that the average value of pure-technical efficiency was 0.944 and that of scale efficiency was 0.703, it can be inferred that inefficiency exists in the field of scale, not in the field of cultivation techniques. As for forestry households with the efficiency score of 1, it is shown that there were 6 households that recorded 1 in the technical efficiency field and 13 households that recorded 1 in the pure technical efficiency. Meanwhile, there were 6 households that recorded 1 in all of the three aspects. In the comparison with the scores from chestnuts management standard diagnostic table, there were 5 households made a high score of over 80, among which are 3 households with score 1 in the technical efficiency. Also, the results of this study and the chestnuts management standard diagnostic table are proved to have the same result, both of them showing the same households that recorded the highest score and the lowest score. This means the management efficiency evaluation using DEA can be applied to the fieldwork along with the chestnuts management standard diagnostic table.

• Journal of Korean Public Health Nursing
• /
• v.3 no.2
• /
• pp.5-46
• /
• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.1949-1953
• /
• 2014

Background: CA125 and HE4 are used in calculating Risk of Malignancy Algorithm (ROMA); and Risk of Malignancy Index (RMI). However, studies showed that normal levels of CA125, and HE4 differ among ethnicities such as between Asians and Caucasians, thus affecting the accuracy of the RMI score and ROMA in predicting ovarian malignancy. This study aimed to determine whether new or modified cutoff values for Ca125, HE4, the RMI score, and ROMA resulted in a better prediction of malignancy compared with the previous or standard ones. Materials and Methods: Serum level of CA125 and HE4 from 128 patients with diagnosis of ovarian tumor that had been collected before surgery at Cipto Mangunkusumo General Hospital (CMH) in Jakarta from November 2010 until May 2011 were reviewed and analysed. The standard cutoff values of these biomarkers, RMI, and ROMA were modified by using logistic regression model. The modified cutoff values were compared to the standard cutoff values in terms of sensitivity, specificity, and accuracy. Results: The modified cutoff value of CA125, HE4, RMI score and ROMA were 165.2 U/mL, 103.4 pM, 368.7, 28/54. The sensitivity and specificity of the modified cutoff values CA125, HE 4, RMI score and ROMA in differentiating benign from malignant and borderline were 67% and 75,4%; 73.1% and 85.2%; 73.1% and 80.3%; and 77.6% and 86.9%. While the sensitivity and specificity of the standard cutoff value of CA125; HE4; RMI score; and ROMA were 91% and 24.6%; 83.6% and 65%; 80.6% and 65.6%; and 91.0% and 42.6%. The accuracy of modified cutoff values compared with standard cutoff values were: 71.2% vs 59.3%, 78.9% vs 75% vs, 76.5% vs 73.4%, and 82% vs 67.9%. Conclusions: The new or modified cutoff values of Ca125, HE4, RMI score and ROMA resulted in higher accuracy compared to the previous or standard ones, at the cost of reduced sensitivity.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.7 no.3
• /
• pp.391-400
• /
• 2000

A long-term bed rest results in an inevitable foot drop. Yet preventive device such as a foot board and high-neck tennis shoes, are not widely used. This study was conducted to compare the effects of a pillow-type foot board with that of the band-type device. The band-type device of a resonable price is designed for an effective prevention of foot drop, and the convenience for it use. Among the non-equivalent control group design, foot drop preventive effects, usefulness of the device, as well as its cost effectiveness were examined. The study was carried out for four months from December 1999, and its subject had been patients and nurses of two intensive care units at K medical center in Seoul. According to the study purpose, the data collected were analyzed by $x^2-test$ and t-test. The results are as follow : 1. The ROM of ankle joint is promoted in the experimental group with a band-type device comparing the control group with a pillow type one. Dorsiflexion is particularly increased in the experimental group as compared with the control group, while planterflexion hardly shows any change. 2. The usefulness score of the experimental group nurses using the band-type device (23.97) is higher than that of the control group nurses (18.88). 3. In an aspect of the unit production cost, band-type devices are low-priced compare with pillow-type or other foot board (wooden) or high-neck tennis shoes. In summary, the newly developed band-type device is both useful and preventive for a foot drop. It is also desirable regarding to the production cost and the cost effectiveness. This fact proves that the new anti-foot drop device could be practical both for clinical care and home care. Yet the results were obtained by some subjects, it should be used after a further examination. More effective nursing intervention could be observed throughout general studies, including proper positioning and foot and ankle exercises which are the important variables of the foot drop prevention.

• Journal of the Korean Society of School Health
• /
• v.29 no.3
• /
• pp.123-131
• /
• 2016

Purpose: Human Papillomavirus(HPV) vaccination is the best prevention for cervical cancer. Therefore, this study was to examine the best predictors of HPV vaccination status in female nursing university students. Methods: Five hundred and forty junior and senior female nursing students from Seoul and provinces of Kyunggi, Chungcheong and Gyungsang completed paper and pencil questionnaires. Descriptive statistics, $x^2$ test, t-test, and multiple logistic regression with dummy variables were conducted using SAS 9.2. Results: Of the total students, 56.8% were vaccinated. As a result of the analysis of the bivariate relationships, family economic status, school type, perceived susceptibility, perceived benefit and perceived barriers (cost, time, distance from hospital and side effects) were significantly related to vaccination status. After controlling for the general characteristics and the HPV related knowledge score, higher family economic status (Adjusted Odds Ratio [AOR]: 3.78, 95% Confidence Interval [CI]: 1.21~11.76), private university (AOR: 1.69, 95% CI: 1.14~2.53), higher perceived benefit (AOR: 1.80, 95% CI: 1.47~2.20), lower perceived barrier (cost) (AOR: 0.86, 95% CI: 0.74~0.99), lower perceived barrier (time) (AOR: 0.71, 95% CI: 0.61~0.84), and lower perceived barrier (side effects) (AOR: 0.82, 95% CI: 0.72~0.94) were significantly related to HPV vaccination. Perceived benefit, perceived barrier (time) and perceived barrier (side effects) were the top 3 predictors of HPV vaccination status. Conclusion: This study suggests that vaccinated female nursing students were more likely to be from higher family economic status and private universities and have a higher perception of benefit and a lower perception of barriers (cost, time, and side effects). Thus, efforts to increase HPV vaccination rates of female nursing students should focus on improving their perception of benefit while lowering their perception of barriers, particularly cost, time and side effects.

• Korean journal of food and cookery science
• /
• v.14 no.4
• /
• pp.407-415
• /
• 1998

The objectives of this study were to analyze the factors that affect the productivity for university food services. In a survey involving four-year university dining centers throughout the country, and correlations among thriteen different variables that affect productivity were determined. Productivity index (PI) was determined by meals per hour, the average score for 38 institutions was found to be 14.2 meals/hour. For serving methods, the fixed ration had a higher PI than the self-serving. When two types of serving trays were considered, the PI of the compartmantalized trays was higher than that of the tray accompanying saparate small dishes. When single (S)-or. multiple(M)-menu was compared with the cafeteria style, a higher PI was obtained by the S-or M-menu. Among the three operation systems, the PI was found to be the highest by direct operation (17.6 meals/hour), followed by contract operation (11.1 meals/hour) and rent operation (7.9 meals/hour). For the factors that affect the productivity of the university food services, the total number sewed (r=0.54, p＜0.001) and the use of convenient food items (r=0.28, P＜0.05) exhibited positive correlations, while food costs and labor costs showed negative correlations. This suggests that the productivity of university food service increases as the total number served and the use of convenient food item increased, but decreases as the food costs and labor costs per meal increased. A regression analysis showed that three variables - total number sewed, labor cost per meal, number of employees-influenced about 73% components of food service showed a negative correlation with PI and a positive correlation with the labor cost per meal.

• Journal of the Korea Convergence Society
• /
• v.12 no.12
• /
• pp.331-338
• /
• 2021

This study used data from the 10rd and 15th year of the Korean Welfare Panel to evaluate the effects of the Energy Voucher Program(EVP) on the consumption and expenditure of EVP users' households. The study consisted of program group using EVP and control group not using. Chi-square and t-test were used for the characteristic differences among the groups, and the difference of consumption expenditure was identified by multiple regression analysis. As a result, EVP had a statistically significant effect on the health care costs of EVP users' households, resulting in an increase in health care costs(𝛽=3.06). However, there was no statistically significant effect on the total cost of living, basic cost, education cost, and recreation/entertainment cost. Therefore, in order to increase the effectiveness of the EVP system, it is required to improve the EVP system by expanding the level of benefits and easing the qualification standards for the eligibility for benefits.

• Korean Journal of Construction Engineering and Management
• /
• v.23 no.1
• /
• pp.89-97
• /
• 2022

Recently, various problems such as reduced productivity, insufficient inflow of skilled manpower, reduced quality, and concerns about increasing safety accidents have appeared in the domestic construction industry. Stakeholder of construction project are considering the Off-Site Construction (OSC) method rather than the conventional on-site construction as an alternative. Despite the importance of decision making in the early stage of the adoption of OSC, there is a lack of methodologies for rational decision making. In this study, a decision making system has been developed to derive the final construction cost score by deriving the project characteristics, selecting the construction difficulty index, and developing a cost model for each construction method alternatives to calculate the standard construction cost. Using this system, the OSC method can be effectively evaluated in terms of its feasibility in the early stage of construction

• Asian-Australasian Journal of Animal Sciences
• /
• v.19 no.4
• /
• pp.468-474
• /
• 2006

Real time ultrasound data was generated on 10,596 live Hanwoo cows to study genetic variation on ultrasonic beef quality traits and to assess the best model to estimate genetic parameters on these traits. Pedigree stacking and data validation was done using the SAS statistical software and the genetic parameter estimates were obtained by EM-REML algorithm. Out of the five different multi-trait mixed animal models constructed, the optimal model included fixed effects of herd, year-season-appraisal, body condition score, linear and quadratic covariates for chest girth, the linear covariate effect of age and the random animal and residual effect of the five models studied. The heritability of longissimus muscle area (LMA), $12^{th}$ rib measurement of back fat thickness (BF) and marbling score (MS) was 0.11, 0.17 and 0.15, respectively. Genetic correlation of LMA vs. BF, LMA vs. MS and BF vs. MS was -0.15, 0.06 and 0.61, respectively. The results showed presence of genetic variation in these ultrasonic beef quality traits in Hanwoo cows and suggest that the selection of Hanwoo cows may be possible by performing ultrasonic scans on live animals, which will ultimately be helpful in reducing the generation interval and the cost of selection procedure.