• Title/Summary/Keyword: Cost Variance

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Comparative Analysis for Clustering Based Optimal Vehicle Routes Planning (클러스터링 기반의 최적 차량 운행 계획 수립을 위한 비교연구)

  • Kim, Jae-Won;Shin, KwangSup
    • The Journal of Bigdata
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    • v.5 no.1
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    • pp.155-180
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    • 2020
  • It takes the most important role the problem of assigining vehicles and desigining optimal routes for each vehicle in order to enhance the logistics service level. While solving the problem, various cost factors such as number of vehicles, the capacity of vehicles, total travelling distance, should be considered at the same time. Although most of logistics service providers introduced the Transportation Management System (TMS), the system has the limitation which can not consider the practical constraints. In order to make the solution of TMS applicable, it is required experts revised the solution of TMS based on their own experience and intuition. In this research, different from previous research which have focused on minimizing the total cost, it has been proposed the methodology which can enhance the efficiency and fairness of asset utilization, simultaneously. First of all, it has been adopted the Cluster-First Route-Second (CFRS) approach. Based on the location of customers, we have grouped customers as clusters by using four different clustering algorithm such as K-Means, K-Medoids, DBSCAN, Model-based clustering and a procedural approach, Fisher & Jaikumar algorithm. After getting the result of clustering, it has been developed the optiamal vehicle routes within clusters. Based on the result of numerical experiments, it can be said that the propsed approach based on CFRS may guarantee the better performance in terms of total travelling time and distance. At the same time, the variance of travelling distance and number of visiting customers among vehicles, it can be concluded that the proposed approach can guarantee the better performance of assigning tasks in terms of fairness.

Regional Variations in the Cesarean Section Rate and It's Determinants in Korea (제왕절개 분만율의 지역간 변이와 관련요인에 대한 연구)

  • Kim, Hye-Kyung;Lee, Jeon-Un;Park, Kang-Won;Moon, Ok-Ryun
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.3 s.39
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    • pp.312-329
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    • 1992
  • The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.

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A Case Study about PET/CT Collaboration Operation (PET/CT 공동운영에 대한 사례 연구)

  • Kim, Chang-Ho;Pyo, Sung-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.87-92
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    • 2010
  • Purpose: In 2003, we decided to buy a PET/CT, at the time, it was the latest cancer diagnostic medical equipment. Equipment company was offered the marketing of collaboration operation because the highly cost of PET/CT. However, this hospital's choice was own purchase way. In this study we evaluated the collaboration operation way by post-mortem analysis to the current situation. Materials and Methods: From 2004 until 2008, five years, we investigate the revenue analysis the number of PET/CT cases about own purchase way and collaboration operation way according (ABC costing). Results: The year 2004, own purchase way is 4 billion 9 thousand 2 hundred million won in deficit, the collaboration operation way is 1 billion 1 thousand 7 hundred million won in deficit. The year 2005, own purchase way is 1 billion 5 hundred million won in deficit, collaboration operation way is 8 thousand 7 hundred million won in deficit. However, the year 2006, own purchase way is 5 billion 1thousand 3 hundred million won in surplus, collaboration operation way is 9 thousand 9 hundred million won in deficits. The year 2007 and 2008, revenue of own purchase way is more increased but the collaboration operation way is more decreased. From the year 2004 to 2008, subtotal of own purchase way is 10 billion 8 thousand 8 hundred won in surplus, sub-total of collaboration operation way is 6 billion 7 thousand million won in deficit. Conclusion: Own purchase way has been a big benefit occurs and to reflect the equipment price, the collaboration operation way became to deficit continues. In other words, the problem of collaboration operation way showed us. When you buy the high cost Equipment, consideration will be risk and economic analysis of variance, the appropriate of the initial investment cost, clinical diagnostic needs and etc.

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A Study on Sample Allocation for Stratified Sampling (층화표본에서의 표본 배분에 대한 연구)

  • Lee, Ingue;Park, Mingue
    • The Korean Journal of Applied Statistics
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    • v.28 no.6
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    • pp.1047-1061
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    • 2015
  • Stratified random sampling is a powerful sampling strategy to reduce variance of the estimators by incorporating useful auxiliary information to stratify the population. Sample allocation is the one of the important decisions in selecting a stratified random sample. There are two common methods, the proportional allocation and Neyman allocation if we could assume data collection cost for different observation units equal. Theoretically, Neyman allocation considering the size and standard deviation of each stratum, is known to be more effective than proportional allocation which incorporates only stratum size information. However, if the information on the standard deviation is inaccurate, the performance of Neyman allocation is in doubt. It has been pointed out that Neyman allocation is not suitable for multi-purpose sample survey that requires the estimation of several characteristics. In addition to sampling error, non-response error is another factor to evaluate sampling strategy that affects the statistical precision of the estimator. We propose new sample allocation methods using the available information about stratum response rates at the designing stage to improve stratified random sampling. The proposed methods are efficient when response rates differ considerably among strata. In particular, the method using population sizes and response rates improves the Neyman allocation in multi-purpose sample survey.

Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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A Study on the Consciousness of Landscape Planting Practitioner about the Measurement Criteria of the Root Diameter of Landscape Trees in the Landscape Planting Construction, in Korea (우리나라 조경식재공사의 근원직경 측정기준에 대한 조경식재 실무자들의 의식)

  • Han, Yong-Hee;Min, Jong-Il;Kim, Do-Gyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.2
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    • pp.27-40
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    • 2021
  • This study was carried out for the description of the conflicts on the measurement of the root collar diameter of the landscape trees that are currently being produced, distributed, and planted in S. Korea, and for determination of the standard for root collar diameter measurement. The difference in consciousness of appropriate measurement of root collar diameter among different ages of landscape practitioners was statistically significant at p<0.05 level. It seemed to be due to the difference in the amount of field experiences among different age groups. On "the ambiguity of measuring the root collar diameter' of landscape trees", the consciousness was significantly different at p<0.05 level among job positions. On "Improvement of measurement criteria for landscape trees," it was significantly different at p<0.05 level among job types. This was thought to be due to the disagreement between the client and the contractor. On "prevention of topsoil removal" when excavating landscape trees, the consciousness was significantly different at p<0.001 level among different age groups, and different at p<0.01 level among different occupations, and different at p<0.05 level among different working area. The consciousness on "removing top soil when excavating landscape trees and rooting after transplantation" was not significantly different. The consciousness on the conflict caused by "ambiguity in root collar diameter measurement criteria" was high with an average of 3.85 for job type, occupation, jop position, and work experience. It was higher for landscape contractors than public institutions. The higher job positions and more experiences, the more conflicts. The consciousness on the appropriate position of root collar diameter measurement for landscape trees revealed that measuring at above-ground part (66.5%) was prefered to the underground part (33.0%). During the excavation of landscape trees for transplant, topsoil removal up to average depth of -2cm to -4cm was favored by 84.0%, and the purpose of removing topsoil was recognized as 'to increase the size and unit cost' by 59.7%.

Formalization of Productivity Metrics for Equipment in Multi-sectioned Road Construction Projects (다(多)공구 도로 공사 현장 장비들의 운영 실태 파악을 위한 생산성 지표 정립에 관한 연구)

  • Kim, Hong-Yeul;Koo, Bon-Sang
    • Korean Journal of Construction Engineering and Management
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    • v.13 no.4
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    • pp.100-109
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    • 2012
  • Large road construction projects are typically partitioned into sections that are then contracted individually to contractors. Each section requires using similar heavy equipment including excavators, dump trucks and pavers, which constitute the highest cost. Normally the equipment is not shared between them, as each contractor wishes to have their equipment readily available. However, such practices result in very low utilization of these equipment. The goal of this research is to develop a programmatic resource sharing system in which contractors can share equipment depending on the changing needs of a multi-sectioned road project. This paper introduces the results of a survey performed to investigate how contractors currently manage the supply and demand of equipment and the equipment that are practical for sharing across a project. More importantly, the paper describes a set of metrics (DPR, nDPR, SDI) needed to quantify the amount of supply/demand variance occurring in each section. The metrics were used on an actual road construction project, and the results show that each section suffers from an imbalance between its monthly planned and actual utilization of equipment. The results also indicate that the sharing of the equipment can lead to potentially large savings as equipment requirements can be met within a project as to short leasing from outside vendors.

Development and Clinical Application of Critical Pathways for Vaginal Delivery and Cesarean Section (정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용)

  • Park, Yong Won;Bai, Sang Wook;Jung, Young Nae;Lee, Hae Woo;Kim, Young Ran;Hong, Sun Bok;Park, Heun Ju;Tark, Kwan Chul
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.32-45
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    • 2000
  • Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

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Comparative Study on the Job Satisfaction of Part-time Nurses and Internship Nurses (시간제 간호사 및 인턴간호사의 직무만족도에 관한 비교연구)

  • Choi, Sook-Ja
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.93-105
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    • 1999
  • Recently, Korean health care industry managers are paying more attention to customer oriented service, the rationalization of business administration, and quality control of service to adjust their business to outer environment since IMF bailout program. They are focusing on the cost reduction through remodeling the size and structure of man power, viz. labor flexibility. Nurses are not free from this juncture and contingent nurses are increasing fast. This article intends to verify the actual condition of two types of contingent nurses -part-time nurses and internship nurses-and to compare their job satisfaction to provide basic resource for efficient management of nurse man power. The concrete goals of this article are; Firstly, to verify the actual condition of their employment. Secondly, to compare their job satisfaction. And Thirdly, to the relation between employment condition and job satisfaction. To accomplish these research goals, a statistical survey was executed, in which 384 questionnaires - 66 for manager nurses, 318 for contingent nurses-were given to nurses working at 66 general hospitals-which have at least 100 beds-in Seoul. Among them, 121 questionnaires-of 28 general hospitals-were returned. Then, the data coded and submitted to mean, standard deviation, T-test, variance analysis (ANOVA), correlation analysis, multiple regression analysis with SAS program. The research results of the contingent nurses are followings: 1. Two types of contingent nurses shows similar age spans: they are mostly 21 - 30 years old and unmarried. But internship nurses have high level of educational career. Part - time nurses spread at general beds, out -patient part, intensive care part, operation part, etc, but internship nurses work mostly at general beds. 2. Two groups shows difference in actual employment condition: average employment career of part -time nurses is 7.0 months but internship nurses' is 2.0 months: average duty-on days per month of part - time nurses are 23.7 days but internship nurses' are 24.8 days. But there are little difference in average working time per day: 7.7 hours for part -time nurses and 0 hours for internship nurses. 3. The average wage per month for part -time nurses is 836,026 won but for internship nurses is 557,428 won-66.7% of part-time nurses'. Both groups are enjoying little additional pay. 4. Both groups are getting job not so much through advertisement of newspaper or hospitals as through acquainted person or college. 5. Both groups show very high level of job satisfaction: 3.2195 for part -time nurses and 3.2881 for internship nurses. But they show very low satisfaction on payment level compared with other categories and two groups show meaningful difference(P<.0001). 6. The multiple regression test reveals the factors related with job satisfaction: wage level, working part(OR or ICU), age, job career, and motive of contingent job-taking('because I can take care of family duties at the same time') influence positively: motive of contingent job-taking('because I can work regularly without alternation') influences negatively.

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The Relationship between Perceived health status, Health conception and Health promoting behavior in the Elderly (노인의 지각된 건강상태 및 건강개념과 건강증진 행위와의 관계)

  • Kim Hyo Jung;Chae Sun Ok;Park Young Sook;Woo Sun Hye
    • Journal of Korean Public Health Nursing
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    • v.15 no.2
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    • pp.262-274
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    • 2001
  • This study was undertaken to grasp the relationship between perceived health status, health conception and health promoting behavior in the elderly. The subjects for this study were 157 old persons in Kyung-ju city. Data were collected by interview with questionnaires from August 24 to October 10, 1999. Analysis of the data was done by SPSS program using descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, stepwise multiple regression. The results were summarized as follows 1. For the practice of health promoting behavior. the mean score was 2.52. The factor of the highest mean score was nutrition(3.02) and factor of the lowest mean score was exerciset(2.03). 2. According to age(F=3.35, P=.012), sex(t=2.26, P=.025), marital status (F=5.08, P=.007), education(F=4.22, P=.003), family numbed(F=5.31, P= .006), people living together (F=2.77, P=.044), economic status(F=7.10, P=.00l), average monthly pocket money (F=3.35, P=.012), there were differences of health promoting behavior. 3. According to age(F=3.40, P=.01l), sex(t=4.30, P=.000), education(F=8.55, P=.000), economic status(F=12.59, P=.000), average monthly pocket money(F=4.26, P=.003), present disease(t=-8.41, P=.000), there were differences of perceived health status. According to marital status(F=3.36, P=.037), education(F=2.89, P=.038), there were differences of health conception. 4. Performance in the health promoting behavior was significantly correlated with perceived health status(r=.272, P=.00l), health conception(r=.345, P=.000) 5. The combination of well-being health conception and average monthly pocket money explained $24.7\%$ of the variance of health-promoting behavior. On the basis of the above findings the following recommendations are made; Nursing interventions enhancing exercise or activity, accountability for health, stress management of the elderly must be provided. And Cost-effective health promoting program for the elderly must be developed.

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