• Title/Summary/Keyword: Cost-benefit

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Analysis on the trends and causes of inhabitant's behavioral changes in medical institutions's utilization after enforcement of regional medical insurance. (pilot-project area of regional medical insurance; mainly Kun-wi and Kwang-hwa county) (의료보험(醫療保險) 실시이후(實施以後) 지역주민(地域住民)의 의료기관이용행태(醫療機關利用行態) 변화(變化) 추이(推移)와 그 요인(要因)에 관한 조사연구(調査硏究))

  • Park, Jung-Yeon
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.47-76
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    • 1989
  • The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

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PM2.5 Simulations for the Seoul Metropolitan Area: (II) Estimation of Self-Contributions and Emission-to-PM2.5 Conversion Rates for Each Source Category (수도권 초미세먼지 농도모사 : (II) 오염원별, 배출물질별 자체 기여도 및 전환율 산정)

  • Kim, Soontae;Bae, Changhan;Yoo, Chul;Kim, Byeong-Uk;Kim, Hyun Cheol;Moon, Nankyoung
    • Journal of Korean Society for Atmospheric Environment
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    • v.33 no.4
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    • pp.377-392
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    • 2017
  • A set of BFM (Brute Force Method) simulations with the CMAQ (Community Multiscale Air Quality) model were conducted in order to estimate self-contributions and conversion rates of PPM (Primary $PM_{2.5}$), $NO_x$, $SO_2$, $NH_3$, and VOC emissions to $PM_{2.5}$ concentrations over the SMA (Seoul Metropolitan Area). CAPSS (Clean Air Policy Support System) 2013 EI (emissions inventory) from the NIER (National Institute of Environmental Research) was used for the base and sensitivity simulations. SCCs (Source Classification Codes) in the EI were utilized to group the emissions into area, mobile, and point source categories. PPM and $PM_{2.5}$ precursor emissions from each source category were reduced by 50%. In turn, air quality was simulated with CMAQ during January, April, July, and October in 2014 for the BFM runs. In this study, seasonal variations of SMA $PM_{2.5}$ self-sensitivities to PPM, $SO_2$, and $NH_3$ emissions can be observed even when the seasonal emission rates are almost identical. For example, when the mobile PPM emissions from the SMA were 634 TPM (Tons Per Month) and 603 TPM in January and July, self-contributions of the emissions to monthly mean $PM_{2.5}$ were $2.7{\mu}g/m^3$ and $1.3{\mu}g/m^3$ for the months, respectively. Similarly, while $NH_3$ emissions from area sources were 4,169 TPM and 3,951 TPM in January and July, the self-contributions to monthly mean $PM_{2.5}$ for the months were $2.0{\mu}g/m^3$ and $4.4{\mu}g/m^3$, respectively. Meanwhile, emission-to-$PM_{2.5}$ conversion rates of precursors vary among source categories. For instance, the annual mean conversion rates of the SMA mobile, area, and point sources were 19.3, 10.8, and $6.6{\mu}g/m^3/10^6TPY$ for $SO_2$ emissions while those rates for PPM emissions were 268.6, 207.7, and 181.5 (${\mu}g/m^3/10^6TPY$), respectively, over the region. The results demonstrate that SMA $PM_{2.5}$ responses to the same amount of reduction in precursor emissions differ for source categories and in time (e.g. seasons), which is important when the cost-benefit analysis is conducted during air quality improvement planning. On the other hand, annual mean $PM_{2.5}$ sensitivities to the SMA $NO_x$ emissions remains still negative even after a 50% reduction in emission category which implies that more aggressive $NO_x$ reductions are required for the SMA to overcome '$NO_x$ disbenefit' under the base condition.

Human Health Risk, Environmental and Economic Assessment Based on Multimedia Fugacity Model for Determination of Best Available Technology (BAT) for VOC Reduction in Industrial Complex (산업단지 VOC 저감 최적가용기법(BAT) 선정을 위한 다매체 거동모델 기반 인체위해성·환경성·경제성 평가)

  • Kim, Yelin;Rhee, Gahee;Heo, Sungku;Nam, Kijeon;Li, Qian;Yoo, ChangKyoo
    • Korean Chemical Engineering Research
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    • v.58 no.3
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    • pp.325-345
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    • 2020
  • Determination of Best available technology (BAT) was suggested to reduce volatile organic compounds (VOCs) in a petrochemical industrial complex, by conducting human health risk, environmental, and economic assessment based on multimedia fugacity model. Fate and distribution of benzene, toluene, ethylbenzene, and xylene (BTEX) was predicted by the multimedia fugacity model, which represent VOCs emitted from the industrial complex in U-city. Media-integrated human health risk assessment and sensitivity analysis were conducted to predict the human health risk of BTEX and identify the critical variable which has adverse effects on human health. Besides, the environmental and economic assessment was conducted to determine the BAT for VOCs reduction. It is concluded that BTEX highly remained in soil media (60%, 61%, 64% and 63%), and xylene has remained as the highest proportion of BTEX in each environment media. From the candidates of BAT, the absorption was excluded due to its high human health risk. Moreover, it is identified that the half-life and exposure coefficient of each exposure route are highly correlated with human health risk by sensitivity analysis. In last, considering environmental and economic assessment, the regenerative thermal oxidation, the regenerative catalytic oxidation, the bio-filtration, the UV oxidation, and the activated carbon adsorption were determined as BAT for reducing VOCs in the petrochemical industrial complex. The suggested BAT determination methodology based on the media-integrated approach can contribute to the application of BAT into the workplace to efficiently manage the discharge facilities and operate an integrated environmental management system.

Determination of Flood Reduction Alternatives for responding to climate change in Gyeongan Watershed (기후변화 대응을 위한 경안천 유역의 홍수저감 대안 선정)

  • Han, Daegun;Choi, Changhyun;Kim, Duckhwan;Jung, Jaewon;Kim, Jungwook;Kim, Soo Jun
    • Journal of Wetlands Research
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    • v.18 no.2
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    • pp.154-165
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    • 2016
  • Recently, the frequency of extreme rainfall event has increased due to climate change and impermeable area also has increased due to rapid urbanization. Therefore, we ought to prepare countermeasures for flood reduction to reduce the damage. To consider climate change, the frequency based rainfall was calculated according to the aimed period(reference : 1971~2010, Target period I : 2011~2040, Target period II : 2041~2070, Target period III : 2071~2100) and the flood discharge was also calculated by climate change using HEC-HMS model. Also, the flood elevation was calculated by each alternative through HEC-RAS model, setting 5 sizes of drainage pumps and reservoirs respectively. The flood map was constructed using topographical data and flood elevation, and the economic analysis was conducted for reduction of flood damage using Multi dimension - Flood Damage Analysis, MD-FDA. As a result of the analysis on the flood control effect, a head of drainage pump was reduced by 0.06m up to 0.44m while it was reduced by 0.01m up to 1.86m in the case of a detention pond. The flooded area shrunk by up to 32.64% from 0.3% and inundation depth also dropped. As a result of a comparison of the Benefit/Cost index estimated by the economic analysis, detention pond E in period I and pump D in period II and III were deemed appropriate as an alternative for climate change. The results are expected to be used as good practices when implementing the flood control works considering climate change.

Geoscientific land management planning in salt-affected areas* (염기화된 지역에서의 지구과학적 토지 관리 계획)

  • Abbott, Simon;Chadwick, David;Street, Greg
    • Geophysics and Geophysical Exploration
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    • v.10 no.1
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    • pp.98-109
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    • 2007
  • Over the last twenty years, farmers in Western Australia have begun to change land management practices to minimise the effects of salinity to agricultural land. A farm plan is often used as a guide to implement changes. Most plans are based on minimal data and an understanding of only surface water flow. Thus farm plans do not effectively address the processes that lead to land salinisation. A project at Broomehill in the south-west of Western Australia applied an approach using a large suite of geospatial data that measured surface and subsurface characteristics of the regolith. In addition, other data were acquired, such as information about the climate and the agricultural history. Fundamental to the approach was the collection of airborne geophysical data over the study area. This included radiometric data reflecting soils, magnetic data reflecting bedrock geology, and SALTMAP electromagnetic data reflecting regolith thickness and conductivity. When interpreted, these datasets added paddock-scale information of geology and hydrogeology to the other datasets, in order to make on-farm and in-paddock decisions relating directly to the mechanisms driving the salinising process. The location and design of surface-water management structures such as grade banks and seepage interceptor banks was significantly influenced by the information derived from the airborne geophysical data. To evaluate the effectiveness ofthis planning., one whole-farm plan has been monitored by the Department of Agriculture and the farmer since 1996. The implemented plan shows a positive cost-benefit ratio, and the farm is now in the top 5% of farms in its regional productivity benchmarking group. The main influence of the airborne geophysical data on the farm plan was on the location of earthworks and revegetation proposals. There had to be a hydrological or hydrogeological justification, based on the site-specific data, for any infrastructure proposal. This approach reduced the spatial density of proposed works compared to other farm plans not guided by site-specific hydrogeological information.

A Study on the analysis of activities of t?e 5.H.T. (5.H.T. in Pusan City) (부산지역 양호교사의 업무분석에 관한 연구)

  • Kim, Lee-Sun;Kim, Bok-Yong
    • Research in Community and Public Health Nursing
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    • v.1 no.1
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    • pp.465-502
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    • 1989
  • The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A Study on Reputation as Corporate Asset (기업자산으로서의 기업명성가치 연구: 국내 4개 기업 슈퍼브랜드와 기업명성, 미디어 이용간 관련성을 중심으로)

  • Lee, Cheol-Han;Cha, Hee-Won
    • Korean journal of communication and information
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    • v.30
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    • pp.203-237
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    • 2005
  • The purpose of this study is to find a model that can measure the public relations programs based on the assumption that the public relations should aim to lift the corporate reputation. It is a trend that corporate's activities are to be measured from the standpoint of cost-benefit efficiency. However, public relations fields in Korea is left behind this trend because the fields lack in sophisticated model. In order to fill this gap, the researchers introduce the reputation measurement model that can calculate individual corporate public relations programs. In addition, this reputation model Is applied to Korean companies with the expectation of producing a PR index which ran be used to measure the reputation as corporate asset, or superbrand. This study examines the effects of superbrand on consumers according to the media use. Based on the expert group interviews and surveys on consumers, the factors of reputation are drawn. These factors contribute to find reputation model and measurement index which are again applied to measure the Korean companies' public relations programs. Using superbrand as dependent variables and managing abilities, corporate responsibility, corporate communication, and product/employee quality, this study seeks to find which factor specifically attribute to lift corporate reputation. Results show that each factor influences the corporate reputation positively. In addition, the researchers find that media use is moderately related to the superbrand building process in cognitive dimension.

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A Study on Ensuring Biosafety of Biotechnology Product under Debate about Trade and the Environment (DDA 무역-환경 논의와 생명공학제품의 안전성 확보)

  • Sung, Bong-Suk;Yoon, Ki-Kwan
    • Environmental and Resource Economics Review
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    • v.13 no.3
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    • pp.519-547
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    • 2004
  • This paper analyze problems about scope of specific trade obligations(STOs), principle of dispute settlement procedure, and non-parties in context of the Cartagena Protocol on Biosafety(POB), which based on sub-paragraph 31(i) of DDA WTO Ministrial Declaration. The implications based on result of this study are as follows. First, to accept the wider scope of STOs under POB in Korea, importing country, won't be harmful to LMOs and Bioindustry. Instead, it will ensure a high level of biosafety concerning the import of LMOs. Exporters can take different kinds of trade measures to countervail adverse effect on the export of LMOs in this case. Therefore importer will endure the aftereffect. However, if korea were in exporter's place, to accept the wider scope STOs under POB will not have a good influence on the export of LMOs. Korea, therefore, should devise scheme for responding to debate about the STOs in MEAs, which have to be based on cost-benefit analysis and scenarios taking into account of speed and level in biotechology progress, status and trend of LMOs R&D and production, and condition of other industries. Second, it is not easy to agree with applying to what's rule between the POB and WTO for settlement dispute. Because there is the incompatibility between the POB characterized according to social rationality and WTO's rules for safety and environmental protection characterized according to scientific rationality. This issue have to be discussed for long period due to gap like that. Accordingly Korea, one of major LMOs importing countries, should suggest continuously that the effort is needed to ensure an adequate level of protection in transboundary movements of LMOs and scientific, environmental and socio-economic study. Third, in case of dispute between party and non-party of the POB, the duties under the WTO of non-party of the POB(if WTO member country) is valid. The country, therefore, will try to settle dispute based on WTO's rules. However, international society have to ensure for sound and safe use of LMOs in the field of transboundary movements. Accordingly Korea should devise scheme for preventing the possibility of dispute between party and non-party of the POB(if WTO member country), which is supported by policy options under the POB.

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A Study on the Hull-dimension of 89 ton class Stow-net Vessel with Stern-fishing (89톤급 선미식 안강망어선의 선형치수에 관한 연구)

  • Park, Je-Ung;Lee, Hyeon-Sang
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.33 no.3
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    • pp.159-165
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    • 1997
  • This paper presents the optimum dimension of 89 ton class stow-net vessel with stern-fishing. The model of basic design is developed by using the optimization techniques referring to objective function and numerous constraints as follows; speed, fishing quantity, fishing days, catch per unit effort(CPUE), and weight/ratio of main dimensions, etc. Thus, the basic design of stow-net fishing vessel is built up by using the optimization of the design variables called the economic optimization criteria, and the objective function represents the criterion which is cost benefit ratio(CBR). The main conclusions are as follows. 1. S/W for decision of optimum hull size is developed in 89 ton class stow-net fishing vessel which is constructed with optimization of the design variables called the economic optimization criteria. 2. For optimum ship dimensions in 89 ton class stow-net fishing vessel, the hull dimensions can be obtained in the range of L= 27.3m, B = 6.6m, D = 2.80m, Cb = 0.695, T/D = 0.80, $\Delta$(displacement)=281.7ton with 10 knots.

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