• Title/Summary/Keyword: DRGs

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Development of Dynamic Route Guidance System for Multiple Shortest Paths Using Genetic Algorithm (유전자알고리듬을 사용하여 다수최적경로를 제공할 수 있는 동적경로유도시스템의 개발)

  • Kim, Sung-Soo;Jeong, Jong-Du;Lee, Jong-Hyun
    • IE interfaces
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    • v.14 no.4
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    • pp.374-384
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    • 2001
  • The objective of this paper is to design the dynamic route guidance system(DRGS) and develop a genetic algorithm(GA) for finding the multiple shortest paths in real traffic network. The proposed GA finds a collection of paths between source and destination considering turn-restrictions, U-turn, and P-turn that are genetically evolved until an acceptable solution is reached. This paper also shows the procedure to find the multiple shortest paths in traffic network of Seoul.

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Neuroanatomical Comparative Studies on the Motor and Sensory Neurons Associated with Daereung(PC7) in the Rats (흰쥐에서 대릉(PC7)과 관련된 운동신경과 감각신경의 분포영역에 대한 신경해부학적 연구)

  • Lee, Sun-Ho;Lee, Chang-Hyun;Lee, Sang-Ryong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.5
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    • pp.416-421
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    • 2015
  • This study was performed to comparative investigate the distribution of primary sensory and motor neurons associated with Daereung(PC7) acupoints by using neural tracing technique. A total 16 SD rats were used in the present study. After anesthesia, the rats received microinjection of 6 ㎕ of cholera toxin B subunit(CTB) into the corresponding sites of the acupoints Daereung(PC7), in the human body for observing the distribution of the related primary sensory neurons in dorsal root ganglia(DRGs) and motor neurons in the spinal cord(C3∼T4) and sympathetic ganglia. Three days after the microinjection, the rats were anesthetized and transcardially perfused saline and 4% paraformaldehyde, followed by routine section of the DRGs, sympathetic chain ganglia(SCGs) and spinal cord. Labeled neurons and nerve fibers were detected by immunohistochemical method and observed by light microscope equipped with a digital camera. The labeled neurons were recorded and counted. From this research, the distribution of primary sensory and motor neurons associated with Daereung(PC7) acupoints were concluded as follows. Muscle meridian related Daereung(PC7) controlled by spinal segments of C5∼T1, C6∼T4, respectively.

A study on the relationship between the concentration status of inpatient services and medical charges per case between 2009 and 2011 (입원서비스의 집중화 수준과 진료비 간의 관계 분석: 2009년~2011년)

  • Kwak, Jin-Mi;Lee, Kwang-Soo;Kwon, Hyuk-Jun
    • Knowledge Management Research
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    • v.16 no.1
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    • pp.209-224
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    • 2015
  • Previous studies provided that limiting the number of services provided in hospital had influences in decreasing cost in delivering medical services. Hospitals could have positive effects on their profit by concentrating small number of services which they have comparative advantages. This study purposed to analyze the relationship between the concentration status of hospitals and medical charge for inpatients. National Inpatient sample data provided by the Health Insurance Review and Assessment Service (HIRA) for three years, 2009 to 2011 was used to compute the three concentration indices (Information Theory Index (ITI), Internal Herfindahl Index (IHI), and number of distinct Diagnosis-Related Groups (DRGs) treated) and total medical charge per inpatient case in each year. It was also used to select the control variables such as bed size, number of doctors per 100 beds, and locations. The ordinary least square regression models were developed and tested for hospital and general hospitals separately. The results showed that the total medical charge per inpatient case was significantly differed depending on the concentration indices, and there were positive relationships in ITI and IHI. The number of distinct DRGs had different directions in regression coefficients depending on the locations and hospital types. Hospitals had larger absolute standardized regression coefficients compare to those of general hospitals. However, their effects could be varied by the hospital types, number of doctors, and locations. It seems that hospitals have more influences on medical charges by concentrating their services than general hospitals. Study results provide knowledges to hospital administrators that concentration strategy can positive influences on the performance of small size hospitals.

Statistical Model for Analysing Variations in Inpatient Procedure and Operation Costs of Some Selected K-DRGs by Type of Hospitals (일부 K-DRG 환례의 의료기관 유형별 수술 및 처치 진료비의 변이 분석 모형)

  • Lee, Young-Jo;Noh, Maeng-Seok;Kim, Yoon;Lee, Moo-Sang;Lee, Sang-Il
    • Health Policy and Management
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    • v.8 no.1
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    • pp.1-14
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    • 1998
  • Analysis of practice variations has been one of important issues in trying to contain costs as well as to manage quality in health care. This study was conducted to provide statistical model for analysing variations in inpatient costs by type of hospitals. Four K-DRGs including Cesarean section, appendectomy, cataract extraction, and pediatric pneumonia with CC class 0 were selected, and means and dispersions of inpatient procedure and operation costs were simultaneously compared between type of hospitals. The results indicated that joint modelling of means and dispersions by gamma distribution was a very useful analytic tool for identifying factors which might have relationship with variations in inpatient costs. This model can be expanded to test the significance of several independent variables in analysing cost variations. In surgical conditions, means and unit variations of procedure and operation costs showed consistent pattern which was tertiarty hospital, general hospital, and hospital in descending order. Different findings were identified in pediatric pneumonia, from which mean and unit variation of procedure and operation cost was the highest in general hospital. The practical implication of this difference could not be drawn from this study. It will be done by further sophisticated researches. In order to develop health policy for cost containment and quality management in Korea, it is essential to find out manageable factors affecting variations in practice patterns which include characteristics of population, providers, regions, and so on. The statistical model presented in this study will give health services researchers useful insights for future investigations in analysing cost variations.

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Korean Red Ginseng extract and ginsenoside Rg3 have anti-pruritic effects on chloroquine-induced itch by inhibition of MrgprA3/TRPA1-mediated pathway

  • Lee, Wook-Joo;Kim, Young-Sik;Shim, Won-Sik
    • Journal of Ginseng Research
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    • v.42 no.4
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    • pp.470-475
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    • 2018
  • Background: It was previously found that Korean Red Ginseng water extract (KRGE) inhibits the histamine-induced itch signaling pathway in peripheral sensory neurons. Thus, in the present study, we investigated whether KRGE inhibited another distinctive itch pathway induced by chloroquine (CQ); a representative histamine-independent pathway mediated by MrgprA3 and TRPA1. Methods: Intracellular calcium changes were measured by the calcium imaging technique in the HEK293T cells transfected with both MrgprA3 and TRPA1 ("MrgprA3/TRPA1"), and in primary culture of mouse dorsal root ganglia (DRGs). Mouse scratching behavior tests were performed to verify proposed antipruritic effects of KRGE and ginsenoside Rg3. Results: CQ-induced $Ca^{2+}$ influx was strongly inhibited by KRGE ($10{\mu}g/mL$) in MrgprA3/TRPA1, and notably ginsenoside Rg3 dose-dependently suppressed CQ-induced $Ca^{2+}$ influx in MrgprA3/TRPA1. Moreover, both KRGE ($10{\mu}g/mL$) and Rg3 ($100{\mu}M$) suppressed CQ-induced $Ca^{2+}$ influx in primary culture of mouse DRGs, indicating that the inhibitory effect of KRGE was functional in peripheral sensory neurons. In vivo tests revealed that not only KRGE (100 mg) suppressed CQ-induced scratching in mice [bouts of scratching: $274.0{\pm}51.47$ (control) vs. $104.7{\pm}17.39$ (KRGE)], but also Rg3 (1.5 mg) oral administration significantly reduced CQ-induced scratching as well [bouts of scratching: $216.8{\pm}33.73$ (control) vs.$115.7{\pm}20.94$ (Rg3)]. Conclusion: The present study verified that KRGE and Rg3 have a strong antipruritic effect against CQ-induced itch. Thus, KRGE is as a promising antipruritic agent that blocks both histamine-dependent and -independent itch at peripheral sensory neuronal levels.

The U.S. Experience of the DRG Payment System and Suggestions to Korea (DRG 지불제도에 대한 미국의 경험과 우리 나라에의 시사점)

  • Park, Eun-Cheol;Lee, Sun-Hee;Lee, Sang-Gyu
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.105-120
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    • 2002
  • In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

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Ant Algorithm for Dynamic Route Guidance in Traffic Networks with Traffic Constraints (회전 제약을 포함하고 있는 교통 네트워크의 경로 유도를 위한 개미 알고리즘)

  • Kim, Sung-Soo;Ahn, Seung-Bum;Hong, Jung-Ki;Moon, Jae-Ki
    • Journal of Korean Society of Transportation
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    • v.26 no.5
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    • pp.185-194
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    • 2008
  • The objective of this paper is to design the dynamic route guidance system(DRGS) and develop an ant algorithm based on routing mechanism for finding the multiple shortest paths within limited time in real traffic network. The proposed ant algorithm finds a collection of paths between source and destination considering turn-restrictions, U-turn, and P-turn until an acceptable solution is reached. This method can consider traffic constraints easily comparing to the conventional shortest paths algorithms.

Is the Hospital Caseload of Diagnosis Related Groups Related to Medical Charges and Length of Stay? (DRGs(Diagnosis Related Groups)별 환자집중도 수준에 따른 입원진료비와 재원일수의 차이 분석)

  • Kwak, Jin-Mi;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.13-24
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    • 2014
  • This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

Development of a neural-based model for forecating link travel times (신경망 이론에 의한 링크 통행시간 예측모형의 개발)

  • 박병규;노정현;정하욱
    • Journal of Korean Society of Transportation
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    • v.13 no.1
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    • pp.95-110
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    • 1995
  • n this research neural -based model was developed to forecast link travel times , And it is also compared wiht other time series forecasting models such as Box-Jenkins model, Kalman filter model. These models are validated to evaluate the accuracy of models with real time series data gathered by the license plate method. Neural network's convergency and generalization were investigated by modifying learning rate, momentum term and the number of hidden layer units. Through this experiment, the optimum configuration of the nerual network architecture was determined. Optimumlearining rate, momentum term and the number of hidden layer units hsow 0.3, 0.5, 13 respectively. It may be applied to DRGS(dynamic route guidance system) with a minor modification. The methods are suggested at the condlusion of this paper, And there is no doubt that this neural -based model can be applied to many other itme series forecating problem such as populationforecasting vehicel volume forecasting et .

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An Approximate Shortest Path Re-Computation Method for Digital Road Map Databases in Mobile Computing Environments (모바일 컴퓨팅 환경에서의 디지털 로드맵 데이타베이스를 위한 근접 최단 경로 재계산 방법)

  • 김재훈;정성원;박성용
    • Journal of KIISE:Databases
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    • v.30 no.3
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    • pp.296-309
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    • 2003
  • One of commercial applications of mobile computing is ATIS(Advanced Traveler Information Systems) in ITS(Intelligent Transport Systems). In ATIS, a primary mobile computing task is to compute the shortest path from the current location to the destination. In this paper, we have studied the shortest path re-computation problem that arises in the DRGS(Dynamic Route Guidance System) in ATIS where the cost of topological digital road map is frequently updated as traffic condition changes dynamically. Previously suggested methods either re-compute the shortest path from scratch or re-compute the shortest path just between the two end nodes of the edge where the cost change occurs. However, these methods we trivial in that they do not intelligently utilize the previously computed shortest path information. In this paper, we propose an efficient approximate shortest path re-computation method based on the dynamic window scheme. The proposed method re-computes an approximate shortest path very quickly by utilizing the previously computed shortest path information. We first show the theoretical analysis of our methods and then present an in-depth experimental performance analysis by implementing it on grid graphs as well as a real digital road map.