• 경영과학
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• 제25권3호
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• pp.87-99
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• 2008

Besieged by needs for upgrading the current Internet, social pressures, and regulatory concerns, a network operator may be left with few options to Improve his services. Yet he can still consider a transition prioritizing network services. In this paper, we describe a transition from a non-priority system to a prioritized one, using non-preemptive M/G/1 model. After reviewing the constraints and theoretical results from past research, we describe steps making the transition Pareto-improving, which boils down to a multi-goal search for a Pareto-improving state. We use a genetic algorithm that captures actual transition costs along with incentive-compatible and Pareto-Improving constraints. Simulation results demonstrate that the initial post-transition solutions are typically Pareto-improving. for non Pareto-improving solutions, the heuristic quickly generates Pareto-improving and incentive-compatible solutions.

• Journal of Preventive Medicine and Public Health
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• 제50권6호
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• pp.393-400
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• 2017

Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results: The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions: The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

• 보건행정학회지
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• 제6권1호
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• pp.110-143
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• 1996

The purpose of this study is to assess the extent of inequality in health outcomes and the distribution of health services according to health need under National Health Insurance System in Korea. For the empirical analysis, data were collected through an interview survey during one month of October, 1994. Interview were conducted with a total of 10, 875 of the employees and the self-employed selected through cluster, systematic sampling. The major findings of this research are as follows: 1. The analysis of the differentials in morbidity rates by socio-economic group showed that health inequality in the pro-higher groups existed in all self-reported morbidity indicators. 2. The findings of the conventional use measures showed that the lower socio-economic groups had more ambulatory and inpatient services than the higher groups. In contrast to the level of the medical care utilization, however, the higher socio-economic groups were more likely to use the high-quality source of care in terms of their treatment place compared to the lower groups. 3. By using the need-based use measures, the results were different from each use-disability ration indicator. Using the use-disability ration measured by physician visits per 100 restricted-activity days in the population, it was found that there was no evidence favoring the higher socio-economic groups. In contrast, the use-disability ration based on physician visits per a chronic patient in one year displayed that there was remarkable relative difference by income group as well as the evidence of the pro-higher income groups. 4. The results of logistic regression analysis and two-stage estimation method indicated that although the utilization is significantly affected by type and duration of insurance coverage, the use or nonuse of service and the volume of physician care consumed is determined by health need and demographic characteristics rater than economic status. In sum, these findings suggest that physician service is equitably distributed according to health need under national health insurance system in Korea. As there were some evidences of inequality including the differential in physician visits of chronic patients by income group, however, the government should strengthen the activities to guarantee the equity of health services utilization.

• 대한수의학회지
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• 제35권3호
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• pp.603-613
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• 1995

Plasma progesterone($P_4$) assay has been introduced to apply to the differential diagnosis of reproductive disorders and the monitoring of responses of ovarian dysfunction to $PGF_2{\alpha}$ or GnRH treatment in the 204 postpartum and postinsemination subestrus dairy cows. 1. The incidence rate of reproductive disorders in 204 subestrus cows, diagnosed by palpation per rectum and plasma $P_4$ determination using 'Two sample test'(Day 0+Day 10) were as follows; silent heat or error of estrus detection 110(53.9%), persistent corpus luteum 26(12.7%), follicular cyst 16(7.8%), inactive ovary 12(5.9%), luteal cyst 11(5.4%), granulosa cell tumor of ovary 1(0.5%), fetal mummification 1(0.5%), endometritis 15(7.4%) and pyometra 12(5.9%), respectively. 2. After the $PGF_2{\alpha}$ treatment to the 76 cows with silent heat or error of estrus detection, persistent corpus luteum, or luteal cyst, plasma $P_4$ concentrations at day 3 post treatment using 'Two sample test'(Day 0+Day 3) remained low(<1.0ng/ml) in all 76 cows. Therefore all 76 cows responded positively to $PGF_2{\alpha}$ treatment. Seventeen cows with follicular cyst or inactive ovary were treated with GnRH. All 7 cows with follicular cyst and 4 cows with inactive ovary remained high($${\geq_-}1.0ng/ml$$) a plasma $P_4$ concentrations at day 12 post treatment using 'Two sample test'(Day 0+Day 12), but 6 cows with inactive ovary remained low(<1.0ng/ml) a plasma $P_4$ concentrations. Therefore all 7 cows with follicular cyst and 4 cows with inactive ovary responded positively, but 6 cows with inactive ovary responded negatively to GnRH treatment. 3. The mean days from treatment to first service, number of cows conceived on first service(%), mean number of services per conception, mean days from initial treatment to conception, and mean number of cows conceived by 100 days post treatment(%) were 5.0 and 26.2 days, 45(59.2%) and 6(35.3%) cows, 1.5 and 1.7 services, 13.6 and 22.6 days, and 62(81.6%) and 9(52.9%) cows in group of $PGF_2{\alpha}$ and GnRH treatment, respectively. These results indicated that plasma $P_4$ assay was practical as an aid to diagnosing reproductive disorders and to monitoring responses of ovarian dysfunction to $PGF_2{\alpha}$ and GnRH treatment in subestrus cows.

• 한국콘텐츠학회논문지
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• 제15권12호
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• pp.285-293
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• 2015

본 연구는 요양병원 의사 및 간호 인력 대상으로 차등등급에 따른 의료서비스 질 향상 및 만족도, 병원운영성과에 대하여 어떻게 인지하고 있는지를 파악함으로써 차등등급제도가 효율적으로 운영되기 위한 기초자료를 제공하기 위하여 수행되었다. 본 연구의 결과는 다음과 같다. 의사 등급과 간호 인력 등급에 따른 차이분석을 위해 독립표본t검증을 실시한 결과, 의사2등급에서 환자권리향상과 경영 효율성이 높다는 것을 알 수 있었고, 간호 인력 2등급에서 환자안전향상, 진료향상, 환자권리향상이 높다는 것을 확인하였다. 의사 및 간호 인력 등급에 따른 차이분석을 위해 ANOVA분석을 실시한 결과, 환자안전향상, 병원재정, 병원위상에서는 의사 1, 간호 인력 2등급에서, 환자권리향상 및 자기계발에서는 의사 2, 간호 인력 1등급에서 높다는 것을 확인하였다. 전반적으로 의사, 간호 인력의 등급은 높지만, 1등급과 2등급 간의 차이는 각 부문 별로 상이한 결과가 나와 향후 요양병원 차등등급제의 의사 및 간호 인력 1, 2등급 간의 산정기준 개편을 고려할 필요가 있을 것이다.

• 대한화학회지
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• 제55권1호
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• pp.57-62
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• 2011

가끔 먼 지역 거주자들은 현대 의약품이나 의학 서비스에 있어서 불충분하거나 접근할 수 없다. 그들은 개똥쑥의 선택된 품종을 경작하고 차 제조의 적절한 방법에 따라 식물로부터 차나 달인즙을 만드는 것에 의해 말라리아에 대항한 치료의 관점에서 이익을 얻을 수 있다. 아르테미시닌에 대한 최대 추출 효율을 위해, 개똥쑥의 차제조의 다른 방법들은 발달된 DPP방법을 적용하여 연구되었고 이 논문에 서술되었다. 차는 시간을 다르게 하여 3가지 다른 방법으로 제조된다(굽기, 섞거나 섞지 않으면서 굽지 않기 그리고 마이크로 웨이브 오븐). 결과로부터, 아르테미시닌의 더 높은 농도(84.7%)는 15분 동안 섞으면서 굽지 않는 차 제조법에 의해 도달될 수 있다는 것을 발견했다(R.S.D. 2.34%). 아르테미시닌의 농도는 마이크로 웨이브 오븐에서 1.5분 이상 구울 때 감소한다. 최대한도의 추출(88.9%)은 증류수에서 5%에탄올과 함께 섞는 추출방법에서 가능했다(R.S.D. 2.28%).