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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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Isocyanate-Induced Occupational Asthma: Immunologic and Challenge Studies (Isocyanate에 의한 직업성 천식환자에서 임상양상과 Isocyanate 특이 IgE 항체에 관한 연구)

  • Suh, Jung-Eun;Park, Hae-Sim;Kim, Seong-Jin;Rhu, Nam-Soo;Cho, Dong-Ill;Kim, Jae-Won;Kyung, Nan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.490-501
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    • 1992
  • Background: Isocyanate is the most significant cause of occupational asthma in this country. The mechanism of isocyanate induced bronchoconstriction is unclear. Subjects and Method: To observe its immunologic and clinical findings, we performed methacholine bronchial challenge test (MBCT), toluene diisocyanate (TDI)-bronchoprovocation test (BPT) and RAST to TDI-, diphenylmethane diisocyanate (MDI)-, and hexamethylene diisocyanate (HDI)-human serum albumin (HSA) conjugate in 22 isocyanate-sensitive asthmatic workers. Results: BPT revealed early (11), dual (5), and late only (6) asthmatic responses. Their latent period ranged from 3 to 120 months (mean:45.9 months). Three cases (13.6%)showed a negative response on initial MBCT, but following MBeT performed 24 hours after TDI-BPT revealed the development of airway hyperresponsivenss. Twelve (54.5%) workers had increased specific IgE to TDI-HSA, seven (31.8%) had to MDI-HSA, and nine (40.9%) had to HDI-HSA conjugate. The prevalence of specific IgE was not associated with latent period, type of asthmatic responses, smoking, and atopic status. After 3 months' avoidance from workplace, airway hyperresponsiveness was improved in 10 (38.3%), among 12 followed cases. Conclusion: It is suggested that isocyanate can induce IgE-mediated bronchoconstriction in 59.1% of isocyanate-sensitive asthmatic workers. Isocyanate-induced asthma can occur even though MBeT showed a negative result, and measurement of the changes of airway hyperresponsivenss after isocyanate-BPT could be helpful to diagnose isocyanate-sensitive asthma.

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Groundwater Flow Analysis in Fractured Rocks Using Zonal Pumping Tests and Water Quality Logs (구간양수시험과 수질검층자료에 의한 균열암반내 지하수 유동 분석)

  • Hamm, Se-Yeong;Sung, Ig-Hwan;Lee, Byeong-Dae;Jang, Seong;Cheong, Jae-Yeol;Lee, Jeong-Hwan
    • The Journal of Engineering Geology
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    • v.16 no.4 s.50
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    • pp.411-427
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    • 2006
  • This study aimed to recognize characteristics of groundwater flow in fractured bedrocks based on zonal pump-ing tests, slug tests, water quality logs and borehole TV camera logs conducted on two boreholes (NJ-11 and SJ-8) in the city of Naju. Especially, the zonal pumping tests using sin91e Packer were executed to reveal groundwater flow characteristics in the fractured bedrocks with depth. On borehole NJ-11, the zonal pumping tests resulted in a flow dimension of 1.6 with a packer depth of 56.9 meters. It also resulted in lower flow dimensions as moving to shallower packer depths, reaching a flow dimension of 1 at a 24 meter packer depth. This fact indicates that uniform permissive fractures take place in deeper zones at the borehole. On borehole SJ-8, a flow dimension of 1.7 was determined at the deepest packer level (50 m). Next, a dimension of 1.8 was obtained at 32 meters of packer depth, and lastly a dimension of 1.4 at 19 meters of packer depth. The variation of flow dimension with different packer depths is interpreted by the variability of permissive fractures with depth. Zonal pumping tests led to the utilization of the Moench (1984) dual-porosity model because hydraulic characteristics in the test holes were most suitable to the fractured bedrocks. Water quality logs displayed a tendency to increase geothermal temperature, to increase pH and to decrease dissolved oxygen. In addition, there was an increasing tendency towards electrical conductance and a decreasing tendency towards dissolved oxygen at most fracture zones.

Analyzing the Economic Value and Planning Factors of Hubs within Urban Green Infrastructure - Focusing on the Case of Sejong Lake Park - (도시 그린인프라 핵심지역의 경제적 가치와 계획 요소 분석 - 세종호수공원 사례를 중심으로 -)

  • Lee, Dong-Kyu;An, Byung-Chul
    • Journal of the Korean Institute of Landscape Architecture
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    • v.49 no.4
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    • pp.41-54
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    • 2021
  • This study targets the urban park corresponding to the core areas (Hubs) of Green Infrastructure and estimates their value utilizing the Contingent Valuation Method (CVM) and determines the planning factors which affect them. The research aims to provide basic data for supporting the value improvement in the planning stage for urban parks representing green infrastructure. The primary purpose of this research is to derive variables that affect economic value and planning factors to improve the use-value of urban parks, one of the Hubs of the green infrastructure. In this study, Sejong Lake Park, located in Sejong City, is the target site. This study collected the responses of 105 people by conducting a survey on the intention to pay for the use-value and the planning factors that affect it, targeting visitors to Sejong Lake Park. The study conducts Contingent Valuation Method (CVM) on this survey responses. The results are as follows: first, as a result of analyzing the variables which affect willingness to pay for use-value, residence and age influence the willingness to pay significantly among socioeconomic characteristics. Next, the survey responses of Double-bounded dichotomous choices (DB-DC) CVM are converted into variables through statistic techniques. Furthermore, the variables are used for a Logit model to draw coefficients. The average willingness to pay per person for the use-value of Sejong Lake Park using the derived coefficients was approximately found to be 8,597 won. Therefore, as of 2019, Sejong Lake Park, with a total of 430,000 visitors, is estimated to have an annual economic value of 3.7 billion won. Third, the average Likert scale of the planning factor affecting the decision to pay for the economic value of Sejong Lake Park was the highest along the waterfront landscape, and the convenience facilities and waterfront landscape showed the highest willingness to pay, 10,000 won. In the range between 2,500 won and 5,000 won, the waterfront area ranks highest. Therefore, it can be said that visitors to Sejong Lake Park take account of the economic value of using the waterfront landscape the most. This study is meaningful as a thesis on use-value and the planning factors that affected value evaluation results of urban parks, and the analysis of the correlation between the planning factors of urban parks as hubs located in urban areas.

The Materials on Korean Folk Religions in the Encyclopedic Literatures of Late Joseon Dynasty (조선후기 유서류(類書類)에 나타난 민속종교 자료)

  • Suh, Young-Dae
    • Journal of Korean Historical Folklife
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    • no.33
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    • pp.31-72
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    • 2010
  • At first, I extract materials on folk religion from four encyclopedic literatures of late Chosun dynasty-Lee, Ji-Bong-Ryu-Seol(『芝峯類說』) by Soo-Kwang(李晬光), San-Lim-Kyung-Jae(『山林經濟』) by Hong, Man-Sun(洪萬選), Sung-Ho-Sa-Seol(『星湖僿說』) by Lee-Ik(李瀷), O-Ju-Yeon-Moon-Jang-Jun-San-Go(『五洲衍文長箋散稿』) by Lee, Kyu-Kyung(李圭景), and present these materials by tables. Second, I examined the contents and characters of these materials on folk religion. The conclusions from this research are as follows. ① There are common features and points of difference between these four encyclopedic literatures. One of common features are that all these four are encyclopedic works, but San-Lim-Kyung-Jae is more practical than another three. ② These encyclopedic literatures regard folk religion as a negative culture, because these literatures based on Confucianism. But they did not deny miraculous virtues of folk religion. ③ These encyclopedic literatures give us many informations on gods and spirits of Korean folk religion, i.e. city gods(城隍神)·Yup-Sin(업신)·spirits of disease, god Kim-Bu(金傅大王神)·god Jung-Duk-Yang(鄭得揚)·god of King Kuan-u(關王神)·god Bu-keun(付根神) etc. So I review these gods and spirits referenced in encyclopedic literatures. ④ These encyclopedic literatures show much interest in ghost in common. The reason of interest is that authors of these encyclopedic literatures are all scholars of Sung Confucianism and Sung Confucian was concern about ghost. The Sung Confucianism denied the ghost as personal being whom Korean folk religion regards to a kind of spirits. Instead of beliefs in ghost of folk religion, they insist on the ghost as Ki(氣), a kind of cosmic principle. But these encyclopedic literatures acknowledge some parts of folk religion's beliefs in ghost, because they admit the miraculous virtues of these parts. ⑤ There are many items on divination in these encyclopedic literatures. But they show dual attitude on divinations. The one is negative attitude to divinations on individual destiny and the other one is positive attitude to divinations on agriculture. ⑥ There are also many items on witchcrafts in these encyclopedic literatures. Through these items, I assumed pervasiveness of beliefs on witchcraft at that time. ⑦ Shamans, as religious specialist, are stand on a central position of Korean folk religion. So it is a matter of course that these encyclopedic literatures concerned on Korean shaman. As Confucians, authors of these encyclopedic literatures did not regards shamans as positive one. But they did not deny miraculous virtues of shamans. In spite of these encyclopedic literatures have negative view points to, and include false informations Korean folk religion, I would like to emphasis on importance of these encyclopedic literatures to understand Korean folk religions, especially Korean folk religions of late Yi Dynasty.