• KSCE Journal of Civil and Environmental Engineering Research
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• v.42 no.6
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• pp.853-860
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• 2022

The purpose of this study is to suggest an improvement plan for the calculation method of the engineer standard wage rate (ESWR) and to compute a reasonable ESWR. To this end, an adequacy review of theESWR calculation criteria was conducted along with an extensive engineering industry survey. The survey results were analyzed using an effective response sample of 748 companies out of 1,000 survey samples extracted by stratifying the 5,879 survey population. The main results were as follows. ①When calculating the engineering service fee, the prime contractor's engineer wage is suitable for the ESWR. The ESWR can be estimated by the formula 'average wage÷[1-proportion of subcontract orders×(1-subcontract rate)].' ② The field survey showed that the number of monthly working days was 20.35-20.54 days at 99 % confidence interval, which was significantly different from the current standard (22 days). In addition, as a result of a legal review of the ESWR criteria, it was found that the number of working days should be calculated in accordance with the Labor Standards Act after 2022. ③ Applying government guidelines, the time difference between the wage survey and the ESWR application can be corrected by the past ESWR increase rate for a specific period. ④ Using modeling based on the analysis above, the current ESWR was 13.5-14.5 % lower than the appropriate level. A lower ESWR was driven by the non-reflection of subcontract structure (4.1 %), overestimation of monthly work days (6.8-7.8 %), and application of past wage (2.6 %). The proposed model is expected to be widely used in policy making, as it can provide a useful framework for calculating the standard wage rate in similar industries as well as calculating appropriate engineering fees.

• Korean Journal of Poultry Science
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• v.41 no.2
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• pp.93-98
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• 2014

This study was conducted to analysis the reason for implementing HACCP system, advantage and disadvantage of HACCP system implemented laying hen farm. The study was carried out by randomly selected fifteen laying hen farms located in all around Korea. All data were collected from fifteen laying hen farms before and after the implementation of HACCP system. The results were as follows: The egg production rate, livability rate and monthly used animal medicine fee did not changed after HACCP system implementation. However, monthly used disinfectant fee tended to be higher in HACCP farm compared to non-HACCP farm. 26.92% of the laying hen farmer responded enhancement of their farm competitiveness as the major propose for implementing HACCP system. The advantages of HACCP implemented laying hen farms were methodical farm management (22.39%), improvement of awareness (21.18%), improvement of the farm sanitation management level (15.30%), safety egg production (15.05%), productivity enhancement (7.29%), reduction of mortality rate (6.82%), and improvement of labor's welfare (5.89%). The disadvantages of HACCP implemented laying hen farms were HACCP recording (43.30%), alteration of consciousness (22.60%), HACCP monitoring (11.11%), HACCP education (9.97%), HACCP verification (6.90%), and A high turnover of labor (6.13%). In conclusion, implementation of HACCP system to laying hen farm did not affect on the productivity or the use of animal medicine. However, the HACCP system may enhance safety and sanitation of egg production for consumer.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.55-71
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• 2020

Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

• Quality Improvement in Health Care
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• v.11 no.1
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• Health Policy and Management
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• v.28 no.3
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• pp.195-196
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• 2018

The Korean Academy of Health Policy and Management (KAHPM) has shown remarkable achievements in the field of health policy and management in Korea for the last 30 years. The KAHPM consists of experts in various fields of health policy and management, and has been the leading academic discussion forum for health policy agendas of interest to the public. Health Policy and Management (HPM), the official journal of the KAHPM, published the first issue of volume 1 in October, 1991 and is publishing the second issue of volume 28 as of 2018. Currently, it is one of Korea' main journals in the field of health policy and management. HPM has published a special issue in commemoration of the 30th anniversary of the KAHPM. The HPM invited authors, including former presidents of the KAHPM and current board members, to write about main issues in health policy and management. Although the HPM tried to set up an invited author on all subjects in the health policy and management field, 19 papers are published, that completed the peer review process by August, 2018. The authors of the special issue of the 30th anniversary of the KAHPM include six former presidents, a senior professor, and 12 board members. The subjects of this issue are reform of the healthcare delivery system, health insurance and medical policy, reform of health system governance, the role of National Health Insurance Service (NHIS), the Korea Institute for Health and Social Affairs (KIHASA) and the National Evidence-based healthcare Collaborating Agency (NECA), ethical aspects of health policy change, regional disparities of healthcare, healthcare accreditation, new healthcare technology evaluation system, globalization of the healthcare industry, the epidemiological investigator system, the quarantine system, safety and disaster, and official development assistance. There are some remaining topics to deal with for the KAHPM: aged society, anti-smoking, non-infectious disease, suicide, healthcare resources, emergency medical care, out-of-pocket money, medical fee payment system, medical aid system, long-term care insurance, industrial accident compensation insurance, community-centered health welfare system, and central government and local government of health. The HPM will continue to publish review articles on the main topics in health policy and management. This is because the KAHPM, which has been the leading academic society of Korea's health policy and management for the last 30 years, feels responsible for continuing its mission for the next 30 years.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.130-145
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• 1996

Purpose : the management of University Hospital is being challenged in maintenance of reasonable level of income and high ranked reputation by domestic competition with each other and emergence of enterprised owned hospitals. It is imperative that University Hospitals have to make management for patient satisfaction. Furthermore, increased patient's requirement for qualified hospital services (quality assurance) and low-estimated service fee also repress the hospital management condition as well as medical markets open following with Urguay Connection. Due to these unforable conditions surrounding hospital management, -University Hospitals are being pressed to seek improved management strategies. To develope the strategies, we need to have basic understanding about the problems on hospital management and detail information for various patient's requirement. Methods: For this study, we have analysed out-patients from five different University Hospitals located in Seoul, Korea. To obtain the data, we have carried out personal interviews with patients who patients who visit the Out-Patient Clinics of five different University Hospitals using a previously prepared questionnaire. Result: Around 65.7 percent of the visits to University Hospitals were indwelt in the vicinity of 1 hour and motuvation of visiting University Hospital was expending high wuality medical csre in 49.3 percent. The 79.3 percent of the patients have experienced inconvenience during medical care in University Hospital. The most inconvenient condition was waiting for doctors. The 57.2 percent of total patient have experienced rudness. The most rudness condition was registration and receipt desk in 44.4 percent. Patient expect that doctors working in University Hospitals as professors have high and updated medical knowledge(50.4%) and University Hospitals have a high quality medical care system(79.4%). The patient satisfaction was relatively low in 61.1 percent of total patient and revealed high frequency of again visit University Hospital in satisfaction group. Comparison of interhospital analytical study showed quite difference on various problems. Conclusion: Almost patients who visit to Out-Patient Clinic of University Hospital havevisiting motivation to high quality medical care. University Hospitals have several different unsatisfactorial factors and revealed different degree of patient satisfaction. In a future day, University Hospitals have to make use of another University Hospital's merits for approach of Benchmarking and also should be studied decision factors of patient satisfaction and interhospital difference of them.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Journal of Distribution Science
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• v.13 no.10
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• pp.123-133
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• 2015

Purpose - The Korean government has devised intermodal transportation policies and granted subsidies to shippers and logistics companies that made a conversion of transportation means through the policies. This provides support by expanding the complex uniform railroad transportation and overhauling the deteriorated railroad facilities. As for 2013, however, the freight transportation percentage of railroad was 4.5% in tons and 8.5% in ton kilometers. Meanwhile, since the 1990s, developed countries such as the U.S. and Europe have been trying to expand intermodal freight transport with a legal and institutional support to build a logistics system corresponding with social and economic environmental changes. In this study, I set out to examine the effects of the intermodal freight transport policies in the EU and the U.S., and to explore the direction of setting up a rail intermodal transport system in South Korea. Research design, data, and methodology - The paper used a qualitative research methodology through the literature review. First, was an overview of Intermodal transportation in the EU, U.S. and UN. Second, it describes the development of transport in Europe and the U.S. with particular emphasis on intermodal freight transport. Third, it explores the direction of setting up a intermodal freight transport in South Korea. The last section contains concluding remarks. Results - As for the EU, it has been promoting integration between transport and intermodal logistics network designs while utilizing ITS or ICT and supports for rail freight intermodal by giving reduction to a facilities fee or subsidizing for rail freight in order to minimize the cost of external due to freight transport. On the other hand, as for the U.S., it has been made up of an industrial-led operating project and has been promoting it to improve accessibility between intermodal hubs and cargo terminals through intermodal corridor program, and an intermodal cargo hub access corridor projects, etc. Moreover, it has tried to construct intermodal transport system using ITS or ICT and to remove Barrier. As a result, in these countries, the proportion of intermodal freight transport is going to be the second significant transport compared with rail and maritime transport. An Effective rail intermodal transport system is needed in South Korea, as seen in the case of these countries. In order to achieve this object, the following points are required to establish radical infrastructure policy; diversify investment financing measures taken under public-private partnerships, legal responsibilities, improvement of utilization of existing facilities to connect the railway terminal and truck terminal, and enhancement service competitiveness through providing cargo tracking and security information that combines the ITS and ICT. Conclusions - This study will be used as a basis for policy and support for intermodal freight transport in South Korea. In the future, it is also necessary to examine from the perspective of the shipper companies using the rail intermodal transport, ie, recognition of shipper, needed institutional supports, and transportation demand forecasting and cost-effective analysis of the railway infrastructure systems improvement.

• Korean Journal of Occupational Health Nursing
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• v.7 no.2
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• pp.164-176
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• 1998

This study deals with the current medical utilization for migrant workers and the characteristics of them. The purpose of this study is to provide the basic information to establish proper medical policy. For the study self-made questionnaire was used, which was answered by 453 migrant workers working in the area of manufacturing and non-technical work in 10 cities like Seoul, Inchon, Namyangju, Sungnam, Kwangju, Pyungchon, Kunpo, Kimpo, Masuk in Kyungki-do and Chunan in Chungchungnam-do. Besides, 303 medical records of those who had visited free medical check-up center were analyzed. The period of accumulating data is 6 months, from November 1st, 1996 to April 30th, 1997. The characteristics of migrant workers and current medical utilization are analyzed by percentage and the relation between characteristics and current medical utilization were analyzed using ${\chi}^2$-test, t-test, ANOVA. The finding of this study was as follows : 1) The number of nationality was 16. The first majority was Philippians as 32.0%. Among 16 nationalities Southeastern and Northern Asians were 48.9%, Southwestern Asian was 46.5%, the rest was 7.3%. Men were 81.0%, those who are aged from 26 to 30 were 39.0%, Graduatee from high school 92.7%, Christians 56.3%, unmarried 55.4% and salary from 600,000 Won to 800,000 Won 53.8% averaging monthly payment 669,810 Won. As for their residence, those who resided over 3 years were 31.9% and the illegal residence reached 77.4%. As for Korean language, those who speak in middle level were 5.6%. 2) As for kind of work and circumstances, manufacturing was 81.1%, 4 off-days per month 72.2% and 9-10 working hours per day 42.1%. As for accommodation, residence in fabric was 62.6% and one or two members as roommate 40.2%. 3) The characteristics of health behavior showed that 89.4% of migrant workers had 3 meals, 70.9% of them did not drink alcohol, 73.5% of them did not smoke. 4) As a characteristic of health status, 71.8% of them perceived of their health. 76.1% thought that they had no illness before coming Korea. Among them who recognized their illness, those who had problem in circulatory system was 35.3%, respiratory system ENT 19.1% and nervous system 19.1%.66.2% of those having illness had already had sickness when coming to Korea. 5) During last one month, 79.2% of them were known as ones having no illness. Among the sick, those who had problem in circulatory system was 31.6%, nervous system 23.7% and respiratory system 21.1%. 60.3% of the sick were not cured at that time. 6) Sorting the symptom of those who visited free medical check up, dental care was 24.2%, orthopedic 14.0% and digestive system 13.8%. Teethache was 34.4%, stomach problem 11.6%, upper respiratory inflammation 10.2% and back pain 5.9%. Averagely they visited free medical check up 1-2 times. According to symptom, epilepsy 25.5 times, heart and vascular disease 9 times, constipation 2.8%, neurosis 2.38 times and stomach problem 2.34 times. 7) The most frequently visited medical service by migrant workers was hospital. The most mentioned reason was good healing as 36.3%. The medical service satisfied migrant workers mostly was hospital as 64.3%. The reason of satisfaction was also good healing as 45.9%. 8) 77.2% of respondents did not spend money for medical check. Average monthly medical cost was 25,100 Won, 3.7% of income. Those who had no medical security was 73.4%. In their case, 67.7% got discount from hospital or support from working place and religious organization. 9) As for the difference of medical utilization according for the characteristics of migrant workers, legal workers and no-Korean speaker used hospital more frequently. 10) Those who were satisfied most of all with the service of hospital were female workers, hinduists and buddhists, legal workers or manufacture workers. 11) Christians, those who have 3 meals or recognize themselves as healthy ones mostly had no illness. As a result, the most of migrant workers in Korea are from Asia. They are good educated but are working in manufacturing and illegal. Their average income is under 700,000 Won which in not enough for medical cost. They have no medical security and medical fee is supported by religious organization or discounted. Considering these facts the medical policy by government is to be established.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.