• Title/Summary/Keyword: Meal cost management

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Analysis of Hospital Foodservice Management and Health Insurance Coverage of Inpatient Meals in Seoul (서울지역 의료기관의 급식서비스 및 환자식 급여화 현황 분석)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.16 no.4
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    • pp.378-396
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    • 2010
  • The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

The Health and Dietary management of Impaired elderly by ADL in Gyeonggi, Korea (ADL에 의한 도움필요 노인의 건강과 식생활관리 -경기지역 농촌노인을 중심으로-)

  • Rhie Seung-Gyo;Choi Mi-Yong;Won Hyang-Rye
    • The Korean Journal of Community Living Science
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    • v.17 no.3
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    • pp.159-174
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    • 2006
  • The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.

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Substituting Bakery Waste for Barley Grains in Fattening Diets for Awassi Lambs

  • Hindiyeh, M.Y.;Haddad, S.G.;Haddad, S.K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.24 no.11
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    • pp.1547-1551
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    • 2011
  • Bakery waste (BW) is much cheaper than barley (20 to 40% the price of barley). Bakery waste and barley grain have similar chemical composition; they contain 99 and 97% organic matter (OM), 1.1 and 1.8% fat, 18 and 15% neutral detergent fibre (NDF) and 14.0 and 14.5% crude protein (CP), respectively (DM basis). The objectives of this study were to determine the effect of substituting BW for barley grain in high concentrate fattening diets for lambs on nutrient intake, growth and carcass characteristics. Forty Awassi lambs (21.75${\pm}$1 kg) weaned at the age of 65 days were assigned randomly to four experimental fattening diets differing in BW ratio in a completely randomized design. The control diet (CON) contained 20, 60, 11, 7, and 2% (DM basis) wheat straw, barley grain, soybean meal, corn grain, and minerals and vitamin mix, respectively. Bakery waste substituted barley grain by 10, 20 and 30% of the diet DM in the LBW, MBW and HBW diets, respectively. The experiment lasted for 56 days. Dry matter intake (DMI) decreased (p<0.05) in LBW diet compared to the CON diet by approximately 10%. No further reduction in DMI was observed with the higher substitution levels. Metabolizable energy intake for the CON diet (3.6 Mcal/d) was also reduced (p<0.05) compared with LBW, MBW and HBW diets (3.4, 3.4 and 3.3 Mcal/d, respectively). Final body weight for lambs fed the CON diet (34.8 kg) was higher (p<0.05) compared with lambs fed the LBW, MBW and HBW diets (30.6, 32.0 and 31.1 kg, respectively). Growth rate for lambs fed the CON diet (232 g/d) was also higher (p<0.05) compared to lambs fed the LBW, MBW and HBW diets (170, 189, and 167 g/d, respectively). Feed to gain ratio was higher (p<0.05) for lambs fed the LBW, MBW and HBW diets (7.2, 6.6 and 7.3, respectively) compared with lambs that consumed the CON diet (5.7). Body weight gain cost was reduced by approximately 8% by the MBW and HBW diets as compared with the CON diet. Dressing percentage, full gut weight, empty gut weight and liver weights were all unaffected by the BW addition to the diets and averaged 48.9%, 6.8 kg, 2.8 kg and 0.444 kg, respectively. However, fat tail weight was increased (p<0.05) with the higher levels of the BW inclusion. In conclusion, substituting BW for barley grain reduced DMI and growth performance. However, when BW substituted barley grain at the 20 and 30% of the diet DM, body weight gain cost was reduced by approximately 8%.

A Survey on the Actual Conditions of Group Feeding in Seoul City and Kyongki Province. (서울 . 경기 일부지역의 전체급식소에 대한 실태조사)

  • 한양일;정은자
    • Journal of Environmental Health Sciences
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    • v.5 no.1
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    • pp.10-17
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    • 1978
  • Recently this writer has conducted a comprehensive survey of 38 private businesses where group feeding is practiced, with a view to determining the condition of nutrition intake by the blue collar workers of these businesses firms as well as gaining an indication of their facilities management along with their sanitary precautions. The survey has revealed, among others, a number of interesting data such as shown below. 1. There are a total of 1,054 workers being fed in groups daily at each of the above business companies, with only one nutrition specialist regardless of the number of workers to be fed or the number of times they are fed daily. The average number of cooks comes to 2.7 persons per 100 workers, while 42.2% of the companies provide four meals a day including mid-night supper, with the result that the workers are fed 3.13 times a day on an average. 2. The average feeding cost amounts to 151 won per meal per person, of which 86 won is payed by the workers themselves and 115 won by the companies involved. 3. The average fbod intake has been found to be 490 grams which can be further broken down into 44grams of animal food and 446grams of vegetable food. These figures are higher than those revealed by the 1975 investigation of the nation's average nutrition intake. 4. The survey also shows the daily calorie consumption per person to be as high as 896 calories including 37 grams of protein which is further broken down into 11 grams of animal protein and 26grams of vegetable protein. With respect to other types of nutrients excepting Vitamin-A, the companies concerned are believed to prorids more than what the survey of the nation's nutrition has revealed or the amount recommended by Korea FAO assoc!ation as desirable. 5. As for facilities management, there is still much room for future improvement. Some 97.4% of the companies surveyed are not equipped with the steam table, which indicates lack of concern along this line as well as a very how degree of equipment utilizations. Distribution of the food in the dining room is generally depedent on self-service method. 6. Speaking of sanitary precautions taken by those businesses involved, some 76.3% are found to have their compounds haunted by rats and other insects. Some 73.7% of them are dependent on boiling method for disinfection of kitchen utensils, which is conducted by 50% of those industries only two or three times a week. It seems hardly feasible to conduct disinfection everyday.

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The Development of Educational program on NCS-Based Medical expense management and Examination claim (의료정보시스템을 활용한 NCS 기반 진료비 관리 및 심사청구 교육프로그램 개발)

  • Choi, Joon-Young
    • The Journal of the Korea institute of electronic communication sciences
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    • v.11 no.10
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    • pp.1009-1016
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    • 2016
  • In this study, an educational program was developed. The program can perform the claim for examination of medical expense, which is one of NCS Competence Unit Elements for hospital administration. Considering various coding to complex compute and process, VB.Net was employed for this development. For database, ACCESS Database was used because it is easy to learn and use. The learning effects by the developed program are expected to be as follows. First, the composition of medical expense can be understood by analyzing Medical history and then selecting insurance code according to the Standard of Medical Care Code. Second, unit cost per score can be learned according to hospital class. Third, selection of Column (medical materials) and Column II(medical practice) can classify items of additional ratio. Fourth, because patient's payment rate on hospitalization and meal expense and use of special equipment are differently applied, user can know patient's payment rate by type and can calculate it. Fifth, additional amount is the amount calculated by additional ratio of Column II(medical practice), and user can learn additional ratio according by insurance type and hospital class. Sixth, user can learn self-pay rate by hospital class and understand the process that self-pay amount and claim amount are calculated according by self-pay rate.

Effects of replacing fish oil with palm oil in diets of Nile tilapia (Oreochromis niloticus) on muscle biochemical composition, enzyme activities, and mRNA expression of growth-related genes

  • Ayisi, Christian Larbi;Zhao, Jinliang;Yame, Chen;Apraku, Andrews;Debra, Grace
    • Fisheries and Aquatic Sciences
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    • v.22 no.11
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    • pp.25.1-25.9
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    • 2019
  • Background: Due to the continuous demand for fish coupled with decline in capture fisheries, there is the need to increase aquaculture production to meet the demand. Aquaculture is faced with high cost of feeding since fish oil and fish meal are expensive. In view of this, there are calls to explore alternatives that are cheap and reliable. Objectives: This study on Oreochromis niloticus was conducted to evaluate the effects of replacing fish oil (FO) with palm oil (PO) at 0%, 25%, 50%, 75%, and 100% on muscle fatty acid and proximate composition as well as growthrelated enzyme activities and mRNA expression. Methods: Oreochromis niloticus were fed five experimental diets (33% crude protein and 10% crude lipid) for 8 weeks. Feed had variation in fish oil and palm oil contents. After the 8 weeks feeding trial, five fish were sampled from each tank (15 from each treatment) and euthanized using an excess dose of tricaine methane sulfonate (MS-222 at 200 mg/L). Fatty acid and enzyme activities were analyzed using standard protocols. Also, RT-qPCR was used to quantify the expression levels of selected growth-related genes. Results: Fish fed 25% PO recorded the least muscle protein content and was significantly lower than the group fed 100% PO. Paired box protein 7 (Pax-7) enzyme activity was significantly higher in the group fed 50% PO compared to the groups fed 25% PO and 100% PO, while caplain-3 (Capn-3) was significantly lower in the group fed 0% PO compared to all other groups. There was a significant difference among treatments with respect to mRNA expression of Pax-7 and Capn-3. Group fed 25% PO had significantly lower mRNA expression of Pax-7, while the group fed 75% PO recorded significantly higher mRNA expression of Capn-3 compared to groups fed 0% PO, 25% PO, and 100% PO. Pearson's correlation analysis revealed that Igf-I and Igf-II mRNA expression have significant correlation with n-3 polyunsaturated fatty acids content in muscle. Conclusion: The results suggest muscle protein content could be modified if FO is replaced with PO. Also, mRNA expression of Pax-7 and Capn-3 is affected by replacing FO with PO.

Investigating the Partial Substitution of Chicken Feather for Wood Fiber in the Production of Wood-based Fiberboard (목질 섬유판 제조에 있어 도계부산물인 닭털의 목섬유 부분적 대체화 탐색)

  • Yang, In;Park, Dae-Hak;Choi, Won-Sil;Oh, Sei Chang;Ahn, Dong-uk;Han, Gyu-Seong;Oh, Seung Won
    • Korean Chemical Engineering Research
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    • v.56 no.4
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    • pp.577-584
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    • 2018
  • This study was conducted to investigate the potential of chicken feather (CF), which is a by-product in poultry industry, as a partial substitute of wood fiber in the production of wood-based fiberboard. Keratin-type protein constituted the majority of CF, and its appearance did not differ from that of wood fiber. When the formaldehyde (HCHO) adsorptivities of CF compared by its pretreatment type, feather meal (FM), which was pretreated CF with high temperature and pressure and then grounded, showed the highest HCHO adsorptivity. In addition, there was no difference between the adsorbed HCHO amounts, which was measured by dinitrophenylhydrazine method, of scissors-chopped CF and CF beated with an electrical blender. Mechanical properties and HCHO emission of medium-density fiberboards (MDF), which were fabricated with wood fiber and 5 wt% CF, beated CF or FM based on the oven-dried weight of wood fiber, were not influenced by the pretreatment type of CF. However, when the values compared with those of MDF made with just wood fiber, thickness swelling and HCHO emission of the MDF were improved greatly with the addition of CF, beated CF or FM. Based on the results, it might be possible to produce MDF with improved dimensional stability and low HCHO emission if CF, beated CF or FM is added partially as a substitute of wood fiber in the manufacturing process of MDF produced with the conventional urea-formaldehyde resin of $E_1$ grade. However, the use of CF or FM in the production of MDF has a low economic feasibility at the current situation due to the securing difficulty and high cost of CF. In order to enhance the economic feasibility, it requires to use CF produced at small to medium-sized chicken meat plants. More importantly, it is considered that the technology developed from this research has a great potential to make provision for the prohibition of animal-based feed and to dispose environmentally avian influenza-infected poultry.

Characteristics of School Menus from the Daegu and Gyeongbuk Area (대구·경북지역 학교급식 제공 메뉴 특성 분석)

  • Ahn, Seon Woo;Choi, Mi-Kyung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.6
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    • pp.983-990
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    • 2013
  • The purpose of this study was to analyze the characteristics of menu items offered for school meals in the Daegu and Gyeongbuk area. A total of 538 menu items were collected from six schools (two elementary schools, two middle schools, and two high schools). There was a significant difference in food costs according to menu groups (p<0.001), with the highest food costs for meat and fish dishes (881.66 won) and the lowest cost for kimchi (114.50 won). The proportion of menu items using processed foods and with low operational efficiency were significantly higher in middle schools (p<0.01). In addition, menu items containing animal products were significantly higher in the non-traditional menu items in middle schools (p<0.001). Traditional menu items were less frequently cooked with oil (p<0.001) and processed foods (p<0.001), and their operational efficiency was higher (p<0.001). In conclusion, we found that traditional menu items in school meals were being offered with healthier ingredients and cooking methods, as well as a more efficient foodservice management, than non-traditional menu items.