• 제목/요약/키워드: Meal cost management

검색결과 68건 처리시간 0.02초

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

  • 김혜진;김은미;이금주;이정주;임정현;이정민;전현정;이해영
    • 대한영양사협회학술지
    • /
    • 제16권4호
    • /
    • pp.378-396
    • /
    • 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.

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

  • 이승교;최미용;원향례
    • 한국지역사회생활과학회지
    • /
    • 제17권3호
    • /
    • pp.159-174
    • /
    • 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.

  • PDF

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
    • /
    • 제24권11호
    • /
    • pp.1547-1551
    • /
    • 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%.

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

  • 한양일;정은자
    • 한국환경보건학회지
    • /
    • 제5권1호
    • /
    • pp.10-17
    • /
    • 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.

  • PDF

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

  • 최준영
    • 한국전자통신학회논문지
    • /
    • 제11권10호
    • /
    • pp.1009-1016
    • /
    • 2016
  • 본 연구에서는 NCS 직무에서 병원행정의 능력단위 요소에 해당하는 진료비 심사청구 수행준거의 내용을 수행할 수 있는 교육용 프로그램을 개발하였다. 프로그램은 VB.Net으로 개발하였으며, 데이터베이스는 ACCESS의 Database를 이용하였다. 프로그램 운영에 의한 학습효과는 첫 번째, 진료내역에 의한 진료비 구성을 이해할 수 있다. 두 번째, 병원종별에 따른 점수당 단가를 숙지할 수 있다. 세 번째, 재료금액과 행위금액을 선택하여 병원종별에 따른 가산율이 적용되는 항목과 적용되지 않는 항목을 구분할 수 있다. 또한 처치 및 수술 등의 의료행위에 대한 야간과 소아에 대한 가산여부와 가산율, 검사의뢰 및 전문의의 가산여부와 가산율을 숙지할 수 있다. 네 번째, 입원 본인일부부담율과 식대 및 특수장비의 본인부담율이 다르게 적용되므로 내역별 본인부담율을 숙지하여 입원내역의 본인부담율을 산정할 수 있다. 다섯 번째, 보험유형에 따른 종별가산율을 숙지할 수 있다. 또한 진료비총액의 계산과정을 이해할 수 있다. 여섯 번째, 병원종별에 따른 본인부담율을 숙지할 수 있으며, 진료비총액에서 본인일부부담금액과 청구금액이 산정되는 계산과정을 이해할 수 있다.

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
    • /
    • 제22권11호
    • /
    • pp.25.1-25.9
    • /
    • 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.

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

  • 양인;박대학;최원실;오세창;안동욱;한규성;오승원
    • Korean Chemical Engineering Research
    • /
    • 제56권4호
    • /
    • pp.577-584
    • /
    • 2018
  • 본 연구는 목질계 섬유판 제조에 있어 목섬유에 대한 도계부산물인 닭털의 부분적 대체화 가능성을 검토하기 위하여 수행하였다. 닭털은 주로 케라틴계 단백질로 구성되어 있으며, 외형적으로 목섬유와 큰 차이는 없었다. 닭털의 전처리 방법에 따른 포름알데히드 흡착능을 비교한 결과, 닭털을 고온/고압에서 처리하고 분쇄한 우모분에서 가장 높았다. 한편 일반 가위로 절단한 닭털과 이를 가정용 믹서로 고해시킨 닭털의 폼알데히드 흡착량을 dinitrophenylhydrazine법으로 측정한 결과 차이는 없었다. 닭털, 고해 닭털, 우모분을 각각 목섬유의 전건무게를 기준으로 5 wt%로 혼합하여 제조한 중밀도섬유판(MDF)의 물성과 폼알데히드방출량은 닭털의 전처리 조건에 영향을 받지 않았다. 그러나 이 측정치를 목섬유만으로 제조한 MDF와 비교하였을 때, 두께팽윤율과 폼알데히드방출량은 크게 개선되었다. 따라서 현재 생산 현장에서 적용되고 있는 요소수지를 이용한 MDF 제조에 있어 목섬유와 함께 일정한 양의 닭털, 고해 닭털 또는 우모분을 첨가할 경우 치수안전성과 폼알데히드방출량이 개선된 MDF의 제조가 가능할 것으로 예상된다. 그러나 MDF제조에 있어 닭털의 사용은 현재 상황에서 목섬유와 비교하여 원료 확보의 어려움과 높은 단가로 경제성이 낮은 것으로 조사되었다. 경제성 향상을 위하여 중소형 도계장에서 발생하는 닭털을 이용하거나, 동물성 사료의 금지에 대한 대비책 및 인플루엔자 감염 조류에 대한 환경적 처리 방안으로 닭털의 섬유판 원료에 대한 부분적 대체화 기술은 향후 사용 가능성이 충분할 것으로 판단된다.

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

  • 안선우;최미경
    • 한국식품영양과학회지
    • /
    • 제42권6호
    • /
    • pp.983-990
    • /
    • 2013
  • 본 연구는 학교급식에서 중요한 메뉴 특성을 파악하고 실제 제공되고 있는 메뉴 특성별 제공 현황을 분석하여 학교급식에서의 올바른 메뉴 운영을 위한 기초자료를 제공하고자 실시되었다. 대구 경북지역 초 중 고 각 2개 학교씩 총 6개 학교에서 제공된 메뉴를 대상으로 하였고 각 학교 영양(교)사를 통해 메뉴 정보를 수집하였으며 계절에 따른 차이를 고려하여 각 학교마다 2회에 걸쳐 1차 조사는 2011년 6월30일~7월 15일, 2차 조사는 2011년 12월 1일~16일에 실시 하였으며 연구 결과는 다음과 같다. 음식군에 따른 메뉴 품목 당 식재료비 차이는 유의적으로 나타났고(p<0.001), 육류 및 생선 찬류가 881.66원으로 가장 높았고 김치류가 114.50원으로 가장 낮았다. 학교급(초 중 고)에 따라서는 중학교가 39.3%로 가공식품 사용 메뉴의 비율이 높았고(p<0.01), 초등학교(86.4%)와 고등학교(83.5%)에 비해 중학교(71.7%)가 노동효율성이 높은 메뉴 품목의 비율이 상대적으로 낮게 나타났다(p<0.01). 비전통 메뉴 품목에서 동물성 식품을 포함하는 메뉴 품목과 가공식품, 기름 사용 가열 조리법을 사용하는 비율이 유의적으로 높아(p<0.001) 전반적으로 전통 메뉴 품목이 학생들의 건강에 긍정적 영향을 미칠 것으로 판단된다. 운영효율성에 있어서도 노동효율성이 높은 메뉴 품목의 비율이 전통 메뉴 품목에서 유의적으로 더 높게 나타났고 (p<0.001), 식재료비 평균도 전통 메뉴 품목(371.57원)이 비전통 메뉴 품목(529.37원)에 비해 낮게 나타나(p<0.001) 운영효율성 역시 전통 메뉴 품목이 우수한 것으로 나타났다. 동 식물성 메뉴별로는 식물성 메뉴 품목(95.4%)이 동물성 메뉴 품목(88.1%)에 비해 기름 사용이 적은 조리법을 사용하는 비율이 유의적으로 높았고(p<0.01), 운영효율성 중 식재료비는 동물성 메뉴 품목에서 650.40원으로 식물성 메뉴품목 274.39원에 비해 유의적으로 높게 나타났다(p<0.001). 조리법별로는 기름 사용이 적은 조리법을 사용하는 메뉴 품목 중 노동효율성이 높은 메뉴 품목(95.8%)이 유의적으로 많았고(p<0.001), 가공식품 사용 메뉴에서 노동효율성이 낮은 메뉴 품목이 유의적으로 높게 나타났다(p<0.001). 조리법별 식재료비는 기름 사용이 적은 조리법을 사용하는 메뉴 품목의 식재료비 평균(413.54원)이 기름 사용이 많은 메뉴 품목(623.47원)에 비해 유의적으로 낮게 나타났다(p<0.01). 본 연구결과 학교급식에서 제공되는 메뉴 중 전통 메뉴와 식물성 메뉴가 가공식품을 적게 사용하고, 조리 시 기름 사용이 적으며 식재료비 역시 저렴한 것으로 나타났다. 이러한 메뉴는 학생들의 건강과 식생활 개선뿐만 아니라 효율적인 메뉴 운영을 위해서도 적극적인 활용이 필요한 것으로 판단되므로 각 학교별로 메뉴에 대한 학생 선호도나 만족도에 대한 조사 등을 바탕으로 한 전통음식 및 식물성 식재료 활용 메뉴 개발이나 메뉴 운영 전략 수립이 필요할 것으로 사료된다. 특히, 메뉴의 효율적인 운영은 식재비용 및 학교별 급식기기/인력 등에 따라 달라질 수 있으므로 각 메뉴별 식재료비, 노동효율성 등의 조사가 식단 작성 시 도움이 될 수 있을 것으로 생각된다. 본 연구에서는 노동효율성 조사에 있어 표준화된 평가기준을 사용하지 못하고 학교별 실무자 회의와 학교 간 의견 조율을 통해 평가를 실시하였으나, 향후 연구에서는 표준화된 평가기준이 사용된다면 학교급식 운영 효율화에 더 큰 도움을 줄 수 있을 것으로 판단된다.