• Archives of Plastic Surgery
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• 제40권5호
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• pp.589-596
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• 2013

Background The treatment of pressure ulcers is complicated, given the various wound dressing products available. The cost of different treatments varies and the cost-effectiveness of each product has not been thoroughly evaluated. We compare two wound dressing protocols-alginate silver dressing (AlSD) and silver zinc sulfadiazine cream (AgZnSD) with regard to wound healing and cost-effectiveness Methods Patients with grade III or IV sacral or trochanteric pressure ulcers were eligible for this prospective, randomized controlled trial. The patients were randomized to receive one of the two dressings for an eight-week period. The criteria of efficacy were based on the Pressure Ulcer Scale for Healing (PUSH) scoring tool. The cost of treatment was also assessed. Results Twenty patients (12 women and 8 men) were randomly assigned to receive either AlSD (n=10) or AgZnSD cream (n=10). The demographic data and wound characteristics were comparable in the two groups. The two groups showed no significant difference in the reduction of PUSH score, wound size, or volume of exudate. The tissue type score was significantly lower in the AlSD group ($3.15{\pm}0.68-1.85{\pm}0.68$ vs. $2.73{\pm}0.79-2.2{\pm}0.41$; P=0.015). The cost of treatment was significantly lower in the AlSD group (377.17 vs. 467.74 USD, respectively; P<0.0001). Conclusions Alginate silver dressing could be effectively used in the treatment of grade III and IV pressure ulcers. It can improve wound tissue characteristics and is cost-effective.

• 한국건설관리학회논문집
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• 제19권5호
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• pp.43-52
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• 2018

일반적으로 공사비에 대한 연구는 직접비 위주로 행해졌으며, 간접비를 면밀하게 산정하는 모델에 대한 연구가 부족하다. 본 연구의 목적은 국내 건설시장에서 큰 축을 차지하는 아파트 건설공사 현장의 현장관리비를 예측하기 위한 모델을 제시하는 것이다. 아파트 건설공사 현장 다수의 전체공사기간 동안의 실비사용 데이터를 분석하여 곡선접합 분석을 통해 공정률별 1일당 현장관리비를 도출할 수 있는 9차방정식을 제안하였으며, 이를 활용하여 300억 규모의 공사의 경우의 현장관리비를 추정하는 결과를 보여줌으로서 활용가능성을 설명하고 있다. 선행연구에서는 총 현장관리비의 규모의 변화패턴을 직접적으로 확인할 수 있는 다항식을 도출한 사례는 없었던 점에 비추어 본다면, 본 연구에서 제시한 모델은 그 편의성과 면밀성에 합리적 근거를 토대로 현장관리비를 예측할 수 있다는 점에서 연구의 기여도가 있다.

• 한국벤처창업학회:학술대회논문집
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• 한국벤처창업학회 2017년도 통합학술대회
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• pp.15-35
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• 2017

본 연구는 주된 일자리에서 은퇴했거나 은퇴를 앞둔 베이비붐 세대 직장인들을 대상으로 은퇴 이후 창 재취업의도에 영향을 미치는 요인과 사회적자본의 매개효과를 규명하고자 한다. 2010년 이후 베이비붐 세대의 대규모 퇴직이 시작되고 있으나 경제적 노후준비를 충분히 확보하지 못한 상태에서의 대규모 은퇴는 노동시장의 불안정과 사회복지비용 지출증가 등 사회 경제적으로 커다란 이슈가 되고 있다. 퇴직 후 30년 이상의 새로운 커리어를 시도할 수 있는 준비를 하도록 개인의 인식변화와 제도적인 지원이 구체화 되어야 한다. 따라서 잠재적 은퇴자인 베이비부머 직장인들이 재직하는 기간 동안에 개인의 경력지향에 맞는 교육, 훈련, 재취업 프로그램을 체계적으로 지원받고, 네트워크나 신뢰 등 사회적자본을 강화하여, 은퇴 후 상대적으로 폭 넓은 창 재취업의 기회를 얻고, 퇴직 후에도 노동시장에 오랜 기간 머물도록 함으로써 경제적 안정과 공적연금 등 사회적 비용증가에 대한 해결책이 될 시사점을 얻을 수 있었다.

• 한국경영과학회지
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• 제1권1호
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• pp.111-125
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• 1976

This study investigates the one-year performance of the Seoul Metropolitan Rail Transit(SMRT) operation. It intends to provide a basic understanding for railway operation in Seoul Metropolitan Area and thereby for making rational transport policy. The paper is conceptually comprised of four sections; analysis of passenger travel characteristics; SMRT costing and traffic cost function: its operating characteristics in terms of finance and utilization; primary social benefits of SMRT and suggestions. In the first year of operation (1974), the average daily traffic was about 335,000, After the drastic increases of fare in both Subway and KNR rail-lines, the travel volume has been cut by almost 10 percent, though most pronounced on intra-Subway line. The spatial distribution of passengers indicates that travelers use the SMRT line mainly for uninterrupted direct travel toward the CBD. In the prospective costing, the opereting expenses are divided into three groups; those which vary directly with volume; those partially variable with volume; and those entirely unrelated to volume change, With this information, cost function was derived for varying schedules of operation. Primary social benefits of the SMRT are assessed, though preliminary. Account should be taken of the nature of common costs of the SMRT in fare-rate making, especially when much of the operating expenses are accounted for by the fixed costs such that the revenue may not readily turn into break-even. The accounting results of the one-year operation coincide reasonably well with the prospective costing estimates. According to the findings of this annd another travelers' behavior studies, managerial effort would bring more revenue gain to the SMRT than fare increase does, not to speak of greater social benefits by so doing.

• 보건행정학회지
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• 제15권2호
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.165-174
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• 2022

Background: One goal of the End tuberculosis (TB) Strategy is to see no TB-affected households experiencing catastrophic costs. Therefore, it is crucial for TB-elimination programs to identify catastrophic costs and their main drivers in order to establish appropriate health and social measures. This study aimed to measure the percent of catastrophic costs experienced by Egyptian TB patients and to identify its determinants. Methods: We conducted a prospective cohort study with 151 Egyptian TB patients recruited from two chest dispensaries from the Cairo governate from May 2019 to May 2020. We used a validated World Health Organization TB patient-cost tool to collect data on patients' demographic information, household income, and direct and indirect expense of seeking TB treatment. We considered catastrophic TB costs to be total costs exceeding 20% of the household's annual income. Results: Of the patients, 33% experienced catastrophic costs. The highest proportion of the total came in the pre-treatment stage. Being the main breadwinner, experiencing job loss, selling property, and the occurrence of early coronavirus disease 2019 lockdown were independent determinants of the incidence of catastrophic costs. Borrowing money and selling property were the most-often reported coping strategies adopted. Conclusion: Despite the availability of free TB care under the Egyptian National TB Program, nearly a third of the TB patients incurred catastrophic costs. Job loss and being the main breadwinner were among the significant predictors of catastrophic costs. Social protection mechanisms, including cash assistance and insurance coverage, are necessary to achieve the goal of the End TB Strategy.

• 한방재활의학과학회지
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• 제33권2호
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• pp.57-76
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• 2023

Objectives This study aims to develop Korean Medicine Clinical Pathway (CP) based on Clinical Practice Guideline of carpal tunnel syndrome to improve quality of treatment and reduce medical cost to maximize the quality of patient management. Methods A draft version of CP for carpal tunnel syndrome is developed by expert agreement and a prospective case study was carried out based on the draft CP. Twenty experts working at various medical institution answered validity verification survey of developed CP. Fifteen patients enrolled in the prospective case study answered survey on demand and satisfaction. Qualification and adjustment process of the draft CP was conducted based on results of both surveys. Results Final version of CP for carpal tunnel syndrome is confirmed after qualification and adjustment on the draft version. Conclusions CP for carpal tunnel syndrome will provide patients with standardized, high-quality Korean medicine treatment and also reduce financial burden of health insurance by reducing medical cost.

• Asian Spine Journal
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• 제12권6호
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• pp.1100-1105
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• 2018

Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

• 한국간담췌외과학회지
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• 제28권3호
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• pp.291-301
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• 2024

This systematic review and meta-analysis aimed to evaluate the impact of prospective payment systems (PPSs) on cholecystectomy. A comprehensive literature review was conducted, examining studies published until December 2023. The review process focused on identifying research across major databases that reported critical outcomes such as length of stay (LOS), mortality, complications, admissions, readmissions, and costs following PPS for cholecystectomy. The studies were specifically selected for their relevance to the impact of PPS or the transition from fee-for-service (FFS) to PPS. The study analyzed six papers, with three eligible for meta-analysis, to assess the impact of the shift from FFS to PPS in laparoscopic and open cholecystectomy procedures. Our findings indicated no significant changes in LOS and mortality rates following the transition from FFS to PPS. Complication rates varied and were influenced by the diagnosis-related group categorization and surgeon cost profiles under episode-based payment. There was a slight increase in admissions and readmissions, and mixed effects on hospital costs and financial margins, suggesting varied responses to PPS for cholecystectomy procedures. The impact of PPS on cholecystectomy is nuanced and varies across different aspects of healthcare delivery. Our findings indicate a need for adaptable, patient-centered PPS models that balance economic efficiency with high-quality patient care. The study emphasizes the importance of considering specific surgical procedures and patient demographics in healthcare payment reforms.

• 한국항만학회지
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• 제13권1호
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• pp.51-64
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• 1999

This study is on the focus of the cost-effective and time-effective in the BCTOC which commenced the On Dock Termainal System in 1998 for the first time in Korea. On this process of study two categories should be considered : (1) Improvement on Business Process (2) Improvement on Information Technology. With these two accesses a new future-oriented and prospective model could be put on our hand as follows. (1) Improvement on Business Process \circled1Consistency of container In-Out Operation \circled2Simplicity of Rate appraisal \circled3Unified operation on Billing and Request (2) Improvement on Information Technology \circled1Scale up the Information Application \circled2Constructing an one-spot simultaneous Information Holding System \circled3Combination of Internet and Integrated Database System.