• 한국임상약학회지
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• 제28권1호
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• pp.40-50
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• 2018

Objective: This study presented the analysis period, the complexity of combined therapy and comparator choice as the key limitations in the economic evaluation of new drugs, and discussed programs for coping with these limitations. Methods: This study evaluated the post-evaluation, risk-sharing agreement, extra funding program, and flexible incremental cost-effectiveness ratio (ICER) threshold as actions or programs that would increase accessibility to costly new drugs. The study also presented the cases of other countries. The application of the post-evaluation was considered to deal with high uncertainty regarding new drugs. Results: The risk-sharing agreement was introduced in European countries as well as South Korea and has been responsible for the shift from using the financial schemes to outcome-based schemes. The drug funding program has had troubled in securing stable extra funds. The application of higher ICER in the economic evaluation of expensive and innovative oncology drugs was criticized because of the inequity between oncology patients and patients with other diseases. Conclusion: Therefore, introducing and applying actions that would increase the accessibility to costly new drugs in South Korea have been deemed necessary after careful reviews and discussions with various stakeholders (insurer, policy makers, pharmaceutical companies and patients).

• 한국임상약학회지
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• 제28권2호
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• 대한교통학회지
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• 제35권4호
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• pp.360-373
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• 2017

국내 민간투자사업의 추진 방식 중 수익형 민간투자사업은 수요 위험이 존재하는 방식이다. 수요 위험이 현실화 될 경우 민간사업자는 예상보다 낮은 수입으로 인해 재무적인 어려움을 겪으며, 정부도 안정적인 사회기반시설 운영에 차질을 빚을 수 있다. 따라서 정부는 수요 위험에 따른 위험 분담 정책을 다양하게 적용해 오고 있다. 하지만 정부의 위험 분담은 수요의 불확실성으로 인한 정부의 우발채무이며, 실시협약의 문구로 표현되어 기존의 전통적인 사업평가 방식인 NPV 방식으로는 위험을 계량화 할 수 없다. 본 연구는 수요 위험 분담 정책의 하나로 2015년에 도입된 손익공유형 방식(BTO-a)을 대상으로 수요 위험을 고려한 정부의 투자위험 분담 가치를 산정하는데 목적을 두고 있다. 투자위험 분담은 금융에서의 옵션(option) 형태를 갖게 된다. 민간사업자는 수입이 감소했을 때 정부로 부터 보조금을 청구할 권리를 가지고 있으며, 반대로 정부는 일정 조건하에서 보조금을 지급할 의무를 가지고 있다. 본 연구에서는 Black-Scholes 옵션가격결정 모형을 활용하여 투자위험 분담의 가치추정 방법론을 정립하고 사례 사업을 통해 결과의 적정성을 살펴보았다. 사례 사업은 제안된 고속도로 민간투자사업을 대상으로 하였으며, 분석결과 투자위험 분담 가치는 약 120억원으로 추정되어 민간이 투자한 투자비의 약 4%를 차지하는 것으로 나타났다. 즉, 정부가 투자위험을 분담함으로써 120억원의 재정지원을 추가로 투입하는 효과로 볼 수 있다. 교통량 위험을 확률변수로 가정할 경우 사례사업에서 도출된 옵션가치는 평균이 122억원이고 표준편차는 36.7억원으로 도출되었다. 누적분포를 도출한 결과 90% 확률 구간의 옵션가치가 69억원에서 188억원의 범위에서 결정될 것으로 나타났다. 본 연구에서 제시한 방법은 미래수요의 불확실성하에서 정부와 민간사업자가 더 나은 위험 분석과 투자위험 분담에 대한 경제적인 가치를 이해하는데 도움을 줄 것으로 기대한다.

• 보건행정학회지
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• 제28권4호
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• pp.360-368
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• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.

• 디지털산업정보학회논문지
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• 제8권4호
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• pp.217-230
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• 2012

To look at Korea trade environment, as increasing the quantity of goods transported in North-East Asia and deepening national competitive, information-oriented logistics environment is needed. That means it is automated work process and can provide value-added service. To do this, logistics business can be efficiently handled through "Electronic Means for the Clearance of Ships" and electronically data processing. Also, by increasing the risk of international terrorism, regulation regarding to logistics security has strengthened around the advanced country, such as USA and EU, etc. or international organization, such as IMO, ISO, etc.. Furthermore, because trade and logistics environment is changing and security becomes more important in logistics area, movement or status information of goods within the port or in entry in/out becomes more and more be needed in real time. In case cross-border logistics activities, international cooperation or agreement between countries is very important. However, different opinions much happened on defining the interface. If to follow one format or type using at a specific country or organization, it was occurred to difficulty in respect of interoperability as well as additional costs or time. Therefore, this paper proposes common interface model to exchange information for the efficient global SCM for using by the output of Korea R&D project, "National Logistics Standardization System Development".

• 한국항해학회지
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• 제21권3호
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• pp.1-18
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• 1997

From the beginning of 1990s , also in the shipping industry, especially liner shipping industry competition has been more intensive and difference of the service quality among shipping companies has been learned . On the other hand, a shipping company has some limitations to do its international mission for itself just by broadening service area. For this reason, the necessity for the global strategi alliance among the shipping companies, which is orginally aimed at sharing of facilities and organixation, has been developed. Through strategic alliance, liner shipping companies do not need to input the additional capitals to increase the material assets such as vessel capacity and spread the risk by the enlargement of the market. Also, they can secure the competitive edge through efficient utilizaton of assets. The purpose of strategic alliance of Hanjin Shipping Ltd., can be summarized as follows ; broadening of service area, cost reduction through vessel sharing, realization of rationalized shipping service by terminal and equipment or facilities sharing. Liner strategic alliances are agreement among liner companies to pol their equipment , andterminals for joint operations and services in which each alliance partner continues to serve its market using jointly operated or used inland feeders,inland terminals, port terminals, and mainline fleets of ship as well as joint pools of containers and equipment. Strategic alliances are generally more formal agreements than consortia and impose longer term and far reaching obligation on their members. It also acts as one in developing and advancing the strategic aims of the alliance members. The most important objective for liner strategic alliances is cost reduction and improvement in capital asset utilization. Main aims of strategic alliance drawn in this paper, can be enumerated follows : 1. improvements in service frequency and quality : 2. improvements in vessel and equipment utilization and thereby reductions in fixed and variable cost ; 3. improvements in market shares and high value cargo booking ; 4. reductions in intermodal storage and port terminal throughput costs ; 5. improvements in negotiating powers with ports and feeder transport providers ; 6. reduction in financial and other fixed costs such as insurance; 7. coordination and integration of MIS and EDI systems and service for greater efficiency and market penetration ; and, 8. improvements in logistic chain management and economic of scale by equipment depot, terminal, and vessel sharing.

• 동서간호학연구지
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• 제10권1호
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• pp.27-40
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• 2004

Relapse is one of the most series problems in alcoholics treatment. Previous studies have shown that significant proportions of treated alcoholics show an early relapse and go through a chronic phase. It is necessity to find more effective relapse prevention program. The Purpose of this study was to develop a relapse prevention program that emphasis on group activities using various action methods. Previous studies revealed that there was no effective therapeutic strategy to prevent relapse and proposed that action methods were more practical ways to be able ti cope with high-risk situation than verbal methods such as discussions and lectures. The special attempt of this program was the application of various actions methods and the integration of many psychosocial therapeutic strategies as compared with many relapse prevention programs. The theoretical framework of this relapse prevention program was based on mainly the Marlatt's Relapse Prevention model and Prochescha and DiClemente's Transtheoretical model. This Program consists of eight structure sessions. Every session has three phase: Warm-up phase, action phase, and sharing phase as sociodrama structure. Sociodrama is based on many of the principles of adult learning. And sociodrama looks at how groups work through an understanding of systems and role theory. Therefore, in working with a group a therapist might explore with them the roles that people play, roles that are missing at present such a visionary and how people can develop new roles or new ways of playing existing roles. The researchers explained the purpose of this study to all participants after their agreement to participate. Voluntary informed consent was obtained from all participants. Every session allows participants to recognize personal specific high-risk situation and to examine possible coping behaviors creatively. Multiple solutions can be proposed, tested and evaluated dramatically, giving new insights or breakthroughs in thinking. This is vital for the initiation of change, and if appropriate, expanding new role development. The first two sessions aim at understanding of relapse process and recognize of high-risk situations focused on orientation about action methods. The next four sessions deal with high-risk situations. The last two sessions give participants opportunities to venture new life-styles. The methods and approaches used in this program utilized as a tool to explore and practice possible coping strategies. and this program can contribute to prevent relapse episode if tune with the particular high-risk situation by using active practices in safe environment.

• 한국전자거래학회지
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• 제24권3호
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• pp.1-18
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• 2019

최근 전자상거래의 발전과 온라인 구매 품목의 변화에 따라 제한된 온도 범위 내에서 특별한 보관 및 운송 방식에 대한 요구 사항이 증가하고 있다. 이러한 요구를 만족시키기 위해 콜드체인에 대한 수요가 급격하게 증가하고 있다. 특히, 콜드체인은 복잡한 네트워크 구조를 가질 뿐만 아니라 각 단계별 상품별 관리해야 하는 기준이나 수준이 달라지기 때문에 전체 과정을 투명하게 모니터링하고 품질을 측정하기 위한 방법이 필요하다. 본 연구에서는 블록체인 기술을 기반으로 실시간 데이터 측정 및 공유를 통해 위험 요인을 사전에 예방할 수 있는 콜드체인의 구현을 위해 서비스수준협약 체결을 위한 평가 지표 제안, 블록체인기반 스마트계약 적용 방법, 블록의 구조, 서비스 플랫폼, 응용방안에 대해 제안하였다. 또한, 서비스수준협약 지표를 기준으로 스마트계약을 통해 블록에 측정된 지표와 서비스 이용자의 평판 정보를 기록하는 방식을 제안하였으며, 이를 통해 서비스 제공자뿐 만 아니라 서비스를 이용하는 사용자 입장에서도 합리적 의사결정을 내릴 수 있는 정보를 실시간으로 확보할 수 있게 된다. 본 연구에서 제안하는 프레임워크를 활용하기 위한 서비스 플랫폼을 구축 및 운영한다면 정보의 투명성과 실시간성을 확보할 수 있고, 위험 요인에 선제적으로 대응할 수 있을 것이다.

• 한국콘텐츠학회논문지
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• 제7권7호
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• pp.171-178
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• 2007

본 연구에서는 파트너십이 IT아웃소싱의 성과에 영향을 미치는 매개변수로 작용할 것인지를 분석하고자 하였다. 분석결과 경제적 요인은 성과와 파트너십에 영향을 미치지 않는 것으로 나타나 아웃소싱의 도입이 비용감소라는 목적과는 달리 오히려 비용의 증가라는 문제점을 노출시켰다는 최근의 시장분석 결과가 입증된 것이라 하겠다. 그러나 전략적 요인과 기술적 요인은 아웃소싱의 성과에 직접 영향을 미친다는 것보다는 파트너십과의 작용을 통해서 성과에 영향을 미치는 것으로 분석되었다. 이는 고객사와 서비스 제공업체간 관계에 대한 계약상의 내용을 기준으로 처리하는 트랜잭션의 형태보다 고객사와 서비스 제공업체가 서로의 위험과 이익을 공유하며 한정된 계약범위보다 필요시 서로 협력하여 지속적인 관계를 유지해 나가는 파트너십이 중요하게 작용한다는 경향이 반영된 결과라 하겠다. 따라서 성공적인 아웃소싱은 양자가 지속적인 의사소통은 물론 상호간 위험과 이익을 공유하며 필요시 서로 상생할 수 있는 파트너십 관계로의 이상적인 관계관리가 요구된다고 하겠다.

• 한국습지학회지
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• 제13권1호
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• pp.25-33
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• 2011

인위적, 자연적, 지리적, 시간적 요소 등에 의하여 기후가 변동되는 현상을 '기후변화'라 하며, 이는 수십년 또는 그 이상 지속되는 변동성이 평균적 상태에 대해 통계적으로 중요한 변화라고 정의된다. 이러한 기후변화가 최근 들어 급속하게 진행되어 자연재해가 발생함에 따라 세계는 이 변화의 추이를 예의 주시하고 있다. 특히 수자원 분야의 기후변화에 대한 취약성은 다른 분야에 비해 높을 것으로 평가되며, 이러한 기후변화로 인한 취약성을 예측하고 재해를 방지하는 것은 이 분야에서의 주요 사안이라고 할 수 있겠다. 국내의 수자원 분야 취약성 평가는 아직 미흡하므로, 본 연구에서는 수자원 분야의 전문가들을 대상으로 델파이 기법을 사용하여 우리나라 중소하천의 기후변화 취약성에 대하여 분석하였다. 조사는 총 3차에 걸쳐 실시하였으며 1차에서 총점분석을 이용하여 대리변수를 선정하였고, 1차에서 선택된 대리 변수들은 2 3차에서 항목 별 분석을 하였고, 이를 통하여 전문가 의견을 평가 정리하였다. 전반적으로 전문가 의견은 조사가 진행될수록 편차가 줄어들며 합의가 진전되었다. 추후연구로는 연구대상지역에 대한 직접적인 취약성 평가의 진행이 필요할 것으로 예상된다.