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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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Echocardiographic Diagnosis of Pulmonary Arterial Hypertension in Chronic Lung Disease with Hypoxemia (만성 저산소성 폐질환의 폐동맥 고혈압에 대한 심초음파 검사)

  • Chang, Jung-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.846-855
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    • 1999
  • Background : Secondary pulmonary hypertension is an important final endpoint in patients with chronic hypoxic lung disease, accompanied by deterioration of pulmonary hemodynamics. The clinical diagnosis of pulmonary hypertension and/or cor pulmonale could be difficult, and simple noninvasive evaluation of pulmonary artery pressures has been an relevant clinical challenge for many years. Doppler echocardiography might to be a more reliable method for evaluating pulmonary hemodynamics in such patients in terms of the accuracy, reproducibility and easiness for obtaining an appropriate echocardiographic window than M-mode echocardiography. The aim of this study was to assess echocardiographic parameters associated with pulmonary arterial hypertension, defined by increasing right ventricular systolic pressure(RVSP), calculated from trans-tricuspid gradient in patients with chronic hypoxic lungs. Method : We examined 19 patients with chronic hypoxic lung disease, suspected pulmonary hypertension under the clinical guidelines by two dimensional echocardiography via the left parasternal and subcostal approach in a supine position. Doppler echocardiography measured RVSP from tricuspid regurgitant velocity in continuous wave with 2.5MHz transducer and acceleration time(AT) on right ventricular outflow tract in pulsed wave for the estimation of pulmonary arterial pressure. Results : On echocardiography, moderate to severe degree of pulmonary arterial hypertension was defined as RVSP more than 40mmHg, presenting tricuspid regurgitation. Increased right ventricular endsystolic diameter and shortened AT were noted in the increased RVSP group. Increased RVSP was correlated negatively with the shortening of AT. Other clinical data, including pulmonary functional parameters, arterial blood gas analysis and M mode echocardiographic parameters were not changed significantly with the increased RVSP. Conclusion : These findings suggest that shortened AT on pulsed doppler can be useful when quantifying pulmonary arterial pressure with increased RVSP in patients with chronic lung disease with hypoxemia. Doppler echocardiography in pulmonary hypertension of chronic hypoxic lungs is an useful option, based on noninvasiveness under routine clinical practice.

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Expression of bcl-2 in Non-small Cell Lung Cancer and its Effects on Cell Proliferation and Survival (비소세포 폐암에서 bcl-2의 발현률과 세포분열주기 및 예후에 미치는 영향)

  • Kuk, Hiang;Koh, Hyeck-Jae;Gu, Ki-Seon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.36-43
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    • 1999
  • Background : Tumor growth is the net result of intrinsic proliferation and escape from active cell death. bcl-2 is a member of a new category of oncogenes that is not involved in influencing cell proliferation but is involved in regulating cell death(apoptosis). Based on this information, it seems to be reasonable to expect that there may be clinical prognostic significance of bcl-2 expression in non-small cell lung cancer. But its prognostic significance is not established. Methods: To investigate the role of bcl-2 in lung cancer, we performed immunohistochemical stain of bcl-2 on 57 biopsy specimens from resected primary non-small cell lung cancer. Thereafter, flow cytometric cell cycle analysis was done. And we analyzed the correlation between bcl-2 expression, clinical parameters, S-, $G_1$-phase fraction and survival. Results: bcl-2 were detected in 43.8% of total 57 patients(according to histology, squamous cancer 47%, adenocarcinoma 32%, according to TNM stage, I 28.6%, II 52.3%, III 45.5%. both differences were insignificant). By using the flow cytometric analysis, mean S-phase fraction of bcl-2(+) and (-) group were 14.1($\pm7.8$)%, 24.7($\pm10.5$)% (p<0.005), mean $G_1$-phase fraction of bcl-2(+) and bcl-2(-) group were 75.5($\pm10.8$)%, 65.5($\pm11.4$)%(p<0.05). 2yr, 3yr and 5yr survival and median survival time of bcl-2(+) group were 65%, 54%, 41%, 53 months, and those of bcl-2(-) group were 71%, 52%, 46%, 37 months. (p>0.05, Kaplan-Meier, log rank) Conclusion: bcl-2 was detected in 43.8% of primary non-small cell lung cancer. The S-phase fraction of bcl-2(+) group was less than bcl-2(-) group, and G1-phase fraction of bcl-2(+) group was more than bcl-2(-) group. But, expression of bcl-2 could not be a prognostic factor.

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Analysis on the Labor Market Performance of Local University Graduates and Regional Education Gap (지방대학 졸업자의 노동시장 성과와 지역별 교육격차)

  • Kim, Hisam
    • KDI Journal of Economic Policy
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    • v.32 no.2
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    • pp.55-92
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    • 2010
  • In terms of labor market accomplishments, such as income, size of the company, and the matching quality between one's job and college major (specialization), a very large discrepancy is observed between the graduates from colleges located in Seoul and those outside Seoul. But, when the department average score of the Scholastic Aptitude Test (SAT) at the time of college entrance is controlled for, the discrepancy is found to be reduced to a considerable degree. In the case of wage gap, at least two third can be explained by the SAT score gap. The remaining wage gap seems to reflect the characteristics of workplace. In other words, graduates with high SAT scores enter colleges located in Seoul and thus tend to find better jobs leading to earning differences. This result that confirms the importance of aptitude test scores suggests that in the labor market, one of the major reasons behind a lower accomplishment of the graduate from local colleges is due to a lower competitiveness of local colleges in attracting the brightest students. But, this should not be viewed as only an internal problem of local colleges. This is because the growth of local economies tends to haul the advancement of local colleges in that area rather than being the other way around. The agglomeration effect in Seoul where headquarters of large corporations and financial institutions gather is the factor that has elevated the status of colleges located in Seoul since this provides highly preferred job choices of graduates. When the competitiveness of college is significantly influenced by exogenous factors, such as the vicinity to Seoul, the effort being made by colleges alone would not be enough to improve the situation. However, the central government, too, is not in the position to carry out countermeasure policies for such problems. The regional development strategy boosted through supportive policies for local colleges, such as financial support, is not based on the persuasive and empirical grounds. It is true that college education is universal and that the government''s intervention in assisting local colleges to secure basic conditions, such as tenure faculty and adequate facilities is necessary. However, the way of intervention should not be a support-only type. In order to improve the efficiency and effect of financial support, restructuring programs, including the merger and integration of insolvent colleges, should be underway prior to providing support. In addition, when the policy is focused on education recipients-local college students, and not on education providers-local colleges, the importance of regional gap in compulsory education (elementary and junior high schools) turns out to be much important as the gap between metropolitan area colleges and local colleges. Considering the educational gap before college entrance shown from the discrepancies of aptitude test scores among different regions, the imbalance between regions in terms of human resources is apparently derived from compulsory education, and not from college education. Therefore, there is a need to double the policy efforts to reduce the educational gap among different regions. In addition, given the current situation where it is difficult to find appropriate ex post facto policy measures to solve the problem of income gap between the graduates from metropolitan colleges and local colleges, it can be said that improving the environment for compulsory education in local areas is a growing necessity for bridging the educational gap among different regions.

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The Effects of Female Wage on Fertility in Korea (여성의 임금수준이 출산율에 미치는 영향 분석)

  • Kim, Jungho
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.105-138
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    • 2009
  • Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

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A Local Governments' Preferences in Selecting Modern Eight Scenic Landscapes (지자체가 선정한 현대팔경에 나타난 경관 선호 양상)

  • So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.1
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    • pp.92-102
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    • 2020
  • The followings are the landscape preference aspects from the 816 landscapes(景, Kyung), which comprise the 78 modern Palkyungs, presented by the 78 local governments in Korea. First, the natural environment elements selected as Kyung(景), which are topographical landscapes, mostly consist of mountain elements such as mountains, terrace(臺), rocks and stones and water elements classified as rivers, oceans, and lakes. Natural elements also include old-growth and giant trees such as pines, ginkgos, Japanese cornels and fringe trees, tree-lined streets and forests, and plant elements such as azaleas, rhododendrons, lotuses, reeds, and silver grasses which provide seasonal landscapes. Second, more than half of Kyung, selected as human environment elements, are historical and cultural heritages such as graveyards, mountain fortresses, town fortresses, traditional villages, pavilion in villas, and temples. And it is followed by leisure tourism facilities such as traditional markets, exhibition halls, theme parks, beaches, and food streets, green-based structures such as trails, plazas, parks, and botanical gardens, and industrial heritages such as ranches, abandoned coal mines, stations, ports and bridges. Third, modern Palkyungs include objects not related to the views such as local representative facilities, regional products, and festivals. Fourth, although most of the modern Palkyungs consist of eight, some include 20, 38, or 100 in order to increase the number of objects of public relations. Fifth, a certain local government makes two modern Palkyungs with different subjects by introducing traditional Palkyung and modern Palkyung altogether. In this case, it presents several modern Palkyungs like by selecting Palkyungs in a limited area. Furthermore, one Palkyung includes numerous place names at a time in some cases. Sixth, Sosangjeonhyeong(瀟湘典型)-style modern Palkyung uses 'NakAn(落雁)' as the name of Kyung. Sosangyusahyeong(瀟湘類似型)-style modern Palkyung expresses 'Hyojong(曉鐘)' and landscape of glow of the setting sun, sunset, night view, dawn, sunrise and depicts cloud, sunset, moon, and snow. There are many Myeongsocheheomhyeong(名所體驗型)-style Palkyungs exhibiting the behavior of tourism and Myeongseunghyeong(名勝型)-style Palkyungs raising the awareness only by the names of the places. Seventh, modern Palkyung's naming styles are diverse, such as using only four letters instead of specifying Kyungmul(景物) or Kyungsaek(景色) in combination with Chinese characters or adding modifiers specializing in places.

A Study on the Job Productivity by the Smart Work Investment - Focused on the Organizational Change Resistance and the Communication - (스마트워크 투자에 따른 직무 생산성에 관한 연구 - 조직 변화저항과 의사소통을 중심으로-)

  • Jung, Byoung-Ho
    • Management & Information Systems Review
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    • v.37 no.3
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    • pp.83-113
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    • 2018
  • The purpose of this study to empirically examine a smart work investment and job performance by change resistance. Firstly, There investigates mediating role of the communication between the smart work investment and the job performance. Secondly, It will identify the job productivity differences through a level of organizational change resistance that reduced smart work investment. The smart work is to provide the flexibility of time and location and is a working method to improve a work productivity of organization members. The introduction of smart work means the adoption of new organizational culture, institution and technology and requires a novel change of a custom and pattern on existing organization culture and institution because of transformation form of communication and collaboration. The method of this study adopts a structural equation model to test a mediating effect of communication and a moderating effect of change resistance level. This model confirms whether smart work investments provide a positive impact on communication and organizational productivity. In addition, I will classify a change resistance level of smart work by cluster analysis and then check a critical path difference of job productivity between each group. As a result, The organizational IT, institution and culture on the smart work investment appeared to important influencers in communication and also had a direct influence of individual performance. Also, The three independent variables of smart work investment have an indirect influence of individual and organizational performance through communication mediating variables. However, the organizational IT and institution as independent variables do not provide direct influence of organization performance. Nevertheless, two independent variables of organizational IT and institution have an indirect influence the organization performance through communication mediating variables. As a result of confirming a productivity of three groups on organization resistance, there was a difference the individual and organizational performance among groups. The low-level group of organizational resistance showed high coefficient value of performance compared to other groups. The group analysis implications, The smart work investment appeared significantly to revise the institution first, build culture secondly and advanced technology lastly. The theoretical implication from this study contributes an extension of social science theory through socio-technical systems, institution, culture, change resistance and job performance based on smart work. The practical implications explain the smart work success in step-by-step investment rather than radical investment as level management of change resistance. In future research, the smart work performance between private and public firms will analyze a difference of the organizational culture, institution, technology and performance.

Study on the Rice Yield Reduction and Over head Flooding Depth for Design of Drainage System (배수 설계를 위한 벼의 관수심 및 관수피해율에 관한 연구)

  • 김천환;김시원
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.24 no.4
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    • pp.69-79
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    • 1982
  • The objective of this study is to contribute to drainage planning in the most realistic and economical way by establishing the relationship between rice yield reduction and overhead flooding by muddy water of each growth stage of paddy, which is the most important factor in determining optimum drainage facilities. This study was based on the data mainly from the experimental reports of the Office of Rural Development of Korea, Reduction Rate Estimation for Summer Crops, published by Ministry of Agriculture and Forestry of Japan and other related research documenta- tion. The results of this study are summarized as follows 1. Damages by overhead flooding are highest in heading stage and have the tendency of decrease in the order of booting stage, panicle formation stage, tillering stage, and stage just after transplanting. Damages by overhead flooding of each growing stage are as follows: a) It is considered that overhead flooding just after transplanting gives a little influence on plant growth and yield because the paddy has sufficient growth period from floo ding to harvest time. b) Jt is analyzed that according to the equation y=11 12x 0.908 which is derived from this study, damages by overhead flooding during tillering stage for 1, 2, 3 successive days are 11.1 %, 20.9%, and 30.2% respectively. c) Damages by overhead flooding after panicle formation stage are very serious because recovering period is very short after damage and ineffective tillering is much. Acc- ording to the equation y=9. 58x+10. Ol derived from this study, damages by overhead flooding fal 1,2,3,5 successive days are 19.6%, 29.2%, 38.8%, 57.9% respectively. d) Booting stage is the very important period in which young panicle has grown up almost completely and the number of glumous flower is fixed since reduction division takes place in the microspore mother cell and enbryo mother cell. According to the equation y=39. 66x 0.558 derived from this study, damages by overhead floodingfor 0.5, 1, 3, 5 successive days are 26.9%, 39.7%, 72. 2% and 97.4%, respectively. Therefore, damages by overhead flooding is very serious during the hooting stage. e) When ear of paddy emerges, flowering begins on that day or the next day; when paddy flowers, fertilization will be completed 2-3 hours after flowering. Therefore overhead flooding during heading stage impedes flowering and increases sterilizing percentage. From this reason damages of heading stage are larger than that of booting stage. According to the equation y-41 94x 0.589 derived from this study, damages by overhead flooding for 0.5, 1, 3, 5, successive days are 27.9%, 63.1 %, 80.1%, and 100% 2. Considering that temperature of booting stage is higher than that of beading stage and plant height of booting stage is ten centimeters shorter than that of heading stage, booting stage should be taken as a critical period for drainage planning because possi- bility of damage occurrence in booting stage is larger than that of heading stage. There-fore, it is considered that booting stage should be taken as critical period of paddy growth for drainage planning. 3. Overhead flooding depth is different depending on the stage of growth. In case, booting stage is adopted as design stage of growth for drainage planning, it is conside red that the allowable flooding depth for new varieties and general varieties are 70cm and 80cm respectively. 4. Reduction Rate Estimation by Wind and Flood for Rice Planting of the present design criteria for drainage planning shows damage by overhead flooding for 1 to 2, 3 to 4, 5 to 7 consecutive days; damages by overhead flooding varies considerably over several hours and experimental condition of soil, variety of paddy, and climate differs with real situation. From these reasons, damage by flooding could not be estimated properly in the past. This study has derived the equation which shows damages by flooding of each growth stage on an hourly basis. Therefore, it has become possible to compute the exact damages in case duration of overhead flooding is known.

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Evaluation of Fertilization Effect of Slow-Release Complex Fertilizer on Pepper Cultivation (원예용 완효성 복합비료의 고추에 대한 시비효과 평가)

  • Lee, Chang-Hoon;Lee, Hyub;Ha, Byung-Hyun;Kang, Chang-Sun;Lee, Yong-Bok;Kim, Pil-Joo
    • Korean Journal of Environmental Agriculture
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    • v.26 no.3
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    • pp.228-232
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    • 2007
  • Slow-release fertilizers (SRF) have been used to reduce nutrient loss through increasing fertilizer efficiency and to save labor. Several SRFs were developed for rice plant in Korea, but there is few for horticultural crop plants. Two slow-release complex fertilizers, 100T and 150T, which made for controlling nitrogen release time up to 100 and 150 days, respectively, were selected for the incubation test cto evaluate nitrogen (N) release rate in soil. The N of urea selected as the control was completely released within a week after application. Sixty three and 53% of total N were released from 110T and 150T of slow release fertilizers within 8th weeks after application, respectively. For pepper cultivation CF110 and CF150, new slow-release complex fertilizer, were made of mixing 40% of conventional fertilizer and 60% of 110T and 150T, respectively, based on the amount of recommended fertilizer for pepper cultivation $(N-P_2O_5-K_2O=190-112-149\;kg\;ha^{-1})$, and were totally applied before pepper transplanting in the field as the basal fertilizer. Inorganic N $(NH_4^+-N+NO_3^--N)$ concentration in soil was higher in the CF110 treatment than in the control (NPK) at all period of pepper cultivation. In the CF150 treatment concentration of inorganic N in soil was low compared to control up to 8th weeks after transplanting. However, there was no difference in plant height and nutrient content of pepper leave between CF110 treatment and the control. In comparison, plant height was significantly lower in CF150 than the control and CF110 treatments. Around 4% of fresh pepper yield was increased in CF110 compared to the control, but it was decreased to about 2% by CF150 treatment. Conclusively, CF110 form could be recommended as a slow release fertilizer for pepper cultivation.

Crosshole EM 2.5D Modeling by the Extended Born Approximation (확장된 Born 근사에 의한 시추공간 전자탐사 2.5차원 모델링)

  • Cho, In-Ky;Suh, Jung-Hee
    • Geophysics and Geophysical Exploration
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    • v.1 no.2
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    • pp.127-135
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    • 1998
  • The Born approximation is widely used for solving the complex scattering problems in electromagnetics. Approximating total internal electric field by the background field is reasonable for small material contrasts as long as scatterer is not too large and the frequency is not too high. However in many geophysical applications, moderate and high conductivity contrasts cause both real and imaginary part of internal electric field to differ greatly from background. In the extended Born approximation, which can improve the accuracy of Born approximation dramatically, the total electric field in the integral over the scattering volume is approximated by the background electric field projected to a depolarization tensor. The finite difference and elements methods are usually used in EM scattering problems with a 2D model and a 3D source, due to their capability for simulating complex subsurface conductivity distributions. The price paid for a 3D source is that many wavenumber domain solutions and their inverse Fourier transform must be computed. In these differential equation methods, all the area including homogeneous region should be discretized, which increases the number of nodes and matrix size. Therefore, the differential equation methods need a lot of computing time and large memory. In this study, EM modeling program for a 2D model and a 3D source is developed, which is based on the extended Born approximation. The solution is very fast and stable. Using the program, crosshole EM responses with a vertical magnetic dipole source are obtained and the results are compared with those of 3D integral equation solutions. The agreement between the integral equation solution and extended Born approximation is remarkable within the entire frequency range, but degrades with the increase of conductivity contrast between anomalous body and background medium. The extended Born approximation is accurate in the case conductivity contrast is lower than 1:10. Therefore, the location and conductivity of the anomalous body can be estimated effectively by the extended Born approximation although the quantitative estimate of conductivity is difficult for the case conductivity contrast is too high.

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