• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.325-333
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• 1995

Laparoscopic cholecystectomy was introduced into Korea in 1990 and has been rapidly replacing open cholecystectomy when the indications were met. In this study a medical utilization and technology was assessed on the selected hospitalized patients with cholelithiasis who underwent open or laparoscopic cholecystectomy from April 1, 1991 to March 31, 1994. The results are as follows. Despite the low reimbursement rate by the health insurance, the number of laparoscopic cases have been steadily increased. The post-operative days before health insurance coverage were significantly shortened from 8.4 days to 4.6 days. The preoperative days before health insurance coverage were significantly shorted from 8.4 days to 4.0 days. The total length-of-stays in the hospital were also significantly shortened from 15.2 days to 10.7 and 9.8 days in laparoscopic cholecystectomy. The laparoscopic cholecystectomy showed low expenses in all aspects expect the average hospital charges per day. For the hospital to have cost containment, it is more effective if length-of-stay is shorter because of high daily inpatient hospital charge. The laparoscopic cholecystectomy also showed shortened anesthesia time and operation time compared with open cholecystectomy that were statistically significant. The mean anesthesia and operation time for open cholecystectomy were 113.2 and 90.2 minutes but those of laparoscopic cholecystectomy were 105.7 and 68.6 minutes. According to this study the laparoscopic cholecystectomy has reduced the medical expenditure and we recommend this procedure over open cholecystectomy. The further discussion on the different morbidity rate between two types of procedure is essential in providing quality medical care, and to educate specialist.

• Journal of the Korean Solar Energy Society
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• v.32 no.5
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• pp.41-51
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• 2012

Heliostat field is the most important subsystem in the tower type solar thermal power plant since its optical performance affects the total system efficiency most significantly while the construction cost of it is the major part of total construction cost in such a power plant. Thus a well designed heliostat field to maximize the optical efficiency as well as to minimize the land usage is very important. This work presents methodology, procedures and result of heliostat filed design for 200kW solar thermal power plant built recently in Daegu, Korea. A $2{\times}2(m)$ rectangular shaped receiver located at 43(m) high and tilted $28^{\circ}$ toward heliostat field, 450 of heliostats of which the reflective surface is formed by 4 of $1{\times}1(m)$ flat plate mirror facet, and the land area having about $140{\times}120(m)$ size are used to form the heliostat field. A procedure to deploy 450 heliostats in radial staggered nonblocking formation is developed. Also the procedures to compute the cosine effect, intercept ratio, blocking and shading ratio in the field are developed. Finally the heliostat filed is designed by finding the optimal radial distance and azimuthal spacing in radial staggered nonblocking formation such that the designed heliostat field optical efficiency could be maximized. The designed heliostat field has 77% of annual average optical efficiency, which is obtained by annually averaging the optical efficiencies computed between the time of where sun elevation angle becomes $10^{\circ}$ after sunrise and the time of where sun elevation angle becomes $10^{\circ}$ before sunset in each day.

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.2
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• pp.206-213
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• 2011

An experiment was conducted to evaluate the effect of replacing barley and soybean meal in finishing diets with sesame hull (SH) on growth performance, digestibility, and carcass characteristics of Black goat kids. Twenty-one Black goat kids were assigned randomly to 0%, 10%, or 20% SH diets (7/diet). The study lasted for 63 d. Intakes of dry matter (DM), organic matter (OM), and crude protein (CP) of kids fed the 10% diet were greater (p<0.05) than for the 0% and 20% SH diets (p<0.10). Neutral detergent fiber (NDF) and acid detergent fiber (ADF) intakes were highest (p<0.05) for kids fed the 10% SH diet when compared to 0% and 20% SH diets. Ether extract (EE) intake was greater (p<0.05) for kids fed 10% and 20% SH diets when compared to 0% SH. Digestibilities of DM, OM, CP, NDF, and ADF were similar among all diets. However, sesame hull inclusion increased (p<0.05) EE digestibility. Final body weight, total gain, average daily gain (ADG), and feed conversion ratio were comparable among all diets. Cost of gain was lower (p<0.05) in kids fed 20% SH than the 0% SH diet, while there was no difference between the 10% SH diet and the other two diets. Dressing percentage, hot and cold carcass weights, non-carcass components, carcass cut weights, and meat quality parameters were not influenced by SH. Total fat percentage in the leg was greater (p<0.05) on 0% SH than on the 10% SH diet. Results of this study demonstrated that inclusion of sesame hull at levels of 10 or 20% did not influence the performance of Black goat kids, but the cost of gain was lower.

• Health Policy and Management
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• v.15 no.2
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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.

• Journal of Communications and Networks
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• v.14 no.6
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• pp.662-671
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• 2012

Plug-in hybrid electric vehicles (PHEVs) will be widely used in future transportation systems to reduce oil fuel consumption. Therefore, the electrical energy demand will be increased due to the charging of a large number of vehicles. Without intelligent control strategies, the charging process can easily overload the electricity grid at peak hours. In this paper, we consider a smart charging and discharging process for multiple PHEVs in a building's garage to optimize the energy consumption profile of the building. We formulate a centralized optimization problem in which the building controller or planner aims to minimize the square Euclidean distance between the instantaneous energy demand and the average demand of the building by controlling the charging and discharging schedules of PHEVs (or 'users'). The PHEVs' batteries will be charged during low-demand periods and discharged during high-demand periods in order to reduce the peak load of the building. In a decentralized system, we design an energy cost-sharing model and apply a non-cooperative approach to formulate an energy charging and discharging scheduling game, in which the players are the users, their strategies are the battery charging and discharging schedules, and the utility function of each user is defined as the negative total energy payment to the building. Based on the game theory setup, we also propose a distributed algorithm in which each PHEV independently selects its best strategy to maximize the utility function. The PHEVs update the building planner with their energy charging and discharging schedules. We also show that the PHEV owners will have an incentive to participate in the energy charging and discharging game. Simulation results verify that the proposed distributed algorithm will minimize the peak load and the total energy cost simultaneously.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.1-20
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• 2009

The purpose of this study is to find the determinant variables to make profitability in regional public hospitals. The data come from financial statements and annual reports of 34 regional public hospitals for five years (from year 2003 to year 2007). The T or F-test and hierarchical multiple regression analysis are used. The dependant variables are the profitability indicators, ordinary income to total asset and operating margin to gross revenue, and the independent variables are general characteristics, diagnosis and treatment patterns, financial and public benefits. The findings of this study are summarized as follows. First, Variables affecting the profitability indexes revealed from DEA results is the bed occupancy rate, number of hospitalized patients to outpatients, ratio of first medical examination for outpatients, number of daily patients per medical specialist, labor cost per patient and managerial expenses per patient. Second, the ordinary income to total asset representing the asset usage performance is affected by the average hospitalized days, bed occupancy rate, labor cost per patient and ratio of patients with medical insurance coverage. Third, the operating martin to gross revenue obtained from the actual operations of hospitals has its significance with the bed occupancy rate, number of hospitalized patients to outpatients, managerial expenses per patient and public benefit indicator. This study has some restriction not to use pannel data analysis, although it used data for five years. Accordingly, various additional studies should be done to supplement such problems.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.411-422
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• 2014

Objectives: A large number of patients require psychiatric therapy. We attempted to determine the present situation regarding psychotherapy and neuropsychological tests for dementia in Korean medicine for the benefit of the Health Insurance Review and Assessment Service (HIRAS). The aim of this study was to aware of the current status about psychotherapy and neuropsychological test for dementia in Korean medicine. Methods: We searched the medical practice records for psychotherapy and neuropsychological tests in oriental neuropsychiatry between 2009 and 2013 using the Health Insurance Review and Assessment Service (HIRAS) database. The search categories were: IJeongByunGi (Medical practice code:59001), JiUnGoRoen (59002), Kyungjapyungji (59003), OhJiSangSeung (59004), neuropsychological test for dementia (29005). Results: 1. The number of patients treated with Korean Medical Psychotherapy increased annually by 151%. The total number of patients treated with Korean Medical Psychotherapy was 4,289 in 2013. 2. The total cost for patients treated with Korean medical Psychotherapy in the public health medical insurance budget was 268,032,000 won in 2013. The average medical cost for one therapy was 17,000 won in 2013. 3. The number of patients in local clinics is increasing faster than the number in Korean medical hospitals. 4. The age group between 20~30 years of age, for both men and women, is the group with the greatest density in Korean Medical Psychotherapy. 5. Neuropsychological Testing for Dementia in Korean Medicine is slowly decreasing. Conclusions: The prevalence of mental illness in Korea is increasing, therefore, the demand for Korean Medical Psychotherapy has increased recently. Authorizing Korean Medical psychiatrists to utilize Korean mental Health resources is essential. This study could be helpful in understanding the current status for the purpose of expanding Korean Medical Psychotherapy.

• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• Journal of the Korean Institute of Telematics and Electronics D
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• v.34D no.8
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• pp.41-51
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• 1997

The device simulator (BANDIS) which can analyze efficiently the electrical characteristics of the semiconductor devices under the three dimensional stationary conditions on the IBM PC was developed. Poisson, electon and hole continuity equations are discretized y te galerkin method using a tetrahedron as af finite element. The frontal solver which has exquisite data structures and advanced input/output functions is dused for the matrix solver which needs the highest cost in the three dimensional device simulation. The discretization method of the continuity equations used in BANDIS are compared with that of the scharfetter-gummel method used in the commercial three-dimensional device. To verify an accuracy and the efficiency of the discretization method, the simulation results of the PN junction diode and the BJT from BANDIS are compared with those of the commercial three-dimensiional device simulator such as DAVINCI. The maximum relative error within 2% and the average number of iterations needed for the convergence is decreased by more than 20%. The total simulation time of the BJT with 25542 nodes is decreased to about 60% compared with that of DAVINCI.

• Journal of Industrial Technology
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• v.20 no.A
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• pp.219-228
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• 2000

The determination of lot sizes in prevailing inventory problems has been made with constant safety stock over the planning horizon. But, it is more profitable to accommodate the safety stock to dynamically fluctuating demands. The objective of this paper is to study the method to determine the dynamic safety stock and lot sizing rules depending on the actual customer demands. The last period or highly fluctuating period during the consumption of a lot is the most critical one to stock-out. It means that such periods must be given more attentions. Some dynamic methods to control safety stock are proposed with viewpoints of the time, quantity, and time-quantity. Simulation results show that lot sizing methods with dynamic safety stock reduce about 10% of average total cost compared to those with constant safety stock.