• 한국의료질향상학회지
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• 제4권2호
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• pp.242-259
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• 1997

This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

• 한국통신학회논문지
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• 제39C권11호
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• pp.1050-1067
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• 2014

CAS는 근접항공지원 작전으로 아군과 근접해 있는 상황에서 적을 항공기로 공격하는 작전이다. CAS의 여러형태 중에 긴급 CAS는 CAS 임무 형태 중에 사전 계획 없이 요청한 표적에 대하여 공격하는 임무로, 적절한 항공기를 분배하는 것이 임무 결과에 커다란 영향을 미친다. 하지만 긴급 CAS 분배에 관련한 이전 연구에서는 항공기의 적합도를 고려한 경우를 찾기 힘들었다. 2014본 연구는 항공기 적합도를 고려한 긴급 CAS 자원 분배 방법론을 제시하고자 한다. 방법론은 총 3단계로 이루어져 있으며 1단계에서, 표적 정보를 바탕으로 상황분석을 실시하고, 2단계에서는, 상황분석 결과를 이용하여 각 표적별로 타격 자산들을 적합도를 정량적으로 산출하며, 3단계에서는 산출한 적합도를 바탕으로 산정한 CAS 분배 추천 안을 결정권자에게 제시한다. 이 방법론은 긴급 CAS 자산 분배에 관한 정량적인 분석을 제공함과 동시에, 추천 대안을 제시함으로써 의사결정을 보다 신속하고 효율적으로 할 수 있도록 지원한다.

• 경영과학
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• 제34권1호
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• pp.47-56
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• 2017

We focus on the Real time Fire Scheduling Problem (RFSP), the problem of determining the sequence of targets to be fired at, for the objective of minimizing threatening probability to achieve tactical goals. In this paper, we assume that there are m available weapons to fire at n targets (> m) and the weapons are already allocated to targets. One weapon or multiple weapons can fire at one target and these fire operations should start simultaneously while the finish time of them may be different. We suggest mathematical modeling for RFSP and several heuristic algorithms. Computational experiments are performed on randomly generated test problems and results show that the suggested algorithms outperform the firing method which is generally adopted in the field artillery.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권4호
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• pp.2058-2074
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• 2017

Dense Heterogeneous Cellular Networks(HCNs) offer a promising approach to meet the target of 1000x increase in aggregate data rates in 5G wireless communication systems. However how to best utilize the available radio resources at densely deployed small cells remains an open problem as those small cells are typically unplanned. In this paper we focus on balancing loads across macro cells and small cells by offloading users to small cells, as well as dynamically switching off underutilized small cells. We propose a joint user association and base station(BS) sleep mangement(UA-BSM) scheme that proactively offloads users to a fraction of the densely deployed small cells. We propose a heuristic algorithm that iteratively solves the user association problem and puts BSs with low loads into sleep. An interference relation matrix(IRM) is constructed to help us identify the candidate BSs that can be put into sleep. User associations are then aggregated to selected small cells that remain active. Simulation results show that our proposed approach achieves load balancing across macro and small cells and reduces the number of active BSs. Numerical results show user signal to interference ratio(SINR) can be improved by small cell sleep control.

• 한국의료질향상학회지
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• 제10권2호
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• 한국사회복지학
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• 제52권
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• pp.89-115
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• 2003

그동안 사회복지 임상실천 분야에서 주로 관심을 기울여 온 것은 개입방법의 개발과 효과성 측정 연구였다. 반면 이러한 연구 결과물이 어떻게 현장에 보급되고 활용되는지에 대한 관심은 상대적으로 부족한 편이었다. 이러한 현상은 결과적으로 연구와 실천간의 괴리를 초래할 수 있다는 비판이 제기되면서, 최근 외국에서는 사회복지 분야에서도 이론과 실천, 또는 학문과 현장을 잇는 중요한 기제로서 지식 및 기술의 보급과 활용에 대한 관심이 부각되고 있다. 이에 본 연구에서는 본 연구자가 프로그램 개발에 이어 현장보급 노력을 기울여 온 성장기술 프로그램을 중심으로 현장보급 과정과 활용현황을 살펴보고자 하였다. 이를 위하여 보급과 활용에 관한 기존 이론 및 모델들을 정리하고, 그 중 Herie와 Martin의 연구-실천 가교 모델에 의거하여 성장기술 프로그램의 현장 보급과정 및 활용 상황을 추적 조사하고 분석해 보았다. 그 결과 성장기술 프로그램 보급과정의 문제점으로는 구체적인 전략의 부재, 계획성 부족으로 인한 즉흥적인 대응, 초기 보급 대상자에 대한 허술한 파악 등을 도출할 수 있었다. 그리고 효과적인 보급과 활용을 위해서는 적절한 모델을 선택하고 그에 따라 보급과정을 적용하고 실천할 것, 프로그램 개발과정부터 보급에 대해 염두를 두고 진행할 것, 프로그램 개발 뿐 아니라 현장 피드백 확보를 위한 노력을 기울일 것, 그리고 사회복지 교육 및 연구에서 전파과정에 대한 부분을 강화할 것 등을 제언하였다. 이를 통해 몇 가지 한계점들에도 불구하고 보급 및 활용에 대한 중요성을 제시할 수 있었으며, 성장기술 프로그램의 현장 활용성도 파악할 수 있었다. 이와 같은 보급과 활용에 대한 논의들은 국내에서 진행되는 연구의 전파 뿐 아니라 그동안 외국으로부터 도입해온 개입방법들을 한국 상황에 맞게 토착화하기 위하여 앞으로 더욱 활성화될 필요가 있을 것이다.