• 한국병원경영학회지
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• 제2권1호
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• pp.1-21
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• 1997

In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

• 대한지역사회영양학회지
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• 제28권1호
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• pp.38-47
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• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.153-174
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• 1995

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

• 한국관개배수논문집
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• 제19권1호
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• pp.50-63
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• 2012

Many reclaimed tideland projects in Korea have been conducted to secure the food self-sufficiency. In fact, the domestic food self-sufficiency has been greatly improved and reclaimed tideland projects contribute to Korea's economic and social development directly or indirectly replacing agricultural lands from urbanization, industrialization. As result, current self-sufficiency of rice reach the demand(104.6%) while rate of upland crops has less than 30% of self-sufficiency rate and corn, wheat, soybeans, etc. are virtually dependent on imports. Domestic price of crop is expected to be unstable by trend of international grain prices. Therefore, developing reclaimed tidelands as upland which is originally constructed for paddy fields could be a good option to become steady in domestic crop market and dedicate to ensure a stable food security. The study to prepare measures for dealing with disasters in reclaimed tidelands of west coast district is required in order to utilize those sites for infra construction of multi-utilization in those sites and The result of flooding analysis in this study can suggest policy direction for practical utilization of reclaimed tidelands in yellow sea area.

• 환경영향평가
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• 제22권3호
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• pp.265-276
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• 2013

This study assessed documentation status of each environmental assessment items by analyzing the 243 case of marine EIS on the Consultation System of Sea Area Utilization. Observed rate of tidal elevation, current, temperature, salinity in maine environment were below 20%. The EFDC tool is applied substantially in hydrodynamic modeling. The verification process, however, is very insufficient using the recent observed data. Also, in-situ assessment rate of pelagic organism such as phytoplankton was below 50%, and assessment for Chlorophyll a was not accomplished. Ecological index evaluation for zooplankton and benthic ecosystem were not considered in statements. Especially, the rational assessment on the fisheries resources and protected species were very limited. It was necessary that the core assessment items (checklists) were established for environmental scoping. Furthermore, suggestion of information related to development, regional coastal management plan, aquaculture farms, and facilities were enhanced. The redundancy problem of proceedings between Environmental Impact Assessment and Sea Area Utilization Assessment System was improved.

• 정보처리학회논문지C
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• 제13C권3호
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• pp.331-338
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• 2006

실시간 멀티미디어 응용의 서비스 품질을 지원하는 공평 패킷 스케줄러는 대부분 패킷의 예상되는 전송 종료시점을 그 패킷의 타임스탬프로 사용하는 종료시각 방식을 채택하고 있다. 이 방식은 예약속도로 레이턴시를 통제할 수 있는 장점을 가지나 속도-지연 결합 특성으로 인해 스케줄러 대역폭의 이용 효율이 저하되는 문제점이 있다. 본 연구에서는 지연 자원 개념을 도입하고, 속도-지연 결합 특성에 의해 손실되는 지연 자원을 속도 자원으로 변환하여 스케줄러 대역폭의 이용 효율을 높이는 스케줄링 방식을 제안한다. 성능 평가 결과 기존 방식보다 50% 이상 우수한 대역폭 이용도 특성을 보였다.

• 한국멀티미디어학회논문지
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• 제7권8호
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• pp.1078-1085
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• 2004

SARLM(Source Adaptive Receiver-Driven Multi-Layered Multicast)은 레이어 병합과 분할을 통해 수신자의 이질적인 대역폭 문제를 개선하고자 하였다. 그러나 이 기법은 레이어 병합 시에 상위 레이어의 수신자가 하위 레이어로 드롭되어 가용 대역폭의 이용률이 저하되는 문제가 있다. 본 논문에서는 수신자의 손실률 정도를 고려한 멀티캐스트 재그룹 기법을 제안한다. 제안 기법은 손실률에 따라 가중치를 부여하여, 상위 레이어와 하위 레이어 중 여유 대역폭이 많은 수신자를 그룹화하고, 하위 레이어와 상위 레이어 중 손실률이 높은 수신자를 그룹화한다. 실험 결과, 상위 레이어 수신자가 높은 전송률을 유지함으로써 수신자의 가용 대역폭 이용률이 향상됨을 알 수 있다.

• 한국통신학회논문지
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• 제31권4B호
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• pp.255-269
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• 2006

The differentiated services(DiffServ) architecture provides packet level service differentiation through the simple and predefined Per-Hop Behaviors(PHBs). The Assured Forwarding(AF) PHB proposed as the assured services uses the RED-in/out(RIO) approach to ensusre the expected capacity specified by the service profile. However, the AF PHB fails to give good QoS and fairness to the TCP flows. This is because OUT(out- of-profile) packet droppings at the RIO buffer are unfair and sporadic during only network congestion while the TCP's congestion control algorithm works with a different round trip time(RTT). In this paper, we propose an Adaptive Regulating Drop(ARD) marker, as a novel dropping strategy at the ingressive edge router, to improve TCP fairness in assured services without a decrease in the link utilization. To drop packets pertinently, the ARD marker adaptively changes a Temporary Permitted Rate(TPR) for aggregate TCP flows. To reduce the excessive use of greedy TCP flows by notifying droppings of their IN packets constantly to them without a decrease in the link utilization, according to the TPR, the ARD marker performs random early fair remarking and dropping of their excessive IN packets at the aggregate flow level. Thus, the throughput of a TCP flow no more depends on only the sporadic and unfair OUT packet droppings at the RIO buffer in the core router. Then, the ARD marker regulates the packet transmission rate of each TCP flow to the contract rate by increasing TCP fairness, without a decrease in the link utilization.

• 대한영양사협회학술지
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• 제10권2호
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• pp.246-257
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• 2004

To provide basic information for the proper usage of frozen convenience foods in elementary school foodservice operations, 51 dietitian employeed in school foodservices in Inchon were surveyed. Among the frozen convenience foods, dumpling-type foods(60.8%) and processed meats(40.4%)were used widely in school foodservice. Generally, the frequency of using frozen food items was fewer than 1 time per month. More than 15% of respondents were using pork cutlet, chicken, chickenball, dumpling stuffed with meat about 2-3 times per month. Sweet and sour pork(Tangsuyuk), kebap(Sanjuk), fish/shrimp cutlet, fried potato items were used only fewer than 1 time per month. Dietitian's age, carrier, employed status influenced the utilization rate. The grand mean of satisfaction score was 3.36 out of 5. The factors affecting satisfaction in using frozen foods were sanitation, taste, price, nutrition, food additives in order. The major reasons of utilizaing frozen convenience foods were 'improved labor productivity(4.47)' and 'meet customer preference(4.25)'. The limiting factors in using frozen foods were taste(35.3%), price(23.5%), nutrition(17.6%). The management practices of frozen convenience foods through food processing flow were assessed. Average performance rate was 64.7%. To enlarge the usage of frozen convenience foods in foodservice operations, dietitians should observe sanitary practices.

• 한국군사과학기술학회지
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• 제24권1호
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• pp.115-122
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• 2021

In this paper, we propose a dynamic slot allocation scheme to improve the slot utilization rate in tactical multi-hop networks in which the channel condition varies due to node movements. The proposed scheme takes advantage of the fact that nodes that are more than three hops apart can use the same slot simultaneously. The frame is divided into two parts: the control period and the data period. To know the available slot information within two-hop distance, the node exchanges a slot allocation information with one-hop neighbors during the control period. The node can get the information on idle slots that are not used within two-hop distance but assigned already to other nodes that are more than three-hop away. The identified idle slot can be used by the node, which increases the slot utilization rate. The performance analysis results of the proposed scheme show that it increases the slot utilization rate sufficiently despite the overhead of the control period in the multi-hop networks of the future soldier system.