• 보건행정학회지
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• 제29권2호
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• pp.130-137
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• 2019

The fee-for-service system is used as the main payment system for health care providers in Korea. It has been argued that it can't reflect differences in the medical practice costs across regions because the fee schedule is calculated based on the average cost. So, some researchers and providers have disputed that there is need for adopting geographic practice cost index (GPCI) used in the United States for the Medicare program for the elderly to the fee-for-service payment system. This study performed to identify whether the difference in the practice costs among regions exists or not and to examine the feasibility of applying GPCI to Korea payment system. For this purpose, we calculated modified-GPCI and examined considerations to introduce GPCI in Korea. First we identified available data to calculate GPCI. Second, we made applicable GPCI equations to Korea payment system and computed it based on four types of regions (metropolitan, urban, suburban, and rural). We also categorize the regions based on the availability of the medical resources and the capability of utilizing them. As a result, we found that there wasn't any significant difference in the GPCI by regional types in general, but the indices of rural areas (0.91-0.98) was relatively low compared to the indices of other regions (0.96-1.07). Considering the need to use GPCI floor, the pros and cons of using GPCI, and the concern of the regional imbalance of resources, the introduction of GPCI needs to be carefully considered.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권11호
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• pp.3182-3203
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• 2023

With the growing adoption of cloud-based technologies, maintaining the privacy and security of cloud data has become a pressing issue. Privacy-preserving encryption schemes are a promising approach for achieving cloud data security, but they require careful design and implementation to be effective. The integrated approach to cloud data security that we suggest in this work uses CogniGate: the orchestrated permissions protocol, index trees, blockchain key management, and unique Opacus encryption. Opacus encryption is a novel homomorphic encryption scheme that enables computation on encrypted data, making it a powerful tool for cloud data security. CogniGate Protocol enables more flexibility and control over access to cloud data by allowing for fine-grained limitations on access depending on user parameters. Index trees provide an efficient data structure for storing and retrieving encrypted data, while blockchain key management ensures the secure and decentralized storage of encryption keys. Performance evaluation focuses on key aspects, including computation cost for the data owner, computation cost for data sharers, the average time cost of index construction, query consumption for data providers, and time cost in key generation. The results highlight that the integrated approach safeguards cloud data while preserving privacy, maintaining usability, and demonstrating high performance. In addition, we explore the role of differential privacy in our integrated approach, showing how it can be used to further enhance privacy protection without compromising performance. We also discuss the key management challenges associated with our approach and propose a novel blockchain-based key management system that leverages smart contracts and consensus mechanisms to ensure the secure and decentralized storage of encryption keys.

• 품질경영학회지
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• 제24권4호
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• pp.90-102
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• 1996

Process incapability index which is intended to evaluate the process capability by measuring process incapability provides more detailed information by dividing information about the process mean and variance. But when the target value is not consistent with the center of specification, it is very difficult to evaluate the process capability accurately. Thus it is necessary to improve the existing process incapability index. The improved process incapability index can identify the variation of the process faster than other process capability indices when applied firstly, to the precision process which can be affected sensitively by the change of the process, secondly, to the ordinary process where cost difference from the change of process is noticeable. By using subindices such as inaccuracy index and imprecision index, it is easier for quality manager to find where the cause of the variation of process is, and to take necessary action in advance.

• 한국재난정보학회 논문집
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• 제9권1호
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• pp.11-21
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• 2013

본 연구는 2004년 이후 도입된 실적 공사비 제도에 의하여 착공된 지하철 건설공사를 대상으로 실적공사비, 공사규모 그리고 시간을 고려하여 공사비를 예측하는 식을 제시하였다. 11개의 지하철공사 자료를 이용하여 지하철 공사비 예측을 위한 비용-규모 지수 n(신뢰범위:0.5~0.7)을 구한 결과, 총공사비 0.713, 순공사비 0.77로 도출되었다. 본 연구에서 제시한 공사비 예측 식 모델은 향후 지하철 공사 적용 현장의 사업기획, 예비조사, 타당성조사, 기본설계 단계에서 개산 공사비를 추정하는데 효과적으로 적용할 수 있을 것이다.

• 한국태양에너지학회 논문집
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• 제24권4호
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• pp.55-63
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• 2004

The purpose of this study is to development of life cycle cost analysis methodology of HVAC system for decision maker. The results of this study are as follows; maintenance/management, equipment construction, planning/design, and demolition/sell phases (1) To develop the cost breakdown structure for LCC in HVAC system, this study apply the method of additional pertinent level, title, CBS number, block number and variable index. (2) LCC analysis order of HVAC system compose four phase. (3) Life cycle costing influence diagram can bring us to make the most efficient decision through a visual graphical diagram that is shown relationship among variables and that decision maker traces easily from life cycle cost analysis situation.

• 전기학회논문지
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• 제59권10호
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• pp.1703-1711
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• 2010

Electric power utilities are facing increasing uncertainties regarding the economic, political, societal, environmental constraints under they operate and plan their future systems. The utilities have to integrate consumers' interruption cost representing reliability worth of electricity into the process of determining the optimum investment level. In order to do so, the estimated outage cost must be included into quantitative index corresponding to system capital and operation investment cost to establish an optimal expansion plan. This paper is a study on the outage cost assessment by using macro approach for calculating IEAR(Interrupted Energy Assessment Rates) and the TRELSS(Transmission Reliability Evaluation for Large-Scale Systems) program was used to calculate EENS(Expected Energy Not Served).

• Journal of Gastric Cancer
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• 제15권2호
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• pp.87-104
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• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

• 보건행정학회지
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• 제32권2호
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• 한방안이비인후피부과학회지
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• 제23권3호
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• pp.122-137
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• 2010

Objective : Atopic dermatitis (AD) in children may profoundly affect the quality of life (QOL), and also cause financial burden, to the families of those suffering from this ailment. The aim of our study was to examine the quality of life and the financial burden of atopic dermatitis in children and their families to evaluate this relationship with the degree of AD. Methods : 37 infant and child atopic dermatitis patients were included and evaluated using the SCORing of Atopic Dermatitis (SCORAD) Index and Eczema Area and Severity Index (EASI). Patients and carers were asked to fill in the questionnaires about their quality of life and financial costs during the past year. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation was used for statistical analysis. Results : 1. The mean score of Children's Dermatology Life Quality Index (CDLQI) was $10.52{\pm}4.82$, Infants' Dermatologic Quality of Life (IDQOL) was $8.21{\pm}3.95$. 2. The mean score of Family Dermatology Life Quality Index (FDLQI) was $13.30{\pm}5.72$, Dermatitis Family Impact (DFI) was $12.5{\pm}4.98$. 3. By analyzing the questionnaire, the monthly average cost was determined to be 730,800 won for each patient : the direct cost was 283,500 won, and the indirect cost was 447,300 won. 4. By analyzing the correlation between the severity of AD and QOL, subjective SCORAD were significantly and positively correlated with QOL(IDQOL, FDLQI, DFI, CDLQI). 5. By analyzing the correlation between the severity of AD and any economic impact, EASI were significantly and positively correlated with the direct cost. Conclusion : The above results show that the QOL of the patients and carers is significantly related to their disease severity. Atopic dermatitis patients pay an average of 730,800 won a month, and the economic impact on the patients is significantly related to their disease severity. The CDLQI, IDQOL, FDLQI and DFImay potentially be of value to help in the appropriate management of AD and can be used as an added measurement in clinical trials involving AD management.

• 정보처리학회논문지D
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• 제19D권1호
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• pp.1-14
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• 2012

데이터 웨어하우스는 크기가 방대하기 때문에 인덱스의 선택은 질의어 처리의 효율성에 상대한 영향을 준다. 인덱스는 질의 처리 비용을 줄이지만, 그것이 차지하는 기억 영역과 데이터베이스의 변경에 따른 보수라는 비용이 수반된다. 데이터 웨어하우스에서 하나의 사실 테이블과 여러 개의 차원 테이블 사이의 조인을 행하는 스타 조인 질의어와 차원 테이블의 선택을 최적화하기 위해서 비트맵 조인 인덱스가 잘 적용된다. 비트맵 조인 인덱스는 이진수로 표현되기 때문에 저장 비용은 적게 들지만 인덱스 할 후보 속성들이 많이 생성되기 때문에 그 중에서 인덱스 할 속성들을 선택하는 일은 어려운 과제가 된다. 인덱스 선택은 일단 후보 속성들의 개수를 축소하고, 그 중에서 인덱스를 선택하게 된다. 본 논문에서는 데이터 마이닝 방법을 사용해서 비트 맵 조인 인덱스 선택 문제에서 후보 속성들의 개수를 축소하는 것을 해결한다. 질의어에 있는 속성들의 빈도에 기준해서 후보 속성들의 개수를 감소시키는 기존의 방법에 비해서 본 논문은 속성들의 빈도를 사용함과 동시에 차원 테이블의 크기, 차원 테이블의 튜플 크기, 디스크의 페이지 크기 등을 고려한다. 그리고 데이터마이닝 기법으로 빈발 항목집합을 마이닝하여 후보 속성들의 개수를 효과적으로 줄인다. 후보 속성집합들의 비트 맵 조인 인덱스에 비용함수를 적용해서 최소의 비용과 기억 영역 제한에 적합한 속성집합들의 비트 맵 조인 인덱스를 구한다. 본 논문의 방법의 효율성을 평가하기 위해서 기존의 방법들과 비교 분석을 한다.