• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• ETRI Journal
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• 제29권5호
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• pp.691-693
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• 2007

Existing methods to process continuous range queries are not scalable. In particular, as the number of continuous range queries on a large number of moving objects becomes larger, their performance degrades significantly. We propose a novel query indexing method called the projected attribute bit (PAB)-based query index. We project a two-dimensional continuous range query on each axis to get two one-dimensional bit lists. Since the queries are transformed to bit lists and query evaluation is performed by bit operations, the storage cost of indexing and query evaluation time are reduced significantly. Through various experiments, we show that our method outperforms the containment-encoded squares-based indexing method, which is one of the most recently proposed methods.

• 한국병원경영학회지
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• 제4권2호
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• pp.305-329
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• 1999

Financial ratio indicators of the 46 sample hospitals provided by the Korea Health Industry Development Institute, together with the survey data responded by the 57 sample hospitals, were analysed to identify the characteristics of the red-figured hospitals' financial structure, financial operational efficiency and management decision-making behavior, The financial characteristics identified through the analysis include high dependency to liabilities, high salary expenses and overhead costs, low profitability of the unduly large amount of fixed assets, and low managerial efficieny of inventory. The hospitals, in face of the IMF economic impasse, took the necessary decision-making and counter measures to cut down salary expenses, to increase the number of patient and medical revenue, and to reduce investment to fixed assets. Based on these findings this study suggested that the hospitals should take more active cost containment measures, financial structural reorganization, and developoment of the strategies that can contribute to increase of the number of patient and medical revenue and that do not. require much capital funds.

• 한국지하수토양환경학회:학술대회논문집
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• 한국지하수토양환경학회 2005년도 총회 및 춘계학술발표회
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• pp.202-210
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• 2005

In this study, the fly ash was employed as a possible alternative to the bentonite for its high sorption capacity against cationic heavy metal. To consider the constituents of barrier possibly used, the specimens were mixed with different material contents (fly ash : weathered soil : bentonite), then sorption test was performed. Also the specimens were molded on the wet side of optimum moisture contents like mixing ratio of sorption test and their hydraulic conductivities were measured in flexible-wall permeameters. And to confirm the effect of dissolved cations, the hydraulic conductivity tests were repeated by converting the permeant liquids from water to $Cd^{2+}$ solution. Finally, the Cd-concentration at the effluent was analyzed for 500hrs to compare the effectiveness of each specimen in contaminant retardation. Test results showed that the more the ratio of fly ash increase, the more Kd value increase, and the hydraulic conductivity of weathered soil/bentonite (95:5) mixture was the lowest $(2.9*10^{-8}cm/sec)$, and specimens made of fly ash and fly ash/weathered soil mixtures showed similar hydraulic conductivity. Although the permeant liquid was changed from water to $Cd^{2+}$ solution, the hydraulic conductivity of all specimens except for weathered soil maintained similarly like before. Consequently, the initial breakthrough point of Cd in weathered soil specimen was observed at about 5hrs after the test started while that of fly ash specimens was not observed during the whole test period of 500hrs. The results implied that fly ash had a sufficient retardation capacity against contaminant transport possibly by its high sorption capacity although it showed little effect on the reduction of hydraulic conductivity. Based on the test results, it could be concluded that the fly ash can be possibly used as a suitable barrier material in containment system to attenuate the contaminant transport for its high retardation capacity and for the low cost.

• 소음진동
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• 제9권4호
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• pp.720-729
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• 1999

Coventional methods for reducing vibration in engineering designs (i.e. by stifferning or detuning) may be undesirable in conditions where size or weight must be minimized, or where complex vibration spectra exist. Some alloys with a combination of high damping capacity and good mechanical properties can provide attractive techanical and economical solutions to problems involving seismic, shock and vibration isolation. Although several non ferrous damping alloys have been developed, none of those materials are applied in any industrial factor due largely to high production cost. To meet these requirement, we have developed a new Fe-Mn high damping alloy. In previous studies, we have reported that an Fe-17%Mn alloy exhibits the highest damping capacity(Specific Damping Capacity:SDC, 30%) among Fe-Mn binary system, and proposed that the boundaries of various types such as $\varepsilon$-martensite variant boundaries, stacking faults in $\varepsilon$-martensite, stacking faults in austenitic and ${\gamma}$$\gamma /\varepsilon$ interfaces give rise to a high damping capacity. The Fe-17%Mn alloy also has advantages of good mechanical properties(T.S. 70 kg/nm$^2$ and low cost over other damping alloys(1/4 times the cost of non-ferrous damping alloy). Thus, the Fe-17%Mn high damping alloy can be widely applied to household appliances, automobiles, industrial facilities and power plant components. In this paper, the overall properties of the Fe-17%Mn high damping alloy is introduced, and its applicability to containment spray pump in the power plant is discussed.

• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.107-116
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• 1994

The United States adopted DRG based prospective payment system (PPS) in order to control the inflation of health care costs. No study used statistical test while many studies reported the cost containing effect of the PPS. To study impacts of the PPS on the Medicare expenditure, this study set the following three hypotheses (1) The PPS decelerated the increase in the hospital expenditure (Part A), (2) the PPS accelerated the increase in the expenditure of outpatients and physicians (Part B), (3) the increase in total expenditure was decelerated inspite of the spill over (substitution) effect because saving in the Part A expenditure were greater than losses in the Part B expenditure. The dependent variables are per capita hospital expenditure, per capita Part B expenditure, and per capita total expenditure for the Medicare beneficiaries. An intervention analysis, which added intervention effect to the time series variation on the Box-Jenkins model, was used. The observations included 120 months from 1978 to 1987. The results are as follows : (1) The annual increase in the per capita Part A expenditure was $5.11 after the implementation of DRG where as that before the PPS had been $11.1. The effect of the reduction ($5.99) was statistically significient (t=-3.9). (2) The spill over (substitution) effect existed because the annual increase in the per capita Part B expenditure was accelerated by $1.73 (t=1.91) after the implementation of the PPS. (3) The increase in the total Medicare expenditure per capita was reduced by $4.26 (t=-2.19) because the spill over effect was less than cost savings in the Part A expenditure.

• Nuclear Engineering and Technology
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• 제49권7호
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• pp.1431-1441
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• 2017

The Fukushima accident reveals the vulnerability of existing active nuclear power plant (NPP) design against prolonged loss of external electricity events. The passive safety system is considered an attractive alternative to cope with this kind of disaster. Also, the passive safety system enhances both the safety and the economics of NPPs. The adoption of a passive safety system reduces the number of active components and can minimize the construction cost of NPPs. In this paper, reflecting on the experience during the development of the APR+ design in Korea, we propose the concept of an innovative Power Reactor (iPower), which is a kind of passive NPP, to enhance safety in a revolutionary manner. The ultimate goal of iPower is to confirm the feasibility of practically eliminating radioactive material release to the environment in all accident conditions. The representative safety grade passive system includes a passive emergency core cooling system, a passive containment cooling system, and a passive auxiliary feedwater system. Preliminary analysis results show that these concepts are feasible with respect to preventing and/or mitigating the consequences of design base accidents and severe accidents.

• Geomechanics and Engineering
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• 제9권4호
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• pp.483-498
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• 2015

This article describes a new in-situ load test called the Hydraulic Cylinder Test (HCT) and its application to determine the geotechnical properties of soil-rock mixtures. The main advantages of the test are its easy implementation, speed of execution and low-cost. This article provides a detailed description of the equipment and the test procedure, and examines a case study of its application to determine the geotechnical properties of an earth-filled dam for a tailings pond. The containment dams of the ponds are made from blocks of gypsum and marl, obtained from the excavation of the ponds, mixed in a matrix of sands and clays. The size of the rocks varies between 1 and 30 cm. The HCT is particularly useful for determining the geotechnical properties of this type of soil-rock mixture. Nine HCTs were carried out to determine its strength (c, ${\phi}$) and deformation (B, G) properties. The results obtained were validated using the Bim strength criterion, recently proposed, and some pressure meter tests carried out beforehand. The properties obtained are used to analyze the stability of the dam using computer simulations and a modification to its design is proposed.

• 한국병원경영학회지
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• 제9권1호
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• pp.1-21
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• 2004

The United States has a unique health care system, which is unlikely any other health care systems in the world. The major part of basic functional components of the system -financing, insurance, delivery, and payment- is in private hands. A market-oriented economy invites the participation of numerous private entities that are interested in carrying out the key functions of health systems. Due to this central feature, U.S.health care is not delivered through a network of interrelated components designed to work together coherently. For lack of standardization, the various components of the system fit together only loosely. The involvement of numerous players in the key functions leads to duplication, overlap, inadequacy, inconsistency, and waste, which add to the complexity and also make the system inefficient. Hence, cost containment remains an elusive goals. Moreover, the system falls short of delivering equitable services to all americans, though consumption of health care services is the largest in the world. On the other hand, United States leads the world in the latest and the best in medical technology, medical training, and research. It offers some of the most sophisticated institutions, products, and processes of health care delivery. This article discuss the characteristic features of the U.S. health care system. and its performance, trying to seek its implication on Korean health care system.

• 한국원자력학회:학술대회논문집
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• 한국원자력학회 1997년도 춘계학술발표회논문집(1)
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• pp.199-206
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• 1997

For the Korean Next Generation Reactor(KNGR) development, LBB is considered for the Main Steam Line(MSL) piping inside its containment to achieve cost and safety Improvement. To apply LBB concept to MSL, leak sensors highly sensitive to humidity is required. In this paper, a ceramic material, MgCr$_2$O$_4$-TiO$_2$ has been developed as a humidity sensor for MSL applications. Experiments peformed to characterize the electrical conductivity shows that the conductivity of MgCr$_2$O$_4$-TiO$_2$ responds sensitively to both temperature and humidity changes. At a constant temperature below 10$0^{\circ}C$, the conductivity increases as the relative humidity increases, which makes the sensor favorable for application to the outside of MSL insulation layer But as temperature increases beyond 10$0^{\circ}C$, the sensor composition should be adjusted for the application to KNGR is to be made at temperature above 10$0^{\circ}C$.