• 제목/요약/키워드: performance improvement

검색결과 12,182건 처리시간 0.048초

자연공원 지속가능성평가에 기반한 군립공원 지속가능성 영향요인 분석 - 경남권역 11개소 군립공원을 대상으로 - (Analysis of Sustainable Management Factors in County Parks Based on the Sustainability Evaluation Framework of Korea Nature Parks - Focus on the 11 County Parks in Gyeongsangnam-do -)

  • 홍석환;안로사;톈완팅;허학영;박준효
    • 한국조경학회지
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    • 제48권3호
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    • pp.12-21
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    • 2020
  • 본 연구는 경상남도에 소재한 군립공원을 대상으로 자연공원 지속가능성평가를 통해 관리효과성평가(MEE)를 실시하여 이를 바탕으로 군립공원의 지속가능한 관리를 도모하기 위한 영향요인을 도출하고자 하였다. 자연공원 지속가능성평가 진단표는 2016년 환경부에서 개발한 보호지역 관리효과성평가를 준용하여 소규모 자연공원에 응답할 수 있도록 보완한 평가표이며, 이를 바탕으로 공원이해관계자가 자가진단을 통해 자연공원의 전반적인 관리를 평가하도록 하였으며, 현장조사 및 인터뷰를 통해 이를 보완하였다. 경남권역 군립공원의 11개소 MEE결과를 살펴보면, 과반수의 군립공원에서 '자연생태적 가치(6개소)'를 주요 가치로 인식하고, '역사문화적 가치(4개소)', '여가휴양적 가치(1개소)'순으로 나타났다. 자연공원 관리의 위협요인으로는 '자연재해 및 환경요인(5개소)', '인위적 요인(3개소)'로 나타났으며, 군립공원 3개소에서는 관리를 저해하는 위협요인이 없다고 인지하고 있었다. 관리효과성평가 점수가 양호한 분야는 휴양가치상태, 역사 및 문화자원의 가치상태, 주요 자연자원 등이며, 미흡한 분야는 조사 및 연구프로그램, 멸종위기종 관리, 생태계 교란 동·식물 관리, 관리활동 모니터링 및 평가 수행이 지적되었다. 지속가능하게 관리에 영향을 미치는 지표를 도출하기 위해 관리효과성평가점수와 관리요인 간 회귀분석결과, 연간공원관리투입예산이 관리효과성평가점수와 통계적으로 유의미하였다. 이는 연간 자연공원관리예산의 적정한 집행이 현 시점에서 군립공원 관리에 가장 필요한 요소임을 의미한다. 향후 군립공원 관리계획 이행 시, 평가결과에서 도출된 미흡한 요인의 보완을 위한 예산확보가 시급한 것으로 판단되었다. 관리투입예산을 고려한다면 군립공원 관리의 효과를 높일 수 있을 것으로 기대된다.

개량형 단상 혐기성 소화공정에서의 혼합슬러지를 이용한 바이오가스 생산효율 증대방안 연구 (A Study on Increasing the Efficiency of Biogas Production using Mixed Sludge in an Improved Single-Phase Anaerobic Digestion Process)

  • 정종철;정진도;김산
    • 한국산학기술학회논문지
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    • 제17권6호
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    • pp.588-597
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    • 2016
  • 본 연구는 유기성폐기물의 혼합슬러지를 개량형 단상 혐기성 소화공정에서 각각의 혼합비율에 따른 바이오가스 생산효율 향상에 관한 연구로, 연구에 사용된 유기성폐기물의 종류는 하수 생슬러지, 음폐수 및 가축분뇨이다. BMP test를 통해 잠재적 메탄발생량을 확인한 결과 단일시료의 경우 가축분뇨가 $1.55m^3CN4/kgVS$로 가장 높게 평가되었고, 혼합시료(생슬러지, 음폐수, 가축분뇨)의 경우는 각각의 비율을 50% : 30% : 20%로 하였을 때 $0.43m^3CN4/kgVS$로 가장 높게 나타났다. 반면 실증플랜트에서 혼합슬러지 최적 혼합비율은 생슬러지(68.5) : 음폐수(18.0) : 가축분뇨(13.5)로 나타나 BMP test와 다소 상이한 결과를 보였다. 이는 혼합슬러지 성상변화와 체류시간 등 소화조 운전조건 변화에 기인한 결과로 판단되며, 단상 혐기성 소화조의 바이오가스 생산량이 $2,514m^3/d$, 메탄함량 62.8%로 조사되어 설계능력인 바이오가스 생산량 $2,319m^3/d$ 기준으로 볼 때 최대성능을 발휘하는 것으로 평가되었다. 아울러 본 연구를 통해 혐기성 소화방식에 있어 소화조의 안정적인 운영과 소화효율 측면에서 고효율 방식인 2상 소화방식을 도입하는 것이 유리하나 기존의 단상 소화방식에 있어서도 소화효율 개선 및 성능향상이 가능하다는 것을 알 수 있었다.

순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로) (A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area-)

  • 박항배;최동욱
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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가축의 개량 및 번식효율 증진에 관한 연구 I. 토끼에 있어서 체외수정능획득 정자에 의한 체외수정 및 수정란 번식에 관한 연구 (Studies on the Improvement of Performance and Reproductive Efficiency in Farm Animals I. In vitro fertilization by in vitro capacitated sperm and transfer of in vitro fertilized embryos in rabbits)

  • 정영채;김창근;주일영;정길생;이규승
    • 한국가축번식학회지
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    • 제10권2호
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    • pp.192-203
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    • 1986
  • Two experiments in this study were designed to compare the potential for in vitro capacitation and in vitro fertilization of ejaculated sperm among individual rabbit bucks. In experiment 1, for in vitro capacitation, the ejaculated sperm were preincubated in DM for 12 hr or 18 hr after HIS treatment, then 12 hr -or 18 hr- preincubated sperm were incubated with superovulated rabbit ova in a 5% CO2 incubator for 36 hr at 38$^{\circ}C$, and a part of cleaved ova was transferred to the recipient does for implantation of embryo. In experiment 2, effect of lysolecithin addition to preincubation medium on induction of accelerated in vitro capacitation and in vitro fertilization of individual rabbit sperm was studied. Experiment 1; 1. Percent acrosome reaction of sperm, noted after staining, after 12 hr or 18 hr preincubation ranged from 52.5 to 76.0% and from 67.5 to 90.0%, respectively and sperm motility index of these sperm ranged from 20.0 to 47.5 for 12 hr-preincubated sperm and from 15.0 to 37.5 for 18 hr- preincubated sperm. There was no a certain relation between percent acrosome reaction and sperm motility index. 2. In vitro fertilization rate (cleavage rate) of in vitro capacitated sperm varied widely among individual bucks, ranging from 0 to 47.8% for 12 hr - preincubated sperm and from 0 to 60.9% for 18 hr -prein- cubated sperm. Cleavage rate of 18 hr - preincubated sperm was higher and faster than that of 12 hr - preincubated sperm. 3. Eight of 44 in vitro fertilized embryos transferred into 6 recipients were implanted in 4 recipients (66.7%) up to day 15 and implnatation rate was 18.2%. Experiment 2; 1. The percent acrosome reaction of sperm before and after 4 hr preincubation in DM without lysolecithin varied significantly among individual bucks, ranging from 0.4 to 18.4% and from 1.7 to 37.4%, respectively and percent acrosome reaction of sperm at 30 min after addition of 60${\mu}$g/ml lysolecithin also was significantly different among bucks, ranging from 19.2 to 67.1%. 2. Effect of accelerated acrosome reaction following lysolecithin addition was more considerable in the individuals showed less percent acrosome reaction before and after 4 hr preincubation. Percentage of motile sperm and motility score showed a trendency towards a decrease with increase of preincubation time and time after lysolecithin addition. 3. In vitro fertilization rate (cleavage rate) at 24 hr postinesmination with pooled sperm were treated to 60 $\mu\textrm{g}$/ml lysolecithin for 30 min after 4 hr preincubation was 24.6%, a higher rate than 13.2% for control. While 80 $\mu\textrm{g}$/ml lysolecithin-added sperm showed a lower cleavage than control and 60$\mu\textrm{g}$/ml-added sperm at both 24 hr and 48 hr postinsemination. These results from 2 experiments suggest that more useful preincubation time for the in vitro capacitation of ejaculated rabbit sperm is 18 hr in DM after HIS treatment, although there is wide variation in vitro capacitation and in vitro fertilization rate among individual bucks, and lysolecithin addition to at least 4 hr - preincubated sperm in DM can result in almost same in vitro fertilization rate as that of 18 hr - preincubated sperm in the experiment 1.

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병원 행정인력이 인지하는 조지.직무특성, 임파워먼트, 직무만족 및 조직몰입간의 관련성 (The Relationship of Organizational and Job Characteristics, Empowerment, Job Satisfaction and Organizational Commitment Perceived by Hospital Administrative Staffs)

  • 박재산
    • 보건행정학회지
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    • 제14권1호
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    • pp.65-88
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    • 2004
  • In general, empowerment is defined as the motivational concept of autonomy and self-efficacy. Recently, the concept of empowerment is applied to improve organizational staff's job satisfaction and organizational commitment in many organizations. Empower-ment in service organizations, i.e., hospitals, has certainly generated more publicity than any other organizations. The objectives of this study are, first, to measure the degree of hospital employees' empowerment using Spreitzer(1995)'s empowerment theory, second, to analyze the causal relationship of organizational and job characteristics, a degree of empowerment, and organizational performance(job satisfaction and organizational commitment), and third, to offer the strategy for the improvement of job satisfaction and organizational commitment. Spreitzer insists that the empowerment is composed of 4 dimensions(meaning, competence, self-determination, and impact). And he argues that various work-related characteristics is a direct cause of empowerment and the indirect cause of job satisfaction and organizational commitment, mediated by the empowerment latent variable. In order to perform this study, data were collected by self-administered questionnaires from hospital employees working in administrative department of 3 university hospitals in Inchon and Kyunggi-Do region. The number of cases is 181(response rate; 86%). The Collected data were analyzed with SPSS Ver. 10.0 and AMOSV Ver. 4.0. First, to test validity of variables, the factor analysis was used. Second, to test reliability, Cronbach's alpha coefficients was calculated. Cronbach's alpha of empowerment variable is 0.8323 showing that there's no problem in regard to the internal consistency. Also the Cronbach's alpha of other variables are 0.8301 of the degree of perceived control, 0.6705 of job characteristics, O.8787 of compensation, 0.9254 of job satisfaction, and 0.8389 of organizational commitment, respectively. Among the questions of job characteristics, two survey questions are deleted due to lowering the reliability. Third, to test multicollinearity and correlation of variables, the correlation analysis was performed. There was no problem of multicollinearity. Finally structural equation modelling (SEM) analysis was conducted to find the causal relationship of organizational and job Characteristics, empowerment, job satisfaction and organizational commitment. The 16 variables are included for the SEM analysis. The major results of this study are as follows: First, in the case of model fitness, the condition of x$^2$ statistic(92.187) is not fully satisfied, but the indices of GFI(0.912), AGFI(0.863), NFI(0.917) and CFI(0.928) are partially satisfied, which needs to upper 0.90. Second, in the result of hypotheses testing, all hypotheses are accepted and have a positive effect in 95% or 99% confidence interval(P<0.05 or P<0.001) except the effect of compensation variable on empowerment(P=0.082). Third, in regard to the direct, indirect, and total effect of variables, the direct effect of perceived control, task characteristics, and compensation on job satisfaction are 0.728, 2.264, 0.328 and on organizational commitment are 0.094, 1.411, 0.418, respectively. Also the indirect effect of perceived control, task characteristics, and compensation on job satisfaction are 0.311, 0.196, 0.028 and on organizational commitment are 0.210, 0.132, 0.019, respectively. Thus, these findings imply that various work-related factors are direct effect of empowerment and indirect effect of result variables, job satisfaction and organizational commitment. Also These results showed that the workplace empowerment is significant mediating factor of employee's job satisfaction and organizational commitment.

협력적 멘토링을 통한 초임 중등과학교사의 교수실행에서 나타나는 반성적 실천의 변화 (The Change in Beginning Science Teachers' Reflective Practice in their Teaching Performance through Collaborative Mentoring)

  • 고문숙;남정희
    • 한국과학교육학회지
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    • 제33권1호
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    • pp.94-113
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    • 2013
  • 이 연구는 초임 중등과학교사를 대상으로 교수에 대한 반성적 사고와 반성적 실천을 유도하는 협력적 멘토링 과정에서 멘토링 전후의 교수행위의 특징과 실제수업에서의 변화를 통해 교수실행의 반성적 실천이 어떻게 발전되어 가는지를 알아보는 것을 목적으로 하였다. 연구 참여자는 대학교수 1명, 박사 석사과정에 있는 연구자 2명, 3명의 멘토교사와 3명의 멘티교사 등 총 9명이 참여하였다. 멘토링 과정에서 멘티수업 녹화본 및 전사본, 학습지도안, 일대일 멘토링 녹음 및 전사본, 멘토 저널과 멘티 저널, RTOP 교수 관찰지 등의 자료를 수집하였다. 수업의 분석은 RTOP을 이용하였으며, 멘티교사의 수업에 있어서의 인식과 변화는 자신의 교수행위에 대한 반성(reflection)과 반성적 실천(reflective practice)으로 범주화하여 수업실행 전후의 멘티저널, 멘토링 협의회 녹음전사본, 멘토링 후 멘티 저널을 바탕으로 분석하였다. 초임 과학교사 3명의 멘토링 이전 수업의 특징은 교과내용지식과 관련된 측면은 어느 정도 구성되어 있으나, 학생들에게 다양한 탐구활동의 기회를 제공해주는 탐구적 교수법과 학생들의 능동적 지식 구성을 강화하는 수업방법에 있어서는 매우 취약함을 보여주었다. 멘토링이 진행됨에 따라 3명의 멘티교사의 차시별 수업을 분석한 결과, 멘티교사별로 상승곡선의 경향이 다소 다르게 나타나기는 하나, RTOP의 평균 점수는 점진적으로 높아진 것으로 나타났다. 협력적 멘토링이 진행되는 과정에서 멘티교사의 교수실행의 변화로 나타난 반성적 실천에서는, 멘토링 과정에서 3명의 멘티교사 모두 수업에 대한 반성이 일어나며 점진적으로 반성 수준이 높아지는 것으로 나타났다. 협력적 멘토링을 통해 멘티교사에게 수업반성의 기회를 제공하고 피드백하는 과정에서 멘티교사의 반성적 성향이 강하게 나타났으며, 이와 함께 반성적 실천에 의한 실제수업에서의 변화로 이어졌다. 이는 수업반성을 통해 교수기술의 향상을 가져옴을 알 수 있다.

Genetic Parameters of Pre-adjusted Body Weight Growth and Ultrasound Measures of Body Tissue Development in Three Seedstock Pig Breed Populations in Korea

  • Choy, Yun Ho;Mahboob, Alam;Cho, Chung Il;Choi, Jae Gwan;Choi, Im Soo;Choi, Tae Jeong;Cho, Kwang Hyun;Park, Byoung Ho
    • Asian-Australasian Journal of Animal Sciences
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    • 제28권12호
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    • pp.1696-1702
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    • 2015
  • The objective of this study was to compare the effects of body weight growth adjustment methods on genetic parameters of body growth and tissue among three pig breeds. Data collected on 101,820 Landrace, 281,411 Yorkshire, and 78,068 Duroc pigs, born in Korean swine breeder farms since 2000, were analyzed. Records included body weights on test day and amplitude (A)-mode ultrasound carcass measures of backfat thickness (BF), eye muscle area (EMA), and retail cut percentage (RCP). Days to 90 kg body weight (DAYS90), through an adjustment of the age based on the body weight at the test day, were obtained. Ultrasound measures were also pre-adjusted (ABF, EMA, AEMA, ARCP) based on their test day measures. The (co)variance components were obtained with 3 multi-trait animal models using the REMLF90 software package. Model I included DAYS90 and ultrasound traits, whereas model II and III accounted DAYS90 and pre-adjusted ultrasound traits. Fixed factors were sex (sex) and contemporary groups (herd-year-month of birth) for all traits among the models. Additionally, model I and II considered a linear covariate of final weight on the ultrasound measure traits. Heritability ($h^2$) estimates for DAYS90, BF, EMA, and RCP ranged from 0.36 to 0.42, 0.34 to 0.43, 0.20 to 0.22, and 0.39 to 0.45, respectively, among the models. The $h^2$ estimates of DAYS90 from model II and III were also somewhat similar. The $h^2$ for ABF, AEMA, and ARCP were 0.35 to 0.44, 0.20 to 0.25, and 0.41 to 0.46, respectively. Our heritability estimates varied mostly among the breeds. The genetic correlations ($r_G$) were moderately negative between DAYS90 and BF (-0.29 to -0.38), and between DAYS90 and EMA (-0.16 to -0.26). BF had strong $r_G$ with RCP (-0.87 to -0.93). Moderately positive $r_G$ existed between DAYS90 and RCP (0.20 to 0.28) and between EMA and RCP (0.35 to 0.44) among the breeds. For DAYS90, model II and III, its correlations with ABF, AEMA, and ARCP were mostly low or negligible except the $r_G$ between DAYS90 and AEMA from model III (0.27 to 0.30). The $r_G$ between AEMA and ABF and between AEMA and ARCP were moderate but with negative and positive signs, respectively; also reflected influence of pre-adjustments. However, the $r_G$ between BF and RCP remained non-influential to trait pre-adjustments or covariable fits. Therefore, we conclude that ultrasound measures taken at a body weight of about 90 kg as the test final should be adjusted for body weight growth. Our adjustment formulas, particularly those for BF and EMA, should be revised further to accommodate the added variation due to different performance testing endpoints with regard to differential growth in body composition.

국소진행 두경부 상피세포암에서 선행유도약물요법 후 보조약물요법의 효과 (The Effect of Adjuvant Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma after Induction Chemotherapy)

  • 김철우;노재경;안중배;박준오;정소영;이석;이혜란;이경희;정현철;김주항;김병수;서창옥;김귀언
    • 대한두경부종양학회지
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    • 제10권1호
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    • pp.13-24
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    • 1994
  • Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

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국민건강보험 발전방향 (Future Direction of National Health Insurance)

  • 박은철
    • 보건행정학회지
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    • 제27권4호
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

정신모형과 감성 요소를 이용한 소프트웨어 사용성 평가 모델 개발 (An Evaluation Model for Software Usability using Mental Model and Emotional factors)

  • 김한샘;김효영;한혁수
    • 한국정보과학회논문지:소프트웨어및응용
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    • 제30권1_2호
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    • pp.117-128
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    • 2003
  • 소프트웨어의 사용성은 소프트웨어 제품 평가시, 사용하기 쉬운 정도, 효율성의 정도, 만족도의 정도 등으로 판단되는 소프트웨어의 특성이다. 이러한 사용성은 소프트웨어 제품의 품질을 결정하는 중요한 요소이다. 따라서 소프트웨어 제품들은 그 자체의 사용성에 대해 평가를 받고 개선지침을 추출하여 이를 기반으로 지속적인 개선이 이루어져야 한다. 그러나 제품마다 사용성 요소들의 중요도가 다르고, 같은 요소에 대해서도 사용자들은 서로 다른 환경과 지식으로 인해 엇갈린 평가를 내릴 수 있으므로 사용성 평가는 제품의 적합성을 판단하고 개선방향을 얻기 위해 다양한 요소들을 고려하여 개발되는 것이 중요하다. 그러나 기존의 만족도 평가와 수행도 평가는 문제점의 원인 발견 평가결과를 수정에 반영하기 힘들고, 모든 영역에 적용되도록 만들어진, 획일화된 평가항목과 내용으로는 평가 대상 제품의 특징을 반영하기가 어려웠다. 따라서 본 논문에서는 대상 제품의 평가 항목별로 사용자의 정신모형과 감성을 평가하는 모델을 개발하였다. 설계자들의 개념 모형과 사용자의 정신 모형의 일치여부를 평가하여 그 결과를 바탕으로 개선 지침을 제공할 수 있는 평가방법과 시스템에 대한 만족도를 높이고 보다 효과적으로 작업할 수 있도록 하기 위해 사용시의 감성과 이에 영향을 미치는 시스템의 구성요소들을 분석하여 평가하고 개선 지침을 추출하는 감성요소론 기반으로 하는 평가방법을 합하여 개발한 평가 모델을 제안한다. 그리고 이 평가 모델에 대한 사례연구로 GUI 프레임워크를 사례로 채택해서 평가하고 개선 방향을 추출하였다. 본 논문에서 제안한 평가 모델은 제품 사용자의 작업분석을 기반으로 추출된 작업항목에 대한 평가요소를 가지고 평가를 수행함으로서, 제품의 특성을 반영할 뿐만 아니라, 수정되어야 할 항목을 정확히 나타내 줌으로서 효과적인 사용성 평가를 가능하게 할 것이다.