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A Study on the Health Insurance Management System; With Emphasis on the Management Operating Cost (의료보험 관리체계에 대한 연구 - 관리비용을 중심으로 -)

  • 남광성
    • Korean Journal of Health Education and Promotion
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    • v.6 no.2
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    • pp.23-39
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    • 1989
  • There have been a lot of considerable. discussion and debate surrounding the management model in the health insurance management system and opinions regarding the management operating cost. It is a well known fact that there have always been dissenting opinions and debates surrounding the issue. The management operating cost varies according to the scale of the management organization and component members characteristics of the insurance carrier. Therefore, it is necessary to examine and compare the management operating cost to the simulated management models developed to cover those eligible for the health insurance scheme in this country. Since the management operating cost can vary according to the different models of management, four alternative management models have been established based on the critical evaluation of existing theories concerned, as well as on the basis of the survey results and simulation attempts. The first alternative model is the Unique Insurance Carrier Model(Ⅰ) ; desigened to cover all of the people with no classification of insurance qualifications and finances from the source of contribution of the insured, nationwide. The second is the Management Model of Large-scale District Insurance Carrier(Ⅱ) ; this means the Korean society would be divided into 21 large districts; each having its own insurance carrier that would cover the people in that particular district with no classification of insurance qualifications arid finances as in Model I. The third is the Management Model of Insurance Carrier Divided by Area and Classified with Occupation if Largescale (Ⅲ) ; to serve the self-employed in the 21 districts divided as in Model Ⅱ. It would serve the employees and their dependents by separate insurance carriers in large-scale similar to the area of the district-scale for the self-employed, so that the insurance qualifications and finances would be classified with each of the insurance carriers: The last is the Management Model of the Multi - insurance Carrier (Ⅳ) based on the Si. Gun. Gu area which will cover their own self- employed people in the area with more than 150 additional insurance carriers covering the employees and their dependents. The manpower necessary to provide services to all of the people according to the four models is calculated through simulation trials. It indicates that the Management Model of Large-scale District Insurance Carrier requires the most manpower among the four alternative models. The unit management operating costs per the insured individuals and covered persons are leveled with several intervals based on the insurance recipients. in their characteristics. The interval levels derived from the regression analysis reveal that the larger the scale of the insurance carriers is in the number of those insured and covered. the more the unit management operating cost decreases. significantly. Moreover. the result of the quadratic functional formula also shows the U-shape significantly. The management operating costs derived from the simulated calculation. on the basis of the average salary and related cost per staff- member of the Health Insurance Societies for Occupational Labours and Korean Medical Insurance Corporation for the Official Servants and Private School Teachers in 1987 fiscal year. show that the Model of Multi-insurance Carrier warrants the highest management operating cost. Meanwhile the least expensive management operating cost is the Management Model of Unique Insurance Carrier. Insurance Carrier Divided by Area and Classified with Occupation in Large-scale. and Large-scale District Insurance Carrier. in order. Therefore. it is feasible to select the Unique Insurance Carrier Model among the four alternatives from the viewpoint of the management operating cost and in the sense of the flexibility in promoting the productivity of manpower in the human services field. However. the choice of the management model for health insurance systems and its application should be examined further utilizing the operation research analysis for such areas as the administrative efficiency and factors related to computer cost etc.

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A Study on the Effects of the Institutional Pressure on the Process of Implementation and Appropriation of System: M-EMRS in Hospital Organization (시스템의 도입과 전유 과정에 영향을 미치는 제도적 압력에 관한 연구: 병원조직의 모바일 전자의무기록 시스템을 대상으로)

  • Lee, Zoon-Ky;Shin, Ho-Kyoung;Choi, Hee-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.95-116
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    • 2009
  • Increasingly the institutional theory has been an important theoretical view of decision making process and IT adoption in many academic researches. This study used the institutional theory as a lens through which we can understand the factors that enable the effective appropriation of advanced information technology. It posits that mimetic, coercive, and normative pressures existing in an institutionalized environment could influence the participation of top managers or decision makers and the involvement of users toward an effective use of IT in their tasks. Since the introduction of IT, organizational members have been using IT in their daily tasks, creating and recreating rules and resources according to their own methods and needs. That is to say, the adaptation process of the IT and outcomes are different among organizations. The previous studies on a diverse use of IT refer to the appropriation of technology from the social technology view. Users appropriate IT through not only technology itself, but also in terms of how they use it or how they make the social practice in their use of it. In this study, the concepts of institutional pressure, appropriation, participation of decision makers, and involvement of users toward the appropriation are explored in the context of the appropriation of the mobile electronic medical record system (M-EMRS) in particularly a hospital setting. Based on the conceptual definition of institutional pressure, participation and involvement, operational measures are reconstructed. Furthermore, the concept of appropriation is measured in the aspect of three sub-constructs-consensus on appropriation, faithful appropriation, and attitude of use. Grounded in the relevant theories to appropriation of IT, we developed a research framework in which the effects of institutional pressure, participation and involvement on the appropriation of IT are analyzed. Within this theoretical framework, we formulated several hypotheses. We developed a second order institutional pressure and appropriation construct. After establishing its validity and reliability, we tested the hypotheses with empirical data from 101 users in 3 hospitals which had adopted and used the M-EMRS. We examined the mediating effect of the participation of decision makers and the involvement of users on the appropriation and empirically validated their relationships. The results show that the mimetic, coercive, and normative institutional pressure has an effect on the participation of decision makers and the involvement of users in the appropriation of IT while the participation of decision makers and the involvement of users have an effect on the appropriation of IT. The results also suggest that the institutional pressure and the participation of decision makers influence the involvement of users toward an appropriation of IT. Our results emphasize the mediating effect of the institutional pressure on the appropriation of IT. Namely, the higher degree of the participation of decision makers and the involvement of users, the more effective appropriation users will represent. These results provide strong support for institutional-based variables as predictors of appropriation. These findings also indicate that organizations should focus on the role of participation of decision makers and the involvement of users for the purpose of effective appropriation, and these are the practical implications of our study. The theoretical contribution of this study is lies in the integrated model of the effect of institutional pressure on the appropriation of IT. The results are consistent with the institutional theory and support previous studies on adaptive structuration theory.

A study on an evaluation model for industrial information systems by industry sectors (업종별 특성을 고려한 기업정보화 성숙모형)

  • 진경수;임춘성;박찬권
    • Proceedings of the CALSEC Conference
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    • 2002.01a
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    • pp.86-106
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    • 2002
  • Informatization is a process that corporation's external environmental factors and internal environmental factors influence as complex. is a phenomenon that appears via this process. To evaluate that informatization was propeled well or informatization level is high can be dangerous work extremely by only once-over-lightly some factors, organization information ability is superior or infrastructure is constructed well. Therefore, an evaluation for industrial information systems that consider corporation's external environment and internal environment configurationally and objective estimation through this is required in national dimension. This research sorted types of business using types of business classification of 2001 EIII(Evaluation Indices of Industrial Informatization) laying stress on corporation's product and product production process for reflecting various industrial classification. And we are dividing whole our country corporations by manufacture industry, the construction industry, distribution industry, service industry, banking industry 5 types of business. To see such classed types industry classification from consistent viewpoint, we saw them within new framework, purchase, operation, physical distribution, marketing and sale. service etc. laying stress on primary businesses except support businesses of planning, financial management etc. To draw special quality of business center from primary business of each types of business, we draw industry classification Key Capability that centers when plans corporation's corporate strategy and information strategy. And we deducted industrial classification key production business connected with industry classification Key Capability. After drawing an evaluation items for industrial information systems in informatization analysis viewpoint laying stress on drawn businesses. Finally we did Case Study by making out an evaluation for industrial information systems questionnaire that considers special quality of manufacturing industry. Through EIII that consider the industrial classification, we could know that it explains the corporation's purchase, production, distribution in general and detail.

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A Study on Curriculum Development For Community Health Practitioners (보건진료원 직무교육 교과과정 개선을 위한 일 연구)

  • 조원정;이경자
    • Journal of Korean Academy of Nursing
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    • v.22 no.2
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    • pp.207-226
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    • 1992
  • This study was designed to develop a conceptual framework for the curriculum and develop the details of the learning content for the education of Community Health Practitioners (CHPs). Since education programs for CHPs started 10 years ago, concepts related to CHP services have changed because of changes in society. The objectives of the study were as follows : 1) to analyse the usefulness of the present education program for CHPs, 2) to analyse the Job performance and self -confidence of the CHPs, 3) to identify the health needs of the clients served by the CHPs and the community problems related to health. 4) to develop a conceptual framework for the curriculum, for the education of CHPs, 5) to develops details for the learning content of the education program for CHPs. Phase I of the study was conducted by questionnaires to 150 CHPs who have worked in remote rural areas for more than 2 years. Among them, 147 responded. Data was collected from August 16, to August 25, 1990. In order to identify the health needs of the community people, research within the last five years was reviewed and analyzed. The data on 1, 842 communities gathered by the WHO Nursing Collaborations Center of the College of Nursing, Yonsei University was utilized to identify community problems related to health and the self - confidence in job performance of the CHPs. Psase II of the study consisted of a workshop with 13 professionals including Community Health Practitioners to evaluate the existing education program and a conceptual framework of the curriculum for the job education of CHPs. The results of the study are Summariged below : 1. The only 26 among 45 content items of the education program related to job skills was used by 80% of the responding CHPs. The knowledge of $\ulcorner$Networking community organization$\lrcorner$ was used by only 53.7% of the respondents. Educational content about $\ulcorner$Mental disease$\lrcorner$ was used by less than 50% of CHPs because of a knowledge deficit. 2. The CHPs reported that their activities concentrated on clinical services during the last six months. The survey showed that they seemed to neglect the activities for health promotion and disease prevention. Thus, $\ulcorner$Education for community loaders$\lrcorner$(15.9%), $\ulcorner$Activity for eavironmental health$\lrcorner$(16.3%) and $\ulcorner$Social work for needey people$\lrcorner$(23.3%) were done by less than 30% of CHPs. 3. More than 90% of CHPs reported being self - confident for the activities of $\ulcorner$Health education and counselling$\lrcorner$, $\ulcorner$Medicine prescription$\lrcorner$ and $\ulcorner$Immunization$\lrcorner$. But 50% of CHPs reported that they were not have self - confident in $\ulcorner$Management of water and environmental health$\lrcorner$ and only 25.6% of CHPs could insert an IUD independently. 4. It was identified that respiratory diseases and the gastrointestinal diseases were most common problems for the community people, followed by musculoskeletal and skin problems. 5. The community problems were classified into eight categories : physical environmental problems, environmental hygiene, health problems, health behavior, social problem, lack of resources, financial problem and the problems of the cultural and value system. 6. The conceptual framework consisted of the target population and their health status, nursing process working site and primary health care services such as health promotion, disease prevention, treatment and rehabilitation. 7. The contents of curriculum of education program for CHPs were formulated from the results of this study.

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A Study on Estimating Optimal Tonnage of Coastal Cargo Vessels in Korea (우리나라 연안화물선의 적정선복량 추정에 관한 연구)

  • 이청환;이철영
    • Journal of the Korean Institute of Navigation
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    • v.13 no.1
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    • pp.21-53
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    • 1989
  • In the past twenty years, there has been a rapid increase in the volume of traffic in Korea due to the Korean great growth of the Korean economy. Since transformation provides an infrastructure vital to economic growth, it becomes more and more an integral part of the Korea economy. The importance of coastal shipping stands out in particular, not only because of the expansion limit on the road network, but also because of saturation in the capacity of rail transportation. In spite of this increase and its importance, coastal shipping is falling behind partly because it is givenless emphasis than ocean-going shipping and other inland transportation systems and partly because of overcompetition due to excessive ship tonnage. Therefore, estimating and planning optimum ship tonnage is the first take to develop Korean coastal shipping. This paper aims to estimate the optimum coastal ship tonnage by computer simulation and finally to draw up plans for the ship tonnage balance according to supply and demand. The estimation of the optimum ship tonnage is peformed by the method of Origin -Destimation and time series analysis. The result are as follows : (1) The optimum ship tonnage in 1987 was 358, 680 DWT, which is 54% of the current ship tonnage (481 ships, 662, 664DWT) that is equal to the optimum ship tonnage in 1998. this overcapacity result is in excessive competition and financial difficulties in Korea coastal shipping. (2) The excessive ship tonnage can be broken down into ship types as follows : oil carrier 250, 926 DWT(350%), cement carrier 9, 977 DWT(119%), iron material/machinery carrier 25, 665 DWT(117%), general cargo carrier 17, 416DWT(112%). (3) the current total ship crew of 5, 079 is more than the verified optimally efficient figure of 3, 808 by 1271. (4) From the viewpoint of management strategy, it is necessary that excessive ship tonnage be reduced and uneconomic outdated vessels be broken up. And its found that the diversion into economically efficient fleets is urgently required in order to meet increasing annual rate in the amounts of cargo(23, 877DWT). (5) The plans for the ship tonnage balance according to supply and demand are as follows 1) The establishment of a legislative system for the arrangement of ship tonnage. This would involve; (a) The announcement of an optimum tonnage which guides the licensing of cargo vessels and ship tonnage supply. (b) The establishment of an organization that substantially arrangement tonnage in Korea coastal shipping. 2) The announcement of an optimum ship tonnage both per year and short-term that guides current tonnage supply plans. 3) The settlement of elastic tariffs resulting in the protect6ion of coastal shipping's share from other tonnage supply plans. 4) The settlement of elastic tariffs resulting in the protection of coastal shipping's share from other transportation systems. 4) Restriction of ocean-going vessels from participating in coastal shipping routes. 5) Business rationalization of coastal shipping company which reduces uneconomic outdated vessels and boosts the national economy. If we are to achieve these ends, the followings are prerequisites; I) Because many non-licensed vessels are actually operating and threatening the safe voyage of the others in Korea coastal routes, it is necessary that those ind of vessels be controlled and punished by the authorities. II) The supply of ship tonnage in Korean coastal routes should be predently monitored because most of the coastal vessels are to small to be diverted into ocean-going routes in case of excessive supply. III) Every ship type which is engaged in coastal shipping should be specialized according to the characteristics of its routes as soon possible.

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Horticultural Therapy: Job Analysis, Performance Evaluation, and Educational Needs (원예치료사의 직무 및 수행평가와 교육요구 분석)

  • Kim, Soo-Yun;Park, Sin-Ae;Son, Ki-Cheol;Lee, Chan
    • Horticultural Science & Technology
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    • v.32 no.6
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    • pp.887-900
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    • 2014
  • This study was conducted to provide a job analysis for, and assess the job performance of horticultural therapists, as well as examine future educational needs. To this end, a chart developed using the DACUM method was chosen as the appropriate tool for the job analysis of horticultural therapists (Study 1). Based on the chart, a survey using an evaluation form was produced to investigate the current level of job performance and future required level of horticultural therapists (Study 2). A total of 8 duties and 45 tasks were classified to examine job performance, based on analysis of the DACUM Council (Study 1). These duties include A. Decide execution organization for horticultural therapy (HT) program, B. Diagnose and assess clients before starting the HT program, C. Plan HT program, D. Develop HT program, E. Prepare to implement HT program for each session, F. Implement HT program for each session, G. Implement overall assessment for HT program, and H. Develop oneself as a horticultural therapist. Their duties were broken down further into five to eight tasks per duty, totaling 45 tasks. Based on the horticultural therapist job performance sheet developed through this process, an assessment of the current job level of horticultural therapists was performed and future required level were examined (Study 2). The evaluation forms were sent to 779 horticultural therapists with level 1 or 2 certification via email or mail delivery. The analysis of 242 questionnaires (31.1%) revealed that horticultural therapists with level 1 certificates have a significantly higher job performance level for 34 of the 45 tasks. Regarding future required level, 20 out of 45 tasks were assessed as higher for level 1 horticultural therapists than level 2. In addition, a Borich formula was utilized to identify the priority of educational needs for the 45 horticultural therapist tasks. The results revealed the following top three tasks: H1. Receive feedback from the supervisor for the horticultural therapy program; A1. Distribute promotional materials about the horticultural therapy program; and H2. Submit a grant proposal for horticultural therapy program to organizations such as welfare foundations. The results of this study are anticipated to facilitate understanding and improve work conditions for current horticultural therapists or horticultural therapists-in-training. In addition, institutions that train horticultural therapists will be able to use this as basic research to develop a practical training curriculum.

Adoption and Efficacy of ISO 15189 in Medical Laboratories for Diagnostic and Research (메디컬시험기관에서 ISO 15189 도입의 필요성과 시행의 효용성)

  • Yang, Man-Gil;Lee, Won Ho;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.158-167
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    • 2016
  • The requirements for medical laboratories ISO 15189 is examined in organization and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Medical services are provided from the areas of resource management, and pre-examination, examination and post-examination processes. The main goal of ISO 15189 accreditation is to improve the quality of laboratory services provided for patients and clinical users not only through compliance with consensually developed and harmonized requirements but also by adopting the philosophy of continual improvement using the Plan-Do-Check-Act cycle. Laboratory quality should be evaluated and improved in all steps of the testing process as the state-of-the art indicates that the pre- and post-analytical phases are more vulnerable to errors than the intra-analytical phase. The Korea Laboratory Accreditation Scheme (KOLAS), a national accreditation body, provides medical laboratory accreditations for appropriate approaches to evaluating the competence of a medical laboratory in providing effective services to its customers and clinical users. Adoption of ISO 15189 in 2010s as a government policy has been delayed, and only 5 laboratories have been accredited to date in Korea. The medical laboratories should seek the adoption of ISO 15189 with a positive attitude for quality improvement and strengthening of international competitiveness.

Influences of Feeding Seleniferous Whole Crop Barley on Growth Performance, Blood and Carcass Characteristics, and Tissue Selenium Deposition in Finishing Barrows (셀레늄함유 청보리 급여가 거세비육돈의 생산성, 혈액 및 도체특성, 조직 내 셀레늄 축적에 미치는 영향)

  • HwangBo, Soon;Jo, Ik Hwan;Kim, Guk Won;Choi, Chang Weon;Lee, Sung Hoon;Han, Ouk Kyu;Park, Tae Il;Choi, In Bae
    • Food Science of Animal Resources
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    • v.32 no.6
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    • pp.828-834
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    • 2012
  • The present study has been conducted to investigate the effects of feeding seleniferous whole crop barley (WCB) to finishing pigs on their growth performance, blood and carcass characteristics as well as on tissue selenium deposition. A total of 40 cross-bred barrows ((Landrace${\times}$Yorkshire)${\times}$Duroc) were allotted to five replicates of four treatments. Each replicate was arranged to 2 pigs per pen; the experimental period lasted for 6 weeks. The finishing pigs were fed diets containing 0.1 (non-seleniferous WCB as a control), 0.2, 0.4 and 0.6 ppm of selenium (Se) by supplementing the diets with seleniferous WCB. The isonitrogenous and isocaloric diets containing 5% non-seleniferous or seleniferous WCB were formulated. Feeding seleniferous WCB did not affect (p<0.05) the feed intake and BW gain. Total blood lipid concentration was significantly (p<0.05) decreased with increasing Se levels. Total blood cholesterol concentration for the control was significantly (p<0.05) higher than that for 0.4 and 0.6 ppm of Se treatments. Increasing the Se levels in WCB significantly (p<0.05) decreased blood triglyceride concentration; however, the levels increased immunoglobulin G and selenium concentrations. Feeding seleniferous WCB did not affect the carcass rate, backfat thickness and meat quality as well as yield grades. The Se concentration in the kidney, liver and loin were significantly (p<0.05) increased with increasing levels of seleniferous WCB. The results indicated that feeding seleniferous WCB may improve the blood characteristics related to lipid metabolism and thus, could produce selenium-fortified pork. Moreover, it is shown that the dietary optimal selenium level to depose selenium in porcine tissues by utilizing seleniferous WCB would be 0.4 mg of Se/kg of ration. Moreover, when 100 g of pork produced from pigs raised under such condition is served to consumers, it meets the minimum recommended daily requirements (40 ${\mu}g$) of dietary selenium proposed by the World Health Organization (1996).

Development of a Pre-treating Equipment and the Carcass Disposal System for Infected Poultry (감염가금 전처리 및 폐사가축 처리시스템 개발)

  • Hong, J.T.;Kim, H.J.;Yu, B.K.;Lee, S.H.;Hyun, C.S.;Ryu, I.S.;Oh, K.Y.;Kim, S.;Kwon, J.H.;Tack, D.S.
    • Journal of Animal Environmental Science
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    • v.17 no.2
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    • pp.81-92
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    • 2011
  • When we bury the infected poultry into the ground, we have many problems such as the difficulty of making sufficient area for burying, environmental contamination by the leachate, unpleasant ordor. Also, in case of burning the carcass of the infected poultry, there are some problems such as high cost, dust, unpleasant odor, etc. It could cause environmental contamination which many peoples and environmental organization complains about. In this study, we develop a treating system which treats the infected poultry carcass in a environmental method preventing the environment contamination. This system is composed of many processes. The euthanasia system uses rigid vinyl to trap and to do a euthanasia the infected poultry with lethal gas, carbon dioxide. And then, with the tractor attached grappler infected poultry carcass could be put into the carcass treating system. The euthanasia system uses rigid vinyl to trap the infected birds and to confine lethal gas, carbon dioxide. Infected poultry carcass are moved to carcass disposal system by collecting device which is attached at tractor. The carcass treatment system (capacity of disposal : 6.3 $m^3$) is installed on a truck and do one pass work, which is input, crush, stir, sterilize, and discharge treated carcass. 1,000 chickens was killed within 9.7min by $CO_2$ (300L/min) in the tent (10 $m^3$). The collecting device could carry 142 chickens at a time, and the movable carcass treatment system could sterilize 2 tons carcass per hour (at one time). This treatment systems was eco-friendly because it reduced the volume of carcass by 31.9% with no wastewater generation.

Current Status and Prospects of Various Methods used for Screening Probiotic Microorganisms (Probiotic 미생물 검사에 사용되는 다양한 방법들에 대한 현황과 향후 전망)

  • Kim, Dong-Hyeon;Kim, Hong-Seok;Jeong, Dana;Chon, Jung-Whan;Kim, Hyunsook;Kim, Young-Ji;Kang, Il-Byung;Lee, Soo-Kyung;Song, Kwang-Young;Park, Jin-Hyeong;Chang, Ho-Seok;Seo, Kun-Ho
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.4
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    • pp.203-216
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    • 2016
  • Probiotic microorganisms are thought to provide health benefits when consumed. In 2001, the World Health Organization defined probiotics as "live microorganisms which confer a health benefit on the host, when administered in adequate amounts." Three methods for screening potential probiotics have currently widely available. (1) In vitro assays of potential probiotics are preferred because of their simplicity and low cost. (2) The use of in vivo approaches for exploring various potential probiotics reflects the enormous diversity in biological models with various complex mechanisms. (3) Potential probiotics have been analyzed using several genetic and omics technologies to identify gene expression or protein production patterns under various conditions. However, there is no ideal procedure for selecting potential probiotics than testing cadidate strains on the target population. Hence, in this review, we provide an overview of the different methodologies used to identify new probiotic strains. Furthermore, we describe futre perspectives for the use of in vitro, in vivo and omics in probiotic research.