• 대한간호학회지
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• 제10권1호
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• 간호행정학회지
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• 제21권3호
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• pp.243-253
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• 2015

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

• 한국전자통신학회논문지
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• 제10권12호
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• pp.1315-1320
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• 2015

본 논문은 군통신 데이터링크 장비에 대해서 주파수 자원을 효율적으로 이용하기 위하여 고속도약기법, 주파수환경센싱기법, 수신2채널기법, 수신필터뱅크부 적용 등을 이용하여 동일한 주파수 대역을 사용하는 레이다 등의 타장비와 공유할 수 있는 기법을 소개한다. 사전에 운용대역의 주파수 환경을 실시간 측정 및 분석하였고, 일차적으로 개발하려는 장비가 기존 운용하고 있는 레이다에 간섭영향성이 최소화하는 방법을 분석하였으며, 반대로 레이다가 간섭을 주는 환경에서 본 논문에서 제시한 주파수 공유기법을 사용하여 최대한 통신확률을 높이는 구조를 제시한다. 최종적으로 설계된 RF송수신기의 잡음지수, 상호혼변조(IMD)와 같은 주요 규격에 대한 모의실험을 통하여 만족여부를 사전 검증하였다.

• 지능정보연구
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• 제20권1호
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• pp.149-161
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• 2014

공공 서비스의 수출의 경우 수출 절차와 대상 선정에 따른 다양한 문제가 발생하며, 공공 서비스 수출 플랫폼은 이러한 문제점들을 해결하기 위하여 사용자 중심의 유연하고, 개방형 구조의 디지털 생태계를 조성할 수 있도록 구현되어야 한다. 또한 공공서비스의 수출은 다수의 이해당사자가 참여하고 여러 단계의 과정을 거쳐야 하므로 사용자의 이해 종류와 탐색 컨설팅 협상 계약 등 수출 프로세스 단계별로 맞춤형 플랫폼 서비스 제공이 필수적이다. 이를 위해서 플랫폼 구조는 도메인과 정보의 정의 및 공유는 물론 지식화를 지원할 수 있어야 한다. 본 논문에서는 공공서비스 수출을 지원하는 플랫폼을 위한 온톨로지 모형을 제안한다. 서비스 플랫폼의 핵심 엔진은 시뮬레이터 모듈이며 시뮬레이터 모듈에서는 온톨로지를 사용하여 수출 비즈니스의 여러 컨텍스트들을 파악하고 정의하여 다른 모듈들과 공유하게 된다. 온톨로지는 공유 어휘를 통하여 개념들과 그들 간의 관계를 표현할 수 있으므로 특정 영역에서 구조적인 틀을 개발하기 위한 메타 정보를 구성하는 효과적인 도구로 잘 알려져 있다. 공공서비스 수출 플랫폼을 위한 온톨로지는 서비스, 요구사항, 환경, 기업, 국가 등 5가지 카테고리로 구성되며 각각의 온톨로지는 요구분석과 사례 분석을 통하여 용어를 추출하고 온톨로지의 식별과 개념적 특성을 반영하는 구조로 설계한다. 서비스 온톨로지는 목적효과, 요구조건, 활동, 서비스 분류 등으로 구성되며, 요구사항 온톨로지는 비즈니스, 기술, 제약으로 구성 된다. 환경 온톨로지는 사용자, 요구조건, 활동으로, 기업 온톨로지는 활동, 조직, 전략, 마케팅, 시간으로 구성되며, 국가 온톨로지는 경제, 사회기반시설, 법, 제도, 관습, 인프라, 인구, 위치, 국가전략 등으로 구성된다. 수출 대상 서비스와 국가의 우선순위 리스트가 생성되면 갭(gap) 분석과 매칭 알고리즘 등의 시뮬레이터를 통하여 수출기업과 수출지원 프로그램과의 시스템적 연계가 이루어진다. 제안하는 온톨로지 모형 기반의 공공서비스 수출지원 플랫폼이 구현되면 이해당사자 모두에게 도움이 되며 특히 정보 인프라와 수출경험이 부족한 중소기업에게 상대적으로 더 큰 도움이 될 것이다. 또한 개방형 디지털 생태계를 통하여 이해당사자들이 정보교환, 협업, 신사업 기획 등의 기회를 만들 수 있을 것으로 기대한다.