• Title/Summary/Keyword: terminal cost

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호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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A Strategic Approach to Competitiveness of ASEAN's Container Ports in International Logistics (국제물류전략에 있어서 ASEAN의 컨데이너항만 경쟁력에 관한 연구)

  • 김진구;이종인
    • Proceedings of the Korean Institute of Navigation and Port Research Conference
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    • 2003.05a
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    • pp.273-280
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    • 2003
  • The purpose of this study is to identify and evaluate the competitiveness of ports in ASEAN(Association of Southeast Asian Nations), which plays a leading role in basing the hub of international logistics strategies as a countermeasure in changes of international logistics environments. This region represents most severe competition among Mega hub ports in the world in terms of container cargo throughput at the onset of the 21 st century. The research method in this study accounted for overlapping between attributes, and introduced the HFP method that can perform mathematical operations. The scope of this study was strictly confined to the ports of ASEAN. which cover the top 100 of 350 container ports that were presented in Containerization International Yearbook 2002 with reference to container throughput. The results of this study show Singapore in the number one position. Even compared with major ports in Korea (after getting comparative ratings and applying the same data and evaluation structure), the number one position still goes to Singapore and then Busan(2) and Manila(2), followed by Port Klang(4), Tanjugn Priok(5), Tanjung Perak(6), Bangkok(7), Inchon(8), Laem Chabang(9) and Penang(9). In terms of the main contributions of this study, it is the first empirical study to apply the combined attributes of detailed and representative attributes into the advanced HFP model which was enhanced by the KJ method to evaluate the port competitiveness in ASEAN. Up-to-now, none have comprehensively conducted researches with sophisticated port methodology that has discussed a variety of changes in port development and terminal transfers of major shipping lines. Moreover, through the comparative evaluation between major ports in Korea and ASEAN, the presentation of comparative competitiveness for Korea ports is a great achievement in this study. In order to reinforce this study, it needs further compensative research, including cost factors which could not be applied to modeling the subject ports by lack of consistently qualified in ASEAN.

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Application of Remote Sensing Techniques to Survey and Estimate the Standing-Stock of Floating Debris in the Upper Daecheong Lake (원격탐사 기법 적용을 통한 대청호 상류 유입 부유쓰레기 조사 및 현존량 추정 연구)

  • Youngmin Kim;Seon Woong Jang ;Heung-Min Kim;Tak-Young Kim;Suho Bak
    • Korean Journal of Remote Sensing
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    • v.39 no.5_1
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    • pp.589-597
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    • 2023
  • Floating debris in large quantities from land during heavy rainfall has adverse social, economic, and environmental impacts, but the monitoring system for the concentration area and amount is insufficient. In this study, we proposed an efficient monitoring method for floating debris entering the river during heavy rainfall in Daecheong Lake, the largest water supply source in the central region, and applied remote sensing techniques to estimate the standing-stock of floating debris. To investigate the status of floating debris in the upper of Daecheong Lake, we used a tracking buoy equipped with a low-orbit satellite communication terminal to identify the movement route and behavior characteristics, and used a drone to estimate the potential concentration area and standing-stock of floating debris. The location tracking buoys moved rapidly during the period when the cumulative rainfall for 3 days increased by more than 200 to 300 mm. In the case of Hotan Bridge, which showed the longest distance, it moved about 72.8 km for one day, and the maximum moving speed at this time was 5.71 km/h. As a result of calculating the standing-stock of floating debris using a drone after heavy rainfall, it was found to be 658.8 to 9,165.4 tons, with the largest amount occurring in the Seokhori area. In this study, we were able to identify the main concentrations of floating debris by using location-tracking buoys and drones. It is believed that remote sensing-based monitoring methods, which are more mobile and quicker than traditional monitoring methods, can contribute to reducing the cost of collecting and processing large amounts of floating debris that flows in during heavy rain periods in the future.

A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Critical Success Factor of Noble Payment System: Multiple Case Studies (새로운 결제서비스의 성공요인: 다중사례연구)

  • Park, Arum;Lee, Kyoung Jun
    • Journal of Intelligence and Information Systems
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    • v.20 no.4
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    • pp.59-87
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    • 2014
  • In MIS field, the researches on payment services are focused on adoption factors of payment service using behavior theories such as TRA(Theory of Reasoned Action), TAM(Technology Acceptance Model), and TPB (Theory of Planned Behavior). The previous researches presented various adoption factors according to types of payment service, nations, culture and so on even though adoption factors of identical payment service were presented differently by researchers. The payment service industry relatively has strong path dependency to the existing payment methods so that the research results on the identical payment service are different due to payment culture of nation. This paper aims to suggest a successful adoption factor of noble payment service regardless of nation's culture and characteristics of payment and prove it. In previous researches, common adoption factors of payment service are convenience, ease of use, security, convenience, speed etc. But real cases prove the fact that adoption factors that the previous researches present are not always critical to success to penetrate a market. For example, PayByPhone, NFC based parking payment service, successfully has penetrated to early market and grown. In contrast, Google Wallet service failed to be adopted to users despite NFC based payment method which provides convenience, security, ease of use. As shown in upper case, there remains an unexplained aspect. Therefore, the present research question emerged from the question: "What is the more essential and fundamental factor that should takes precedence over factors such as provides convenience, security, ease of use for successful penetration to market". With these cases, this paper analyzes four cases predicted on the following hypothesis and demonstrates it. "To successfully penetrate a market and sustainably grow, new payment service should find non-customer of the existing payment service and provide noble payment method so that they can use payment method". We give plausible explanations for the hypothesis using multiple case studies. Diners club, Danal, PayPal, Square were selected as a typical and successful cases in each category of payment service. The discussion on cases is primarily non-customer analysis that noble payment service targets on to find the most crucial factor in the early market, we does not attempt to consider factors for business growth. We clarified three-tier non-customer of the payment method that new payment service targets on and elaborated how new payment service satisfy them. In case of credit card, this payment service target first tier of non-customer who can't pay for because they don't have any cash temporarily but they have regular income. So credit card provides an opportunity which they can do economic activities by delaying the date of payment. In a result of wireless phone payment's case study, this service targets on second of non-customer who can't use online payment because they concern about security or have to take a complex process and learn how to use online payment method. Therefore, wireless phone payment provides very convenient payment method. Especially, it made group of young pay for a little money without a credit card. Case study result of PayPal, online payment service, shows that it targets on second tier of non-customer who reject to use online payment service because of concern about sensitive information leaks such as passwords and credit card details. Accordingly, PayPal service allows users to pay online without a provision of sensitive information. Final Square case result, Mobile POS -based payment service, also shows that it targets on second tier of non-customer who can't individually transact offline because of cash's shortness. Hence, Square provides dongle which function as POS by putting dongle in earphone terminal. As a result, four cases made non-customer their customer so that they could penetrate early market and had been extended their market share. Consequently, all cases supported the hypothesis and it is highly probable according to 'analytic generation' that case study methodology suggests. We present for judging the quality of research designs the following. Construct validity, internal validity, external validity, reliability are common to all social science methods, these have been summarized in numerous textbooks(Yin, 2014). In case study methodology, these also have served as a framework for assessing a large group of case studies (Gibbert, Ruigrok & Wicki, 2008). Construct validity is to identify correct operational measures for the concepts being studied. To satisfy construct validity, we use multiple sources of evidence such as the academic journals, magazine and articles etc. Internal validity is to seek to establish a causal relationship, whereby certain conditions are believed to lead to other conditions, as distinguished from spurious relationships. To satisfy internal validity, we do explanation building through four cases analysis. External validity is to define the domain to which a study's findings can be generalized. To satisfy this, replication logic in multiple case studies is used. Reliability is to demonstrate that the operations of a study -such as the data collection procedures- can be repeated, with the same results. To satisfy this, we use case study protocol. In Korea, the competition among stakeholders over mobile payment industry is intensifying. Not only main three Telecom Companies but also Smartphone companies and service provider like KakaoTalk announced that they would enter into mobile payment industry. Mobile payment industry is getting competitive. But it doesn't still have momentum effect notwithstanding positive presumptions that will grow very fast. Mobile payment services are categorized into various technology based payment service such as IC mobile card and Application payment service of cloud based, NFC, sound wave, BLE(Bluetooth Low Energy), Biometric recognition technology etc. Especially, mobile payment service is discontinuous innovations that users should change their behavior and noble infrastructure should be installed. These require users to learn how to use it and cause infra-installation cost to shopkeepers. Additionally, payment industry has the strong path dependency. In spite of these obstacles, mobile payment service which should provide dramatically improved value as a products and service of discontinuous innovations is focusing on convenience and security, convenience and so on. We suggest the following to success mobile payment service. First, non-customers of the existing payment service need to be identified. Second, needs of them should be taken. Then, noble payment service provides non-customer who can't pay by the previous payment method to payment method. In conclusion, mobile payment service can create new market and will result in extension of payment market.