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Development of the Model for Activity Based Costing in the Hospital (의료기관의 활동기준원가 산출 모형)

  • Chun, Ki-Hong;Cho, Woo-Hyun;Kim, Bo-Kyung;Kim, Byung-Cho
    • Korea Journal of Hospital Management
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    • v.6 no.2
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    • pp.37-69
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    • 2001
  • A new cost management system, called Activity Based Costing (ABC) system, has arisen to solve the limitation of a Traditional Cost Accounting (TCA) system until last two decades and ABC has been applied by many companies. TCA systems have limitation in tracing cost because they arbitrarily allocate overhead cost to the cost objects without standard for direct cost distribution. ABC is an accounting system that assigns costs to products or services based on the resources they consume. The costs of all activities are traced to the products for which they are performed. Therefore ABC is a cost management system that provides a matrix to accurately quantify consumed resources triggered by activities and activities triggered by products and services. There is little implementation of ABC in the health services field, one of service industries, due to complicated and many activities, and volatile cost object. However, the necessity for applying reasonable cost accounting system is largely issuing as strategy responding hostile environment, and financial pressure, and it is imperative to implement the Activity Based Costing (ABC) system. Therefore, this study presents the framework to develop ABC system for total health service organizations. Cost objects in this study base on medical service activities per health insurance claim from one general hospital located in Metropolitan Statistical Areas (MSAs). Medical service activities include all health insurance claims in the hospital. The purpose of the study is presenting useful tools and basic frame to develop Activity Based Costing system for health service organizations which want to use ABC system. The steps to develop ABC system for health service organizations are following: 1. Identifying of activity centers; 2. Definition of cost objects and activity by activity center; 3. Analysis of activity and tracing activity contribution; 4. Allocation of direct cost for specific activity; 5. Allocation of indirect cost for specific activity; 6. Allocation of depreciation for facilities, applicants, and consumption goods; 7. Allocation of administration cost; 8. Allocation of cost among activity centers; and 9. Tracing cost of cost objects by activity center. This study identified necessary information from existing reports which hospitals generally made by each step, and defined outcome which had to be produced in each step using this information. The steps of this study had limitation to apply all different size hospitals because the steps were structured ABC system by one hospital, however, this study used similar basic framework and methods with general cases. When a health service organization want to apply Activity Based Costing (ABC) system on all activities of it in future days, this study is very useful to design system structure in the health service organization.

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An Experimental Study of the Soil Nailed Wall Behavior with Front Plate Rigidity (전면벽체 강성에 따른 쏘일네일링 벽체의 거동특성에 관한 실험적 고찰)

  • Kim, Hong-Taek;Kang, In-Kyu;Kwon, Young-Ho;Park, Si-Sam;Cho, Yong-Hoon
    • Journal of the Korean Geotechnical Society
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    • v.18 no.3
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    • pp.87-94
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    • 2002
  • Recently, there have been numerous attempts to expand the traditional temporary soil nailing system into a permanent wall. Two reasons for this include the soil nailed system's advantage of efficient and economic use of subgrade space and its ability to decrease the total construction cost. However, the systematic and logical design approach has not been proposed yet. The permanent soil nailing wall system, which utilizes precast concrete from soil nailing system, is already used in many countries, but the study of cast-in-place concrete lacing or rigid walls in bottom-up construction of traditional soil nailing walls is imperfect and insufficient. In this paper, various laboratory model tests have been carried out to investigate the influence of parameters, including stiffness of the rigid wall to the soil nailing structure with respect to failure mode, displacement patterns and tensile forces at the nail head in several levels of load. Then, the variation of earth pressure distribution on the soil nailing wall, built with a rigid front plate, is sought through different levels of surcharge load and tensile forces at the nail head.

Efficacy and Adverse Events of Bangpungtongseong-san(Bofutsusho-san) and Bangkihwangki-tang(Boiogiot-tang) by Oriental Obesity Pattern Identification on Obese Subjects : Randomized, Double Blind, Placebo-controlled Trial (비만 환자에서 한방 비만 변증에 따른 방풍통성산과 방기황기탕의 치료효과 및 부작용 비교 : 무작위 배정, 이중 맹검, 위약-대조군 임상시험)

  • Park, Jung-Hyun;Lee, Myeong-Jong;Kim, Ho-Jun;Hong, Sun-woo;Lee, Dong-Ki;Yoo, Jae-Wook;Choi, Sun-Mi;Moon, Jin-Seok;Lim, Chi-Yeon;Lee, Jung-bok
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.2
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    • pp.265-278
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    • 2011
  • Objectives : This trial were conducted to evaluate the efficacy and adverse events of Bofutsusho-san(BTS) and Boiogiot-tang(BOT) by oriental obesity pattern identification on obese subjects, as compared to placebo. Methods : 166 subjects(body mass index ${\geq}25kg/m^2$) were recruited and randomized to receive BT(n=55), FH(n=55) or placebo(n=56) for 8 weeks. Anthropometric factors, serum lipid, glucose, blood pressure(BP), pulse rate, resting metabolic rate and oriental obesity pattern identification questionnaire were measured at baseline and 8 weeks. Adverse events and safety outcome variables were also checked during trials. Results : The frequency of top-scored oriental obesity pattern was ordered by indigestion(食積) > stagnation of the liver qi(肝鬱) > yang deficiency(陽虛) > spleen deficiency(脾虛) > phlegm(痰飮) > blood stasis(瘀血) in subjects. BTS group significantly decreased body weight, body mass index(BMI), waist circumference(WC), body fat mass, total cholesterol and HDL-cholesterol in stagnation of the liver qi(肝鬱) and WC in indigestion(食積). BOT group showed significant decrease of body weight, BMI, WC, and body fat mass in indigestion(食積) not in deficiency(虛症). Adverse events were reported most frequently in yang deficiency(陽虛) by BT group and stagnation of the liver qi(肝鬱) by BOT group. Conclusions : Bofu-tsusho-san was effective in treating obesity with stagnation of the liver qi(肝鬱). Obesity pattern identification could be a useful diagnostic tool predicting treatment effects and adverse events.

Comparison of high molecular coating type dentine hypersensitivity desensitizers (고분자 기반 코팅형 상아질 지각 과민 처치제의 효과에 대한 비교 연구)

  • Roh, Young-Hoon;Lee, Joo-Yeon;Park, Hyun-Jung;Choi, Cha-Nam;Park, Yoon-Jeong;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung
    • The Journal of the Korean dental association
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    • v.46 no.11
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    • pp.683-688
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    • 2008
  • Purpose : The aim of this study was to evaluate the clinical efficacy of two commercially available desensitizing agents over 3 weeks on patients with dentin hypersensitivity. Materials and Methods : An oxalate-based solution, Sensblok (NIBEC Inc. Seoul, Korea) & Superseal (Pheonix Inc. Michigan, USA), and a distilled water placebo were compared in a clinical setting. Seven volunteers exhibiting three or more teeth that were sensitive to tactile & air were enrolled in the study (35 teeth total). A visual analog scale (VAS) was used for recording each patient s level of sensitivity to tactile & air stimuli. A Florida probe was rubbed across the exposed dentin three times with a constant pressure 20 grams to measure the tactile stimulus. The air stimulus was generated by dental unit air syringe for 1-second blast from 1/2 inch distance. The desensitizing agents were applied according manufacture s guideline. VAS scores were recorded at baseline, 1 minute after treatment, at 1 week, 2weeks, 3weeks. VAS score were analyzed using a repeated measures ANOVA ( =0.05). Results : The Sensblok, Superseal, and distilled water placebo all decreased dentin sensitivity. A statistically significant difference existed between Sensblok and placebo when tactile stimulus was applied (P<0.05), but no significant difference was found among other desensitizing agents and tactile and air stimuli.

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Design Concept Value Competitive Research Between Service Provider and Service Receiver (수면무호흡 환자의 양압기 제품서비스디자인 개발에 대한 서비스 제공자와 수혜자가 느끼는 디자인 컨셉 가치 비교연구)

  • Lee, Sung Pil;Jung, Ju Young;Lee, Sang Ki;Hong, Jung Pyo
    • Journal of Service Research and Studies
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    • v.7 no.4
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    • pp.39-50
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    • 2017
  • As a comparative study on the value of design concept between service provider (Developer) and service receiver (Customer) group, the aims of this study was to present a service model focused on Continuous positive airway pressure (CPAP) based on U-health care and user environment. Double Diamond-based methods led to a case study that conducted jointly by the department of otolaryngology in U hospital, Ulsan. By targeted on Sleep Apnea patients from the stage of diagnosis to CPAP treatment, variety of meaningful experiences have been extracted and classified into several types of customers. In the final analysis of the 13 service scenario models, Kano Satisfaction and Potential Customer Satisfaction Improvement Index (PCSI) were conducted with the customers, yet Score Model and Concept Position were evaluated by the service provider groups who engaged in development services. The results of this study showed that 7 items in the total of 12 items reached a consensus of viewpoint on value between service receiver and service provider, which the attributes of the service model are based on user environment. Whereas the other 5 items showed the divergent viewpoint on value which included the attributes of U-healthcare service model.

Antioxidant and digestive enzyme inhibitory effects of Eisenia bicyclis extracted by different methods (추출방법에 따른 대황 추출물의 항산화 및 소화효소 저해 효과)

  • Kim, Jin-Hak;Park, La Young;Lee, Shin-Ho
    • Food Science and Preservation
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    • v.23 no.1
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    • pp.97-103
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    • 2016
  • The antioxidant and digestive enzyme inhibitory effects of Eisenia bicyclis extracted by various extraction methods (RE, reflux extraction; SE, ultrasonification extraction; AE, autoclave extraction; LE, low-temperature high-pressure extraction) were investigated. The extraction yield (55.21%) and the laminarin (39.03%), fucoidan (24.75%), total polyphenol (115.68 mg GAE/g) and flavonoid (36.67 mg RHE/g) contents of AE were higher than those in other methods. The DPPH radical (86.60%, 500 mg%), ABTS radical (58.56%, 25 mg%), nitrite (86.38%, 100 mg%) scavenging activities of the Eisenia bicyclis extracted by AE were higher than those of Eisenia bicyclis extracted by other methods. The ABTS radical and nitrite scavenging activities were above 98% in all tested Eisenia bicyclis extracts and these activities were dependent on its concentration. The inhibitory effects of AE against amylase (50 mg%) and ${\alpha}$-glucosidase (5 mg%) were 64.76% and 86.71%, respectively. The AE showed the best inhibitory effect of Eisenia bicyclis extracts (50 mg%) against trypsin (24.37%) and ${\alpha}$-chymotrypsin (49.05%), respectively. These results suggest that Eisenia bicyclis extracted by AE can be used as a bioactive and functional material in the food industry.

Removal of Off-flavor from Laminaria Japonica by Treatment Process of Supercritical Carbon Dioxide (초임계 이산화탄소 처리 공정에 의한 다시마 유래 이취성분 제거)

  • Park, Jung-Nam;Kim, Ryoung-Hee;Woo, Hee-Chul;Chun, Byung-Soo
    • Clean Technology
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    • v.18 no.2
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    • pp.191-199
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    • 2012
  • In order to reduce or remove off-flavor and volatile organic compounds (VOCs) from Laminaria japonica effectively, continuous treatment process by supercritical carbon dioxide (SC-$CO_2$) was applied. After freeze-drying, Laminaria japonica powdered with $710{\mu}m$ was used. Experiments were carried out at temperature range from 35 to $55^{\circ}C$, and pressure range from 10 to 25 MPa for evaluation of SC-$CO_2$ treatment effect. Flow rate of carbon dioxide used in this reseach was constantly fixed at 26.81 g/min. Before and after treatment of SC-$CO_2$, off-flavor and VOCs from Laminaria japonica were analyzed by gas chromatography-mass spectrometry detector (GC-MSD). Total 47 VOCs emitted from Laminaria japonica were identified before treatment of SC-$CO_2$, major components of seaweed smell (ordor) in Laminaria japonica were identified as alcohols, aldehydes, ester and acids, ketone, halogenated compounds and hydrocarbon. Off-flavor and VOCs in all experimental conditions was reduced or removed after SC-$CO_2$ treatment. Among the experimental conditions, the highest removal yield was at 25 MPa and $55^{\circ}C$.

Glycerol Carbonate Synthesis by Glycerol Oxidative Carbonylation over Copper Catalysts (구리 촉매상에서 글리세롤의 산화 카르보닐화 반응에 의한 글리세롤 카보네이트 합성)

  • Choi, Jae Hyung;Lee, Sang Deuk;Woo, Hee Chul
    • Clean Technology
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    • v.19 no.4
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    • pp.416-422
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    • 2013
  • In environmental friendly aspects, the synthesis of glycerol carbonate from glycerol using carbon monoxide and oxygen gases which were produced in petrochemical plants was studied. The oxidative carbonylation of glycerol under batch reaction system was performed on parameter conditions such as effect of various metals (Cu, Pd, Fe, Sn, Zn, Cr), oxidizing agents, mole ratio of carbon monoxide to oxygen, catalyst amount, solvent types, reaction temperature and time and dehydrating agents. In particular copper chloride catalysts showed the excellent activities, and the glycerol carbonate yields over CuCl and $CuCl_2$ catalysts were the maximum of 44% and 64%, respectively at the following reaction conditions: solvent as nitrobenzene, mole ratio of 1:3:0.15 (glycerol:carbon monoxide:catalyst), mole ratio of 2:1 (carbon monoxide:oxygen), the total pressure of 30 bar at 413 K for 4 hr. It was found that reactivity were significantly different depending on the oxidation number of Cu catalysts, and oxygen plays an important role as oxidizing agents in producing H2O during oxidation reaction after carbonylation of glycerol.

The Quality of Salted and Semi-Dried Mackerel Processed by Cold Osmotic Dehydration during Storage (저온삼투압탈수법으로 제조(製造)한 반염건(半鹽乾)고등어의 저장안정성(貯藏安定性))

  • Lee, Jung-Suck;Joo, Dong-Sik;Kim, Jin-Soo;Cho, Soon-Yeong;Lee, Eung-Ho
    • Korean Journal of Food Science and Technology
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    • v.26 no.4
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    • pp.422-427
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    • 1994
  • The quality of salted and semi-dried mackerel prepared by cold osmotic dehydration using a high osmotic pressure resin during storage at $5{\pm}1^{\circ}C$ was evaluated. The moisture contents in salted and semi-dried mackerel decreased in. range of 4 during storage. The brown pigment formation content and peroxide value of salted and semi-dried mackerel prepared by osmotic dehydration were more lower than those of salted and semi-dried mackerel prepared by traditional drying methods such as sun-drying, hot-air drying and cold air drying. The viable cell count and histamine contents of cold osmotic dried products were much lower and revealed a tendency to increase during storage, but even these values after storage of 15 days showed that the salted and semi-dried mackerel was safety in respect of food sanitation. The ratio of saline soluble nitrogen to total nitrogen in cold osmotic dried products were higher than that of traditional dried products during storage. Judging from the results of chemical and sensory evaluation, shelf-life of salted and semi-dried mackerel by cold osmotic drying were more longer than that of salted and semi-dried mackerel prepared by traditional drying.

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Effects of Iksujisundan on Renal Function, Peroxynitrite Scavenging Activity and Polyol Pathway in Streptozotocin-induced Diabetic Rats (익수지선단(益壽地仙丹)이 Streptozotocin으로 유발된 당뇨병 흰쥐의 신기능, 활성산소, 활성질소 및 Polyol Pathway에 미치는 영향)

  • Jeon, Chang-Min;Jeong, Ji-Cheon
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.237-248
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    • 2007
  • Objectives : Diabetes is a disease in which the body does not produce or properly use insulin. Etiological studies of diabetes and its complications showed that oxidative stress might play a major role. Therefore, many efforts have been tried to regulate free oxygen radicals for treating diabetes and its complications. Iksujisundan has been known to be effective for the treatment of diabetes. The present study was carried out to investigate the effect of Iksujisundan on renal function, peroxynitrite(ONOO-) scavenging activity and polyol pathway in streptozotocin-induced diabetic rats. Methods : The crushed Iksujisundan was extracted 3 times, each time with 3 volumes of methyl alcohol at 60$^{\circ}C$ for 24 h. The extract was filtered and evaporated under a reduced pressure using a rotary evaporator to yield 87.8g. Iksujisundan extract was orally administreted at 100 mg per 1 kg of body weight for 20 days to the diabetic rats induced by streptozotocin(60mg/kg). The effects of Iksujisundan extract on the streptozotocin-induced diabetic rats were observed by measuring the serum level of glucose, insulin, lipid components, creatinine and BUN, and also the kidney levels of superoxide anion radical(${\cdot}$O2-), nitric oxide(NO) and ONOO-, and also the enzyme activities involved in the polyol pathway. Results : The effects of Iksujisundan on the streptozotocin-induced diabetic rats with regards to body weight, blood glucose and indulin levels, creatinine and BUN levels, total cholesterol and triglyceride lavels, and HDL-cholesterol levels were all shown to be good enough to prevent and cure the diabetes and its complications. Iksujisundan inhibited the generation of ${\cdot}$O2-,NO and ONOO- in the kidney of streptozotocin-induced diabetic rats. Renal aldose reductase and sorbitol dehydrogenase activities were increased in the streptozotocin-induced diabetic rats were reversed toward natural activities. Conclusions : Iksujisundan might inhibit the development of diabetes and its complications by scavenging reactive oxygen and nitrogen species, thereby by reducing oxidative stresses and also by regulating the activities of polyol pathway enzymes, all of which could help to recover kidney function.

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