In order to account for whether a doctor should indemnify damages resulted from violation of duty of care, the fact that a doctor violated duty of care, that damages were incurred, and the link between violation of duty of care and damages incurred, respectively, should be verified. So even though a doctor violated duty of care to patients, he or she will not bear the responsibility to indemnify damages unless it is not verified. If a doctor's negligence in medical practices is assessed that obviously unfaithful medical practice far exceeds the limit of admission of a patient, it will not go against people's general perception of justice or law and order to constitute a medical malpractice itself as an illegal action that will require liabiliy for damage. However, when the limit of admission is set too low, a patient's benefit and expectation of proper medical treatment can be violated. In contrast, if the limit of admission is set high, it can leave too little room for doctors' discretion for treatments due to a bigger risk of indemnification for damages. Thus, a reasonable balance that can satisfy both benefit and expectation of patients and doctors' right to treatment is needed.
Kim, Jeong-Gook;Lee, Junghun;Jang, Cheolyong;Song, Doosam;Yoo, Seunghwan;Kim, Jonghun
KIEAE Journal
/
v.16
no.5
/
pp.39-45
/
2016
Purpose: The purpose of this study is to analyze the energy saving and cost benefit analysis of the Low-income Energy Efficiency Treatment Program supported by KOREF(Korea Energy Foundation). This program was launched in 2007 and performs building energy retrofit for the low-income and energy poverty houses. Method: Energy simulation and cost benefit analysis were accomplished for the low-income detached houses. The structure of detached house was a lot og block structure, wood frame (single glass) and concrete roof. Baseline model of the low-income detached houses was proposed. Result: Annual heating energy consumptions were decreased by about 3.2% with the window system replacement(Case 1), 9.3% with reinforcement of insulation(Case2), and 12.5% with both(Case 3) compared to those of baseline model. The construction cost will be recouped within 5 years for the Case 1, 3 years for the Case 2, and 3 years for the Case 3. Case 3 was the most cost beneficient construction method in the analyzed cases in this study.
Recognition of liability for damages due to medical malpractice has been developed largely on the basis of two paths. First is the case where there is an error in a physician's medical practice and this infringes upon the legal interests of life and body, and the compensation for monetary and non-monetary damages incurred from such infringement on life and body becomes an issue. Second is the case where there is a breach of a physician's duty of explanation that results in a infringement on the patient's right of autonomous decision, and the compensation for non-monetary damages incurred from such infringement becomes an issue. However, even if there is a medical error, since it is difficult to prove the causation between the medical error of a physician and the infringement upon legal interests, the physician's responsibility for damage compensation is denied in some cases. Consider, for example, a case where a patient is already in the final stage of cancer and has a very low possibility of a complete recovery even if proper treatment is received from the physician. Here, it is not appropriate to refuse recognition of any damage compensation based on the reason that the possibility of the patient dying is very high even in the absence of a medical error. This is so because, at minimum, non-monetary damage such as psychological suffering is incurred due to the physician's medical error. In such a case, our courts recognize on an exceptional basis consolation money compensation for losing the chance to receive proper treatment. However, since the theoretical system has not been established in minutiae, what comes under the benefit and protection of the law is not clearly explicated. The recent discourse on compensating for damages incurred by patients, even when the causation between the physician's medical error and infringement upon the legal interests of life and body is denied, by establishing a new legal interest is based on the "legal principle of loss of opportunity for treatment." On what should be the substance of the new legal interest, treatment possibility argument, expectation infringement argument, considerable degree of survival possibility infringement argument and loss of opportunity for treatment argument are being put forth. It is reasonable to see the substance of this protected legal interest as "the benefit of receiving treatment appropriate to the medical standard" according to the loss of opportunity for treatment argument. The above benefit to the patient is a value inherent to human dignity that should not be infringed upon or obstructed by anyone, and at the same time, it is a basic desire regarding life and a benefit worthy of protection by law. In this regard, "the benefit of receiving treatment appropriate to the medical standard" can be made concrete as one of the general personal rights related to psychological legal interest.
Objective: To use health economics methodology to assess the screening program on gastric cancer in Zhuanghe, China, so as to provide the basis for health decision on expanding the program of early detection and treatment. Materials and Methods: The expense of an early detection and treatment program for gastric cancer in patients found by screening, and also costs of traditional treatment in a hospital of Zhuanghe were assessed. Three major techniques of medical economics, namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA), were used to assess the screening program. Results: Results from CEA showed that investing every 25, 235 Yuan on screening program in Zhuanghe area, one gastric cancer patient could be saved. Data from CUA showed that it was cost 1, 370 Yuan per QALY saved. Results from CBA showed that: the total cost was 1,945,206 Yuan with a benefit as 8,669,709 Yuan and an CBR of 4.46. Conclusions: The early detection and treatment program of gastric cancer appears economic and society-beneficial. We suggest that it should be carry out in more high risk areas for gastric cancer.
Common utility tunnel is essential to the daily lives of people underground utilities (electricity, gas and supply facilities such as water, communication facilities, sewer facilities, etc.) to improve the appearance by co-acceptance and disaster prevention, important for the conservation of the city's population was concentrated road construction the city-based facilities. There is recognition of the importance of the various supply treatment facilities in common utility tunnel as infrastructure to accommodate joint according to the city expanded, the demand for infrastructure. In this paper, a cost-benefit analysis using a one-time occurrence, without simply relying on cost or current cost, project manager for the city-dimensional feasibility study conducted, the user level of the maintenance costs and user costs, including social costs items from various angles can be investigated and proposed a mechanism of economic feasibility common utility tunnel. Evaluation of the proposed technique is cost-benefit and cost caused by installing common utility tunnel the existing pipeline area - was investigated by the benefit analysis, extended and repeated common utility tunnel installation depends much affected by the excavation, so users of reducing the number of repeat excavation convenience can be seen that this occurs.
Choi, Seo-In;Nam, Ye-Lim;Kim, Jin-Kyoung;Park, Hyung-Jin;Song, Kun-Ho;Seo, Kyoung Won
Korean Journal of Veterinary Research
/
v.61
no.1
/
pp.10.1-10.11
/
2021
The purpose of this retrospective study was to provide additional data on the use of toceranib in a wide variety of tumor types in small breed dogs, especially < 8 kg (except 5 dogs). This was a retrospective study of 31 dogs with malignant tumors treated with a 2.5 mg/kg median dose of toceranib (Palladia; Zoetis, USA) on a Monday-Wednesday-Friday schedule. Clinical benefit was observed in 13 of 15 dogs (86.7%, 3 with complete response, 4 with partial response, 6 with stable disease) with gross disease. Distant metastasis, response to treatment, and treatment setting were significantly associated with survival time. Negative prognostic factors were multiple chemotherapy and distant metastasis (affecting progression-free survival [PFS]), surgery, regional enlarged lymph nodes, underlying disease, and toxicity (affecting median survival time [MST]). Positive prognostic factors were epithelial and round cell tumor (affecting PFS), epithelial tumor, microscopic disease, no evidence of disease response, and stable disease (MST). In conclusion, a clinical benefit from toceranib treatment was noted in most of the dogs with gross disease in our study. This study suggested that the toceranib is probably selective treatment to various tumor types in small breed dogs.
Recently, high-concentration linked wastewater has been introduced into a nearby municipal wastewater treatment plants(MWTPs), but it is difficult to MWTP in local governments due to an unreasonable linked treatment charge system, and there is insufficient evidence or data to prove this. However, the MWTP, which is a national essential infrastructure, is generally exempt from the preliminary feasibility study, so there have been no cases where economic evaluation was conducted. Therefore, we proposed an improvement plan that can compensate for the disadvantages of the existing linked processing charges through previous studies. In this study, a comparative evaluation of how much economic feasibility can be improved compared to the existing ones when applying the improvement plan by conducting an economic analysis. For this, reference was made to the preliminary feasibility assessment data of the existing environmental facilities and the cost factors and benefit factors established during the modernization of the old sewage treatment facilities. As a result of the study, the B/C(Benefit/cost) value was quite low in the past, but when the improvement proposal proposed by the researchers was applied, it was confirmed that the B/C value increased close to 1. Therefore, it is considered to be very reasonable to calculate the linkage processing charge according to the linked wastewater load proposed by the researchers.
This study reviewed the current status and problems of sewerage system in Korea and then proposed possible methods to correct the problems. Also, evaluation of future development in sewerage system is included. It can be summarized as follows : 1. Investment in sewerage system is relatively low . 0.23% of GNP, Considering that the investment portion is 0.35% in OECD and 0.63% in Japan, it should be increased further. 2. The reasons wily the investment in sewerage system is low can be ' (1) Low priority is given to the investment in sewerage system. Local government builds and operates its own wastewater treatment plant. Local government as well as residents prefer to invest their money in roadwork, housing and parks to in wastewater treatment facilities because of greater investment effects. (2) Besides capital investment, more maintenance cost is needed for sewerage system. Proper operation of wastewater treatment facilities requires a well-trained operator. Because of public conception that operation of wastewater treatment facility is a dirty job, it is difficult to find a well-trained operator. (3) It is difficult to estimate the effect of sewerage system (4) Cost required to build and maintain wastewater treatment facility should be paid by people, who benefit from the facility. People to benefit are sometimes different from people to pay. 3. Advanced treatment is necessary to protect the bay aura and raw water source as well as to prevent eutrophication of lakes and ponds. 4. Wastewater treatment facility were mainly build in big cities during the decade of 1980. Followings should be solved first to expand the facilities. (1) Rapid repair and construction of sewer. (2) Technical development of wastewater treatment . Prevention of efficient and economical wastewater . Development of efficient and economical wastewater treatment techniques . Development of high-efficiency treatment using bioreactor . Reuse of wastewater treatment plant effluent (3) Sludge treatment and disposal . Composting of sludge cakes . Development of techniques to reduce the volume of sludge cake : incineration and reuse of sludge ash and slag. (4) Utilization of wastewater treatment facilities . Construction of community parks or sports families(ie, on the tops of the covered aeration tanks and sedimention tanks) Construction of wastewater treatment facilities under ground and of parking facilities and community parks above ground. (5) Education of wastewater treatment personal.
The author installed $3.75mm\times10mm$$Br{\aa}nrmark$ osseointegrated implants and $3.5mm\times8mm$ I.T.I. hollow screw implants(Benefit) as a free standing abutment to replace lower left and right molars of 44-year-old female patient. Form the foregoing procedure, the author obtained the following results. 1. Free-standing $Br{\aa}nrmark$ and I.T.I. Hollow screw implants(Benefit) could be used to replace molars effectively without reduction of adjacent natural teeth, 2. Rotation of occlusal gold screw of $Br{\aa}nrmark$ implants was observed under occlusal force. 3. Adjustment of height of I.T.I. abutments was necessary in the mandibular second molar because of the limited occlusal clearance. 4. Form the oral examination, patient comments, panoramic and periapical radiographs, there were no pain, gingival imflammation and mobility, but slight reduction of alveolar bone level was shown around both implant systems. 5. Patient comments were comfortable on both systems. but the patient complained about economic problem of $Br{\aa}nrmark$ system and long treatment treatment time of both systems.
Objectives: Since 1991, nationwide massive neonatal screening program for phenylketonuria (PKU) and congenital hypothyroidism have been performed in Korea. As in many other countries, efficiency of this program has not been definitely concluded. For the purpose of evaluation of this program, from the perspective of efficiency, a cost-benefit analysis was carried out. Methods: Costs of the detection and the treatment program were compared with the projected benefit(avoided costs) that results from the prevention of the mental retardation associated with the disorders due to PKU and hypothyroidism. Costs and benefits were discounted at an annual rate of 5%, and duration of life-long labor was assumed to be 30 years. Cost and benefit were estimated based on the detection rates of one case of PKU per 5,572 and one case of congenital hypothyroidism per 32,554 babies screened during 1991-1997. Results: The benefit-cost ratio was 0.418. The sensitivity analysis for the discount rates and labor durations showed that most cost-benefit ratios were lower than one(1.0) except when discount rate was changed to 3% and detection rate to two- or threefold and/or labor duration to 40 years. Conclusion: The result of this study suggested that present program of mass screening for PKU and congenital hypothyroidism could not be justified in terms of efficiency. It doesn't coincide with the results of previous studies in major developed countries, presumably because of difference in detection rates and welfare cost for the disabled.
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