What makes hybrid insourcing successful: A new public–private partnership model for social welfare services

Yang Jae‐jin,Kim Hey Sung,Choi Seong Eun,Ryu Lanhee,Choi Young Jun 한국사회복지학회 2020 Asian Social Work and Policy Review Vol.14 No.1

Outsourcing has been a key policy tool for delivering a range of social services, and regarded as more effective than insourcing or direct government provision. At the same time, it has also caused many delivery issues such as principal‐agent problems, a lack of policy coordination, and poor‐quality welfare services. While the pendulum continues to swing between insourcing and outsourcing, we aim to propose a new public–private partnership model called the “hybrid insourcing model” and examine which factors influence the performance of the model. In South Korea, around 2010, the local government in Namyangju City was the first to implement the “Hope Care Center model,” a kind of hybrid insourcing model, which has been praised for its innovation and widely emulated by central and local governments. Our analysis utilizes data collected between December 2017 and January 2018 from public sector employees and civilian staff in Namyangju and a comparable city, A. From this, we draw a number of implications, both for theory and for policy. We argue that, for public–private partnerships, active cooperation and equality are the biggest factors in contributing to positive performance. These work alongside leaders with a clear vision and with employees' positive attitude

한의진단명과 진단요건의 표준화 연구 III : 3차년도 연구결과 보고

최선미,양기상,최승훈,박경모,박종현,심범상,김성우,노석선,이인선,정진홍,이진용,김달래,임형호,김윤범,박성식,송태원,김종우,이승기,최윤정,신순식 한국한의학연구원 1997 한국한의학연구원논문집 Vol.3 No.1

The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.

8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

4세 유아에 발생한 몰입성 하마종(plunging ranula); 증례보고

최진호,양동환,김일규,오남식 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.4

Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. When there is a soft anterior neck swelling without oral swelling, diagnosis is still difficult. In such a case, clinical suspicion may be low and the pathologist may be misled by the histologic appearance. Recognition of the diagnosis of plunging ranula is essential for the correct treatment of these lesions We report a case of a 4-year-old girl and review the literatures to discuss the differential diagnosis and treatment modalities.

골수염의 진단에 있어서의 Tc-99m Hexamethylpropylene amine oxime 백혈구 스캔의 임상적 유용성

최상호,김양수,정준원,정진원,추은주,서동대,배인규,양승오,우준희,류지소 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.1

배경 : 골수염의 진단에 있어 Technetium-99m을 이용한 삼상 골스캔(Tc-99m MDP스캔)은 단순방사선 검사상 정상소견을 보이는 경우에 쓰이는 1차적 검사로 매우 높은 민감도를 보인다. 그러나 Tc-99m MDP 스캔은 골절이나, 정형외과적 삽입물, 신경병적 관절병변과 같이 뼈의 재형성이 증가되는 상황에서도 양성소견을 보여 특이도가 낮은 단점이 있다. 이러한 단점을 보완하고자 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 골수염이 의심되어 Tc-99m HMPAO 백혈구 스캔을 시행했던 15명의 의무기록을 후향적으로 분석하였다. 골수염의 확진은 임상관찰 소견과 배양검사 결과와 병리소견을 기준으로 하였다. 결과 : 골수염의 진단에 있어 Tc-99m HMPAO 백혈구 스캔의 민감도와 특이도는 각각 100%와 78%였고 Tc-99m HMPAO 스캔의 경우는 100%와 18%였다. 가장 흔한 원인균은 methicillin-resistant S. aureus였다. Tc-99m MDP 스캔에서 양성소견을 보였던 환자중 3명의 환자가 Tc-99m HMPAO 백혈구 스캔에서 음성 소견을 보였으며 이 환자들은 추적관찰상 골수염이 없는 것으로 확인되었다. 결론 : Tc-99m HMPAO 백혈구 스캔은 골수염의 존재를 진단하는데 있어 민감도와 특이도가 높으며, 특히 뼈의 재형성이 증가되어 Tc-99m MDP 스캔의 특이도가 낮게 나타나는 상황에서 유용하리라 사료된다. Background Three phase bone scintigraphy, performed with technetium-labeled diphosphonates (Tc-99m MDP scan), is the very sensitive radionuclide procedure of choice for diagnosing osteomyelitis. But, Tc-99m MDP scan is less specific when bone remodeling is increased. To overcome this limitation, we evaluated the diagnostic value of technetium-99m hexamethylpropyleneamine oxime (HMPAO) labeled leukocyte scan in osteomyelitis. Methods : We retrospectively reviewed 15 patients with suspected osteomyelitis who performed Tc-99m HMPAO labeled leukocyte scan. The diagnosis of osteomyelitis was based on clinical course and bacterial culture, and pathologic findings. Results The sensitivity and specificity of Tc-99m HMPAO leukocyte scan was 100% and 78%, and those of Tc-99m MDP scan was 100% and 18%, respectively. The most common organism was Methicilein-Resistant S. aureus. Among the patients that showed persistent accumulation on Tc-99m MDP scan, three patients showed no uptake on Tc-99m HMPAO leukocyte scan and these patients were confirmed that had no osteomyelitis. Conclusion : Tc-99m HMPAO leukocyte scan is a useful test for determining the presence or absence of osteomyelitis, especially under condition that bone remodelin is increased.

개심술(開心術)의 임상적 고찰 : 치험 200예 200 Cases

최형호,서홍주,임영혁,김정중,배대양,이석기,임진수 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.2

Background and Objectives: Two hundred cases of the open heart surgery due to congenital and acquired heart disease were done using the cardiopulmonary bypass in the Department of Thoracic and Cardiovascular surgery, Chosun University Hospital from November, 1980 to June, 2001. Material and Methods: The number of congenital heart disease was 132 cases. 68 cases were acquired heart disease. 'The age of the congenital heart disease was from 22 days to 45 years. In the acquired heart disease, the age was from 14 to 72 years. Result: Congenital heart disease consisted of 113 congenital acyanotic heart disease, 19 congenital cyanotic heart disease. Corrective operation was done for congenital heart disease with 4. 5 % operative mortality. Of 68 cases acquired heart disease, 44 patients were valvular heart disease, 3 cardiac tumors, 9 ischemic heart diseases, 12 aortic dissections and etc. The operative mortality was 13%. Conclusion: The postoperative complications were appeared in 68 cases and the complications were wound infection, occipital alopecia, low cardiac output syndrome, arrhythmia, septicemia etc. The mortality after open heart surgery was 15 cases and the causes of death were low cardiac output syndrome, septicemia, respiratory failure and left ventricle rupture.

한강변 응급센터에 내원한 익수환자에 대한 임상적 고찰

양진홍,박규남,최승필,김영민,김세경 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: There are approximately 2,400 drowning deaths reported every year in Korea, but there are few good reports about submerged patients visiting the emergency room, so this study was designed to investigate the clinical characteristics and outcomes of submerged patients treated at an emergency medical center near the Han river. Methods: A retrospective review of 123 cases of submerged patients admitted to our emergency medical center over a 5 year period from 1996 to 2000 was conducted. Results: Among the 123 submerged patients, there were 66 males and 57 females, and their mean age was 33.18. The common cause of submersions was a suicide attempt, followed by lack of attention, unknown etiology, and water sports such as swimming. Most of the patients were transported to ER by 119 ambulance. In-hospital CPR was performed on 27(22%) cases. At initial ECG rhythm of these cases, asystole was noted if 25 patients; VF and pulseless electrical activity, respectively, were noted in two others. Prehospital CPR had been performed on all in-hospital CPR cases except 2. Prolonged ROSC after succesful CPR was noted in 13 cases, The mean duration of CPR was 26 minutes. Five patients survived after CPR. Their neurologic outcomes were assessed on CPC(cerebral performance category). Three patients were categorized in CPC1, the other two patients were categorized in CPC3 and CPC4. Conclusion: Submerged patient's visits to emergency medical center near the Han river were most frequent in summer for suicide purposes. Drowned patients were more hypothermic than other cardiac arrest cases, and resulted in better outcome even with prolonged arrest time, if they were given appropriate prehospital CPR and aggreissive in-hospital resuscitation.

유비쿼터스 컴퓨팅에서 얼굴 정보 인식을 이용한 감성 추론 연구

양동일,박순희,박용,김진봉,최형진 강원대학교 정보통신연구소 2007 정보통신논문지 Vol.11 No.-

Recently, much research have been done on ubiquitous computing models in advanced countries as well as in Korea. Ubiquitous computing is defined as a computing environment that isn't bounded by time and space. Different kinds of computers are embedded in artifacts, devices, and environment, thus people can be connected everywhere and everytime. To recognize user's emotion, facial expression, temperature, humidity, weather, and lightning factors are used and ontology is built using those. Ontology Web Language (OWL) is adopted to implement ontology and Jena is used as an emotional inference engine. The context-awareness service infrastructure suggested in this research can be divided into several modules by their functions.

Malate dehydrogenase의 조직특성에 관한 연구

양융,최진길 연세대학교 대학원 1990 延世論叢 Vol.26 No.1

Abstract Malate dehydrogenase was extracted from cardiac muscle and skeletal muscle, and biochemical characteristics were compared each other. Results obtained are summarized as follow : 1. Malate dehydrogenase activity in cardiac muscle was 2.80 times as high as that of skeletal muscle. 2. The content of cytoplasmic malate dehydrogenase was higher than that of mitochondrial palate dehydrogenase of cardiac muscle and skeletal muscle. 3. Malate dehydrogenase of cardiac muscle was more thermostable than that of skeletal muscle. Thermostability of cytoplasmic malate dehydrogenase was more stable than that of mitochondrial palate dehydrogenase. 4. The Km value of mitochondrial malate dehydrogenase showed high affinity for malate, while Km value of cytoplasmic malate dehydrogenase showed high affinity for oxaloacetate. 5. Distribution of surface charge between cytoplasmic and mitochondrial malate dehydrogenase was different from each other. Molecular weight of malate dehydrogenase subunit was 35,000.

프로스타글란딘 E₁에칠에스테르의 외용 리오겔 제제 설계

양성운,이진교,이지은,김희규,박혜숙,김종석,최한곤,용철순,최영욱 한국약제학회 2004 Journal of Pharmaceutical Investigation Vol.34 No.2

External lyogels containing prostaglandin E₁ethyl ester(PGE₁-EE), a produrg of prostaglandin E₁(PGE₁) as a therapeutic agent for erectile dysfunction, were formulated to overcome the aqueous instability and enhance the percutaneous absorption. Lyogels of PGE₁-EE were prepared with ethanol (EtOH)/proplyene glycol (PG) cosolvent system as a vehicle, cineol as an enhancer, and hydroxypropylcellusose as a gelling agent. In vitro percutaneous absorption studies were performed to determine the rate of PGE₁ absorption through rat or hairless mouse skin. The permeability of PGE₁-EE lyogel with enhancer was 16-fold greater than that of lyogel without enhancer. Cosolvent produced 9-fold increase in percutaneous absorption. Pharmacodynamic effects of lyogels were evaluated in mature male cats in terms of intracavernosal pressure (ICP). Lyogles containing 0.01% of PGE₁-EE showed higher ICP compared to intraurethral preparation of PGE₁(1%) and enhancer-free control lyogel. The shelf-life (t_(10%) of lyogel at refrigerated condition (4℃) was calculated as 928 days, which is 4.2 times longer than that of control hydrogel. As a result, PGE₁-EE was formulated successfully to a lyogel system with a selective enhancer and cosolvent system for the topical delivery of PGE₁.