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서울시 및 7개 광역시 국공립어린이집 운영효율성 비교 및 인건비의 영향력에 대한 연구
이재무(Jae-Moo, Lee),이 배(Bae, Lee) 한국여성정책연구원 2016 여성연구 Vol.90 No.1
본 연구는 공보육을 실천하는 일선기관인 국공립어린이집의 운영효율성을 서울특별시와 7개 광역시 소재 국공립어린이집을 대상으로 자료포락분석(DEA)으로 확인하였다. 함께 인건비가 운영효율성에 영향을 미치는지 토빗회귀분석으로 확인하여 향후 국공립어린이집에 대한 관리 전략에 유용한 시사점을 발굴하고자 수행되었다. 분석결과, 투입과 산출요인의 규모적 측면에서 상위권을 서울, 부산, 인천 소재 시설들이 높은 수준을 나타냈지만 보육아동의 정원과 시설 수를 고려한 결과 다른 지역의 광역시들이 보다 높은 수준인 것으로 확인 되었다. 또한 상대적 효율성 지수가 가장 높은 것으로 확인된 15개 시설의 요인 현황을 감안하면 운용효율성 개선을 위해서는 다소 적은 규모로 운영되면서 그에 부합하는 수준 이상의 성과를 내는 것이 바람직하다. 그리고 분석결과를 근거로, 국공립어린이집의 운용효율성 개선을 위해서는 보육아동 정원의 조정이 반드시 필요하고, 그를 통해 현원을 충족시킴으로써 산출을 늘리는 것이 적절함을 제시하였다. This study verifies operational efficiency of an educational institution in frontline that practices public child care, national & public child care centers, with national & public child care centers in Seoul and 7 metropolitan cities by verify Data Envelopment Analysis(DEA). This study is also to find out useful implications for a management strategy of national & public child care centers in the future by verifying if personnel expenses affect operational efficiency by Tobit regression analysis. As a result of analysis, Despite the result that the input and output scale factor aspects Incheon facilities for top Seoul, Busan, from their high level considering the number of child-care facilities for children and the garden was found to have higher levels of other metropolitan areas. It is also desirable given the relative efficiency factors into the index 15 were identified as the highest operational facilities as a somewhat smaller scale in order to improve operational efficiency, that the level of performance that meets more than them. And based on the results of the analysis, the necessary adjustments in the nursery garden for children to improve the operational efficiency of national and public child-care centers, and suggested that it is appropriate to increase the yield by meeting the present personnel through him.
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실신을 주소로 응급의학센터에 내원한 환자에 대한 임상적 연구
박정배,김상은,배성만,정호성,박철완,이 근 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1
Syncope is not uncommon problem that needs broad differential diagnosis. Correct diagnosis of the cause of syncope is important, because although some causes of syncope such as vasodepressor syncope have benign prognosis, others such as ventricular tachycardia may need prompt diagnosis and treatment. We present a retrospective study of the patients with episodes of syncope brought to Emergency Medical Center of Chung Ang Gil Hospital from January 1994 to October 1994 and the results were as followings. 1. The patients with episodes of syncope accounte for 0.5% of total Emergency Department visits. 2. The male to female ratio was 4 : 6 and mean age was about 54-years old. 3. The cause of syncope was identifiable in 48% of the case and not in 52%. The noncardiac cause(56%) was more common than the cardiac(44%) and cardiac, noncardiac, SUO(Syncope of Unknown Origin) ratio was 1 : 1.4 : 2.6. 4. 29% of patients were dignosed by history taking, physical examination, and electrocardiography when they visited the Emergency Department initially, and 88% of patients with identifiable causes were diagnosed through initial Emergency Department investigation and Holter monitioring. 5. The rate of correct diagnosis can be increased if initial investigation includes Holter monitoring, and the further research for more accurate, inexpensive and noninvasive diagnostic method for syncope is needed.
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원형섭,김상은,배성만,박철완,이 근,조상훈,김상일,우병완 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1
Extremity vascular trauma is common in most emergency centers, and controversy remains about the optimal management of arterial injuries. Retrospectively we reviewed the records of 23 patients who had upper or lower extremity arterial trauma from July 1994 to December 1995. The purpose of this study was to evaluate our department`s management policy to major arterial injuries. The leading cause of major arterial injuries was penetrating trauma. We found that there were clinical findings such as absence of or decreased strength of pulsation(82.6%), cool ischemic extremity(69.6%), large expanding hematoma(43.5%), major bleeding(17.4%) and bruit or thill(8.7%). We gave the priority to management of life-threatening injuries and applied the pressure dressing to wounds as early as possible. There were 18 men(78.3%) and 5 women(21.7%); the mean age was 35(range 20-56 years old) years. There were 12 arterial injuries(52.2%) in the upper extremity and 11 arterial injuries(47.8%) in the lower exteremity. The most commonly injured artery was the brachial artery in the upper(34.8%) and the femoral artery in the lower(30.4%) extremity. The etiology included knife stabbing in 10 patients(43.5%), motor vehicle accidents in 6(26.1%), industrial accidents in 4(17.4%), falls in 2(8.7%) and a farm equipment accident in 1 patient(4.3%). The associated injuries were muscle injuries(78.3%), fracture(56.5%), nerve injuries(52.2%), vein injuries(43.5%), shock(17.4%) and dislocation(13.0%). All patients with arterial injuries were given a preoperative prophylactic antibiotic and TIG(tetanus immunoglobulin). We used Doppler technique as a means of detecting the blood flow. Fourteen patients(60.9%) underwent preoperative arteriography in the radiology department. We performed surgical exploration as soon as major arterial injuries were suspected. The most common methods of treating major arterial injuries were interposition vein graft(69.6%) and end to end anastomosis(21.7%). Systemic or locally infused heparin was used for all vascular repairs. In many of our patients(56.5%), fasciotomy was performed before the vascular repair, as a part of the exploration of the distal arteries. There were 2 amputations(8.7%) but no death. The reason for secondary amputation were wound infection in one and failure to achieve sufficient arterial flow to the involved extremity with resulting gangrene in the other. As the time factor is vitally important in the management of arterial injuries, we advocate prompt and early surgical treatment within 6 hours of the trauma. In conclusion, we believe that the crucial factorsin successful management of major arterial injuries of the extremities are early diagnosis, prompt treatment, complete debridement, fasciotomy when indicated, and simultaneous treatment of concomitant injuries.
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