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원내검사 및 원외검사 결정을 위한 손익분기점 분석 경험
김윤희 대한진단검사의학회 2006 Annals of Laboratory Medicine Vol.26 No.6
배경 : 심화된 경쟁구도 의료시장에서는 의료서비스의 지속적품질개선을 통한 원가절감이 요구된다. 검사실에서는 정기적으로원내 또는 원외검사(make-or-buy) 결정을 위한 자료들을 검토하는 것이 요구되는 데, 이때 유용한 도구가 손익분기점(break-even point, BEP) 분석이다. 본 연구에서는 최근 본원 검사실에서 의뢰건수의 증가추세를 보인 면역측정 외부위탁검사들을 검사실 내부에서 시행(make)할 경우의 원가계산을 하여, BEP 분석을 시행하였다. 대 상 및 방 법 : AFP, CEA, PSA, ferritin, fT4, T3, TSH,CA 125, CA 19-9 및 HBeAb 의 10가지 검사를 Abbott Ax-SYM 장비로 검사실 내부에서 자체 시행할 경우의 고정비 및 변동비를 계산하였다. 손익분기건수(break-even volume)는 연간고정비를 단위당 외부위탁구매가와 단위당 변동비의 차로 나누어서, BEP 비율은 손익분기건수에서의 총 구매가를 현재의 연 검사건수에서의 총 구매가로 나누어서 구하였다.\\Test volumeLoss\6,149,000 \18,447,000 \30,745,000ProfitTotal purchasing costsTotal purchasing costsContribution margin rateBreak-even pointTotal costsBreak-even pointBreak-evenvolume: 155930,000,00025,000,00020,000,00015,000,00010,000,0005,000,000012,000,00010,000,0008,000,0006,000,0004,000,0002,000,0000-2,000,000-4,000,000-6,000,000-8,000,000-10,000,0000 500 1,000 1,500 2,000 2,500 3,000A B464 김윤희결과 : AFP, CEA, PSA, ferritin, fT4, T3, TSH, CA125,CA19-9 및 HBeAb의 연 고정비는 평균 8,279,187원, 단위 당 변동비는 평균 3,786원이었다. 손익분기건수는 평균 1,599건, BEP비율은 평균 852%이었다. 고정비에 질 관리 비용을 포함하지 않은 경우의 BEP 비율은 평균 74%이었다.
가미강활산(加味羌活散)이 집먼지 진드기 추출물로 유도된 NC/Nga mouse의 아토피 피부염에 미치는 영향
김윤희,한재경,김윤희,Kim, Yun-Hee,Han, Jae-Kyung,Kim, Yun-Hee 대한한방소아과학회 2008 대한한방소아과학회지 Vol.22 No.1
Objectives The purpose of this study is to investigate the effect of KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to this condition in humans. Methods To investigate the effect of KKHS on atopic dermatitis (AD), we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells(PBMCs), splenocytes, draining lymph node(DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis of NC/Nga mouse in vivo. Results In vivo, clinical skin severity score was significantly lower in the KKHS group than in the control group. IgE, IL-6, TNF-${\alpha}$, IgM, IgG2a and IgG2b levels in serum decreased remarkably in the KKHS group than in the control group, and the level of IFN-${\gamma}$ production which is secreted from Th1 cell was increased by KKHS. After this experiment we analyzed immunological cells ($CD3^+$, $CD19^+$, $CD4^+$, $CD8^+$, $CD3^+CD69^+$, $CD4^+CD25^+$ and $CD49b^+$) by flow cytometry. It results that the total absolute number of $CD3^+$, $CD19^+$, $CD4^+$ and $CD8^+$ cells were recovered as much as normal state, and the level of $CD3^+CD69^+$ in isolated DLN and PBMCs were significantly decreased, and total absolute number of $Gr-1^+$, $CD11b^+$ and $CD3^+$ in dorsal skin of NC/Nga mouse were decreased by KKHS. We analyzed ear, DLN, and neck-back skin after biopsy and dyeing by hematoxyline/eosin(H&E), toluidine staining (mast cells marker). KKHS were very effective to the histological symptoms which are in dermal and epidermal thickening, hyperkeratosis and inflammatory cell infiltration. Ear thickness was significantly decreased compared with the control group and the size of inflammatory lymphocytes cells (ILC) and plasma cells (PC) in DLN were also decreased. Conclusions KKHS on atopic dermatitis in an in-vivo experiment using an NC/Nga atopic dermatitis mouse was very effectiveness to the atopy dermatitis treatment.
산림치유 프로그램 개발을 위한 숲 방문 빈도에 따른 요구분석
김윤희 한국인간·식물·환경학회 2016 인간식물환경학회지 Vol.19 No.2
Forest visiting frequency level is likely to indirectly affect the preferences and needs of the program. The forest visiting frequency degree is an important factor which can affect the development and conduct of the program. Therefore, forest needs analysis was conducted for the development of forest therapy program in accordance with the frequency of visits. First, after examining the frequency of forest visits degree according to demographic characteristics, the group of 217 people visiting the forest at least once a week or a month was classified as a high-frequency group. The group of 403 people visiting the forest at least once a quarter or a year and almost no visit was classified as a low-frequency group. The need difference according to the frequency of visits was analyzed through descriptive statistics analysis, frequency analysis, crosstabs by use of SPSS 21.0 program. The most important factors of Implementation period, season, paid the participation fee made differences depending on the frequency of visit. This study, as an exploratory research, making us understand the needs related to forest healing program for the forest visit groups of high and low frequencies, will be an important basis for the development and operation of forest therapy program.