• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.9-20
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• 2006

Objectives: This study was aimed at investigating the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors. And we want to compare the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Methods: In order to compare, the data was referred to National health insurance center for affirming the insurance type of the dead. And age adjusted mortality rate of tuberculosis of each insurance type was analyzed by whole country and the provinces. Related factors of the provinces were gathered from public statistic books. We analysed correlation study between the ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis and related factors among the provinces. Results: Major findings were as follows 1. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis was 5.6. And the ratio was relatively high at 40-60 ages. 2. The ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis by the province was varying. And the factors that were financial independence, crowdedness, percent of people on medical aid, population size served by each public health center, number of hospital by a million peoples have correlated with increment of the ratio. Conclusions: As a consequence of tuberculosis control, the ratio was high. Thus this finding suggests that medical utilization and preventive behavior, environment of tuberculosis patient are under handicapped condition. Especially large cities like metropolitan area who have high financial independence, high population density, high percentage of medical aid peoples have high ratio of medical aid over health insurance of age adjusted mortality rate of tuberculosis. There is need for additional and systematic research on the attitude or tendency toward medical services(inc1uding preventive services) utilization of medical aid tuberculosis patients.

• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.457-468
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• 1993

This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.1%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow : the routine CBC was 75.0%, the liver function test was 72.1%, and the computer tomogram was 15.4%.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.91-95
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• 2004

This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

• Journal of Oral Medicine and Pain
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• v.34 no.2
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• pp.197-205
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• 2009

The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.

• The Journal of the Korean Institute of Forest Recreation
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• v.22 no.4
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• pp.59-69
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• 2018

This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured email survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.

• Journal of agricultural medicine and community health
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• v.47 no.4
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• pp.211-219
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• 2022

Objective: This study was conducted to investigate the awareness of work-related disease prevention of farmers. Method: As a research method, a qualitative focus group interview was conducted in 18 participants. Results: Prevention and management services for work-related diseases of farmers mostly are based on research from other fields and so are not highly effective because their content is not relevant to agricultural work. It has been suggested that such program designers be required to have some appropriate related knowledge, and that incentives and a certification system for participation in such education be established. To analyze work-related diseases of farmers, fields of prevention, diagnosis, treatment, and rehabilitation should be created. They demanded the designation of hospitals and the actualization of compensation for farmers' safety insurance. The work-related diseases to address were include musculoskeletal diseases, pesticide poisoning-related diseases (cardiovascular disease, respiratory disease), psychiatric diseases such as depression, and allergic diseases. However, this must have been the result of the harmful factors they felt during agricultural work. And for farmer patients diagnosed with work-related diseases, it was said to strengthen farmer safety insurance. Conclusion: In order to increase the safely and health effects of agricultural work, it is necessary to prevent and manage work-related diseases of farmers. Projects should be developed in consideration of cultural and economic barriers of farmers and the characteristics of the work.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.3
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• pp.360-372
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• 2023

The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into 'general characteristics', 'number of dental treatments and working days per year', 'proportion of covered services', 'perceptions of supply and demand of pediatric dentists'. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future.

• Journal of Teachers' Pension
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• v.3
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• pp.69-105
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• 2018

저출산과 고령화 이슈는 우리사회의 경제적 문제뿐만 아니라 공적연금의 재정지속가능성 여부와도 맞물려 있다. 실제로 우리나라 모든 공적연금은 사회보험역설(social insurance paradox)이 지속되기 힘든 새로운 도전에 직면하였다. 즉, 재정지속가능성은 제도 내적 연금개혁 혹은 제도 외적 재정지원이 없다면 항시적 수지불균형 상태가 누적될 것으로 예측된다. 이에 정부는 직접 고용과 관련된 공무원연금과 군인연금에 대해서만 연금충당부채를 산출하도록 규정하고 있다. 발생주의회계를 채택한 국제회계기준(종업원급여)을 참조하여 연금충당부채 산출을 위한 연금회계준칙(2011.8.3. 제정; 2011.1.1. 시행) 그리고 '연금회계 평가 및 공시 지침(2011.8.3. 고시 : 이하 편의상 연금회계지침이라 함)'을 신설하였다. 사학연금에 적용성 여부 논의에 앞서, 이들의 산출방법상의 문제점을 먼저 살펴보았다. 첫째, 공적연금은 공통적으로 세대 간 합의에 의해 운영되는 사회계약에 해당하므로 제도의 연속성을 전제로 한다. 하지만 연금회계준칙 및 지침은 제도의 청산을 전제로 현재 가입자(연금 미수령자, 연금 수령자)에 대해서 연금충당부채를 산출하는 폐쇄형측정(closed group valuation)을 채택하고 있다. 즉, 폐쇄형은 제도의 연속성 속성을 반영하고 있지 못하고 있어 기본 전제와 모순된다. 둘째, 공무원연금과 군인연금은 이미 기금 소진(최소한의 유동성기금만 보유함)이 되었고 정부의 보전금에 의해 수지 균형이 유지되는 순수부과방식 체계로 전환되었다. 따라서 연금충당부채는 해당 적립기금의 과소 여부를 판정하는 재정상태 기준 값에 해당하므로 기금소진이 진행된 현 상황에서는 산출의 목적, 필요성을 찾기가 힘들다. 부언하면, 제도 외적 재정지원(보전금)에 의한 수지균형방식이라면 발생주의회계보다는 현금주의회계가 회계의 목적적합성이 높다. 마지막으로 연금충당부채 산출에 있어 가장 민감한 할인율 설정 권한을 기재부장관에게 위임한 내용은 산출의 객관성, 일관성을 확보하기 힘들다고 판단된다. 이를 해소하기 위한 방안으로 본 연구에서는 5년마다 실시하고 있는 장기재정계산에서 예측된 명목 기금투자수익률을 연도별로 적용할 것을 권고하고 있다. 현행 정부회계기준을 사학연금제도에 그대로 적용하기에는 상당한 무리가 있다. 그 이유와 공시방안에 대해 살펴본다. 현재 사학연금은 기금소진 이슈로부터 상당부분 벗어나기 위해 2015년 연금개혁을 단행한 바가 있고 이를 통해 상당기간 부분적립방식 체계가 유지될 것이다. 물론 제도 외적 재정지원은 사학연금법 제53조의7에서 정부지원의 가능성만을 열어 놓은 상태이므로 미래기금소진의 가능성은 상존한다고 볼 수 있다. 먼 미래에는 순수부과방식 체계로 전환될 개연성이 높다. 이러한 재정의 양면성을 본 연구에서는 이중재정방식(dual financing system)이라고 한다. 이러한 속성을 고려하여 연금충당부채(연금채무라는 표현이 적합할 것으로 사료됨)를 산출하고 공시하여야 한다. 그 주요 연구 결과는 다음과 같이 요약된다. 먼저 현행 부분적립방식의 재정상태 검증을 위해 연금채무를 산정할 필요성이 있다. 이를 위해 본 연구에서는 기발생주의(예측단위방식 적용)에 근거한 폐쇄형 측정I(제도 종료를 전제로 현 가입자의 잠재연금채무(IPD) 산출에 초점을 둠) 그리고 미래발생주의(가입연령방식 적용)에 근거한 폐쇄형 측정II(추가적으로 현 가입자의 일정기간 급여 및 기여 발생 허용)을 제안하고 있다. 이를 통해 미적립채무의 규모 그리고 이를 해소하기 위한 상각부담률을 산출할 수 있다. 최종적으로 미래 가입자들까지 포함하고 기금소진 가능성까지 고려하는 개방형측정(open group valuation)을 다루고 있다. 단, 본 연구에서는 공무원연금처럼 기금부족분에 대해서 향후 정부보전금이 있다는 가정 하에 공시 방법을 제시하고 있다. 요약하면, 현행 사학연금제도는 현재와 미래의 재정 양면성을 모두 고려하여 연금채무 및 미적립채무를 공시하여야 한다. 부언하면, 현재 부분적립방식 재정상태를 반영하는 연금채무는 발생주의회계를 적용하고 미래에 도래할 순수부과방식 재정상태는 현금주의회계를 적용할 것을 최종 결론으로 도출하고 있다. 마지막으로 본 연구의 한계는 정부보전금의 가능성에 대한 법률적 해석과 병행하여 책임준비금 범위의 안정적 확대를 전제로 한 공시 논의 그리고 보전금의 책임한도 범위에 따른 공시 논의 등은 다루고 있지 않다는 점이다. 이러한 논의 사항은 향후 연구과제로 두고자 한다.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.26 no.4
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• pp.283-304
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• 2015

The purpose of this study was to identify Web accessibility issues of healthcare websites of the Korean government and public agencies by evaluating these websites' accessibility in accordance with the Korean Web Contents Accessibility Guideline. This study conducted both automated and expert testing to assess the accessibility of a total of 27 health-related websites. The results of the assessment which was conducted in two stages indicated that institutions such as the National Hospital and National Rehabilitation Center demonstrated almost no Web accessibility error. In addition, the Korea Health Insurance Review and Assessment Service, the Ministry of Health and Welfare, the Health Services Agency, the Ministry of Food and Drug Safety, and the Korea Medical Dispute Mediation and Arbitration Agency attained very high web accessibility. However, the results of an expert evaluation highlighted that there were considerable errors in providing appropriate alternative text, which was not found in the automated test, and the color contrast of the text content did not comply with Web accessibility standard. Therefore, these websites did not support web accessibility for the sight-impaired. Furthermore, the present study found that it was difficult to deliver accurate information to users due to errors in the default language display and markup, and also, issues of skipping repeated content, content linearization, and compliance with keyboard use were considered as challenges that might arise for people with sight, cognitive and mobility impairments with respect to Web accessibility. It is the first study that evaluated accessibility of healthcare websites of the Korean government and public agencies based on the Korean Web Contents Accessibility Guideline. The present study made a contribution to research on Web accessibility by conducting expert testing, which provided a more complete assessment that identified the degree and specific issues of accessibility errors when compared to automated testing.

• Journal of Korea Port Economic Association
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• v.31 no.4
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• pp.53-73
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• 2015

This study analyzes the economic impact of the shipping and port logistics industry in Gwangyang Bay Area on the regional economy. For this purpose, the study constructs an input-output table of 29 sectors for 2010 in the area. The main findings are as follows. In terms of production, value added, and share of employment, the regional shipping and port logistics industry accounts for approximately 10.8 percent, 6.0 percent, and 2.9 percent of the national shipping and port logistics industry, respectively. Moreover, the economic impact of the industry on the regional economy is estimated to be an increase in terms of production of about 6 trillion Korean won), to be an increase in value added of about 2.5 million Korean won, and an increase of about 16,000 in employment. Furthermore, the industry is found to have strong inter-industry linkages with the main manufacturing as well as the main producer service industries.