• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• Korean Security Journal
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• no.17
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• pp.255-276
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• 2008

The important items, which should be considered in Private Investigation Law, can include subjects, licenses, the scope of business, qualifying examinations, and supervisory and penal provisions. The subjects of Private Investigation Law should be permitted to be both natural persons and juridical persons in terms of providing various services, but should be permitted to be juridical persons and should be administered on a license system, even in order to ensure public interests. Concretely, the introduction scope of Private Investigation Law can be regulated to include the followings: that is, investigating the whereabouts identification of runaways and missing children, investigating the personal identification, habit, way of action, motivation, whereabouts identification, real child confirmation, association, transaction, reputation, and personality of specific persons or specific groups, investigating the whereabouts identification of missing persons, owners of government-vested properties or renounced properties, investigating the whereabouts of lost properties or stolen properties, investigating the causes of fire, character defamation, slander, damage, accident, physical disability, infringement on real estate or movable property, and investigating all sorts of accidents including traffic accidents, insurance accidents, and medical malpractices. In the qualifying examination, examinees' age should be restricted to be over age 25. The person, who is exempted from its primary examination, should be restricted to be the person, who has the career of over 20 years in related fields, in consideration of its equity with other certificates of qualification. In the supervisory institution, as the policy institution is the supervisory institution in many countries including France (the police) and Japan (public security committee), so the National Policy Agency should be the supervisory institution in consideration of management aspects. In the penal regulations, especially, we should clarify the management of personal information (personal information protection, personal information management), and so should prevent the infringement of people's basic rights, and then should ensure the public interest.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.1
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• pp.28-35
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• 2020

This study aimed to investigate the differences in the upper and lower limits of the 95% distribution of fasting blood glucose (FBG) by age groups. We also analyzed the changes in the mean values and dispersion of the data using the Korean Blood Glucose Reference Standard raw data published by the National Health Insurance Service (NHIS). Furthermore, the trends among 16 administrative districts were analyzed and any gender differences were determined. We also assessed whether the study results correlated with the relative standard uncertainty, as published by the NHIS. On the dispersion analysis using the differences between the upper and lower limits of the 95% distribution of FBG by age group, there were significant differences across gender and administrative districts (P<0.05). The gender differences in FBG measurements, as published by the NHIS, were significant across different administrative districts and age groups (P<0.001). This confirmed the need to recalculate the blood glucose reference standards for men and women. No significant correlation was observed between the relative standard uncertainty, as published by NHIS, and the dispersion and number of measurements analyzed in this study. However, it showed a high correlation with the measured mean value (R²=0.95). Therefore, further research on the reference standard and uncertainty is needed.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.14 no.4
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• pp.233-238
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• 1981

A recirculating water system without filter bed was used for a high density experimental rearing of common carp, Cyprinus carpio, during the summer of 1981. Of the water system, 3 tanks were used for stocking each tank with 10,000, 20,000 and 30,000 common carp fingerlings which averaged 0.6 g. The water in the system was maintained in dark green colour by heavy growth of phytoplankton during the most period of the experiment. In this experiment, the best daily growth rate, $3.7\%$, was obtained from the 10,000 fish group followed by $2.8\%\;and\;3.0\%$ from the 20,000 and 30,000 fish groups respectively. Thus there was no significant difference between the latter two groups. Especially, notably high concentration of total ammonia, $5\sim7$ ppm ammonia-N, in the culture water appeared during the most experimental period, but this did not seem to have affected feeding and growth of the fish when the water was kept at heavy bloom. It was also obvious that the outbreak of columnaris disease was effectively depressed in this green water recirculating system compared to that in clarified recirculating system. One tank ($7m^2$) of this system was stocked with 446 common carp of intermediate size averaging 352.2 g and after 40 day rearing they grew to 486.3 g in average with a daily growth rate of $0.8\%$. This result was a little inferior to that reared in a tank of the clarified water system as control which showed $1.0\%$ daily growth rate. Therefore, before an initiation of the commercial production of fish in this method, further studies concerning the amount of ammonium with its effect on the fish under rearing in this system and the columnaris disease problem should be carried out.

• Journal of Oral Medicine and Pain
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• v.33 no.4
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• pp.353-374
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• 2008

The descriptive epidemiology of specific neuropathic pain disorders has not been well-des-cribed, although the burden of neuropathic pain is well recognized. The true incidence of neuro-pathic pain disorder is unknown, but it is believed to be under diagnosed and treated inade-quately, despite the development of various diagnostic system. The purpose of this study was to report the epidemiology of specific neuropathic pain as managed by all kinds of hospital in Korea. A descriptive analysis of the epidemiology of prevalent trigeminal neuralgia(TN)(n-=77,053 27,6%), atypical facial pain(AFP)(n=12,382 4.4%), glossopharyngeal neuralgia(GN)-(n=1,319 0.5%), post-herpetic neuralgia(PHN)-(n=84,598 30.3%), diabetic neuropathy(DN)-(n=85,989 30.8%), atypical odontalgia(AO)-(n=16,001 5.7%) and glossodynia(GD)(n=2,133 0.8%) and treatment departments and treatment durations from computerized Health Insurance Review and Assessment Service(HIRA) of Korea: January 2003 to December 2005, are reported with rates increasing over time for PHN and DN and decreasing for the other neuropathic pain disorders. Most patients were treated at private clinic record for 57.6-72.8% of patients except OA for 10.3%. The percentage of Dept of dentistry for outpatients was 3.2% for TN, 34.7% for AO and 15.4% for GD. Other neuropathic pain patients visited nearly medical clinic.

• Journal of the Korea Society of Computer and Information
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• v.5 no.4
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• pp.28-40
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• 2000

As the surrounding of companies is more complicated and intensive. many companies attempt managerial innovations by using information technology(IT) strategically. Recently, information technology, especially Electronic Data Interchange(EDI), is highlighted in the surrounding of companies, because it is regarded as a core technology. EDI is the direct computer-to-computer exchange of business documents in standard formats. EDI brings many benefits to the organization such as reduced costs, faster turnaround, better customer service, and strategic advantage. The Purpose of this study is to identify the effects of relational characteristics-communication, trust, conflict, and commitment- on the performance of Business-to-Business EC. In other words, this study examine the relationships between each characteristics and the effects of these characteristics on the organizational performance. The results of empirical analysis revealed that communications between parties have positive influence on the trust and commitment, and high label of commitment on the EDI is improved the organizational performance. In addition, trust in parties indirectly affects characteristics has unexpectedly positive influence on the trust, commitment, and performance.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.609-618
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• 2013

This study aims to identify utilization status of medical care and factors to affect quality of life in diabetes mellitus patients. The research selected 6,146 adults aged over 50, who appeared with EQ-5D, from the Korean health panel. We analyzed states of medical care utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with quality of life in diabetes patients. The result shows that quality of life(EQ-5D) in diabetes is significantly associated with gender, age, insurance type, education level, household income, diabetes ambulatory medical cost and the number of ambulatory medical utilization for other diseases. Females, higher age, lower levels of education, medicaid, the lower household income, the higher diabetes ambulatory medical cost, and the higher the number of ambulatory medical utilization for other diseases were the significant factors of lower quality of life. Therefore, it is necessary to develop effective social programs and individualized approach to improve the quality of life in diabetes patients. In the future, these findings can be used as important data for health care policy and assessment.

• Korean Journal of Social Welfare
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• v.53
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• pp.105-128
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• 2003

This study examined the factors affecting family caregiver's preference for utilization of community care services among those who are caring for 65+ elderly parents, and aimed to show how social eldercare services would be settled in Korea. Help-seeking behavior model developed by Anderson and Newman(1973) was used to analyze the factors affecting their preference for utilizing the community care service among 283 family caregivers. Frequency, Chi-square, and Multinominal logistic analysis on SAS 6.12 was used. According to the results, about 90% of the family caregivers have preference for community and institute care services. In community care service, about a half comprise the preference with charge while the other without charge. However, about 90% of those for institute care service show their willingness to pay for the service. Also, a majority of caregivers like to rely on social eldercare service, rather than family as exclusively responsible, against long-term care for their elderly parents. Multinominal analysis demonstrates that use versus nonuse of community care services is primarily affected by predisposing factors(including age, carer-caree closeness, and familism) and need factors (including economic or psychological burden of eldercare, and additional role for family care). Enabling factors, such as family income level, economic support from other family members and siblings, and supportive care-helpers, are mainly associated with the preferences of free versus charge in service use. These findings provide some implications and suggestions for the development of social eldercare services in our aging society.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.33-49
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• 2017

Background: Health care utilizations and costs of the patients with degenerative lumbar spine disease in Korea increased dramatically. We analyzed whether hospital market competition is associated with charges and length of stay for patients with degenerative lumbar spine disease. Methods: We used Medical claims data of 2002 and 2010 from the nationwide representative sample of National Health Insurance Service of Korea. The study subjects were inpatients with degenerative lumbar spine disease (N=24,768) in 2002 and 2010. We employed a multilevel linear mixed model that included patient- and hospital-level variables in hierarchical data. Results: Higher hospital competition was associated with lower charges (${\beta}=57.5$, p<.0001 in 2002; ${\beta}=353.7$, p<.0001 in 2010) and shorter length of stay (${\beta}=0.3$, p<.0001 in 2002; ${\beta}=0.9$, p<.0001 in 2010) in both 2002 and 2010. Compared to 2002, the magnitude of such association became greater in 2010. However, subgroup analyses show that the influence of competition on charges and length of stay differed by hospital size. Conclusions: This study showed that hospital market structure (e.g., hospital competition) affects hospital efficiency (i.e., hospital charges and length of stay). It is necessary to continue to monitor how changing market structure influences hospital outcomes, including more detailed outcomes such as patient satisfaction.

• The Journal of the Korea institute of electronic communication sciences
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• v.8 no.7
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• pp.1103-1110
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• 2013

This study was investigated the subjects' satisfaction in the therapy among the internet age. The subjects of the study were 200 women who have menses in ages from 18 to 55 among visitors of five public health centers and attendants of A church in Gwangju. The period of the study ranged from September 6 to October 10, 2010. As a study instrument, this study used a questionnaire developed based on questions from studies published by An Seung-duk(2003). This study used SPSS 17.0, for a frequency analysis, a cross-tabulation and a chi-squared test. During the analysis, 43.4% of the subjects used the complementary alternative therapy. 56.3% visited used oriental medical clinics or herbal medicine shops as places to use the therapy, 42.5% received medicine, acupuncture, moxibustion and cupping at oriental medical clinics. As expenses of the therapy, 56.3% spent less than 500,000 won a year. After the therapy, 51% answered they were satisfied with the therapy. In conclusion, it was discovered that use rate of the therapy is increasing, the subjects decided to use the therapy for themselves or through recommendation from acquaintances, and they mainly depended on reliable oriental medical clinics or folk remedies against menstrual pain, and insurance benefits for the therapy should be considered except oriental medical hospitals or clinics.