• Health Policy and Management
• /
• v.34 no.2
• /
• pp.163-177
• /
• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• International Commerce and Information Review
• /
• v.14 no.3
• /
• pp.49-73
• /
• 2012

India is a gigantic market with a population of 1.2 billion and an economy that is growing at the second-fastest pace in the world. The volume of trade between India and Korea has been sharply increased with the increase of dispute since 2000. Although avoidance of disputes is always a priority, it is also important to prepare methods of dispute resolution which are efficient and economical. So, understanding of Indian dispute resolution system is a necessary requirement for successful business operation with Indian companies. This article analyzed and compared with the various ways of Indian ADR such as negotiation, mediation, conciliation, Lok Adalat and arbitration in order to help the Korean traders who enter into business with the Indian companies to settle their disputes efficiently. In conclusion, this article suggests the following ways to overcome problems of dispute with Indian companies: First, the Korean companies should recognize the characteristics of Indian ADR Ways respectively. Second, the Korean companies should utilize the conciliation or the mediation in small claim but arbitration in large claim. Third, Write a contract and insert the KCAB's standard arbitration clause in their contract.

• Journal of the Korean Data and Information Science Society
• /
• v.28 no.6
• /
• pp.1403-1414
• /
• 2017

The purpose of this study is to examine the factors that affect eating disorder of female adolescents. Collecting data from 297 female adolescents, we carried out logistice regression on SPSS Win 20.0. The significant predictors of eating disorder for female adolescents were BMI, body-shape satisfaction, subjective body-fatness, experience weight control (diet control and exercise), self-control, and body esteem. The results of this study may help to design a school health nursing program which treats female adolescents eating disorder.

• Convergence Security Journal
• /
• v.15 no.7
• /
• pp.63-68
• /
• 2015

In rapid aging society, the disease prevention and management for healthy life of the elderly is very important. Regular physical activity is known to be a useful intervention for the physical and mental health of the elderly. In this study, we explore the convergence contents using IT technology as the intervention for encouraging the regular physical activity in the elderly. There are u-Healthcare and serious game as the convergence of health care and IT technology, and the serious game which is added special purpose such as education, training, and treatment to the fun-one of the game element- can be suitable to provide a variety of contents that leads to physical activity in the elderly. The contents inducing physical activities are "Puffer(ATARI, USA)", "WiiFit(Nintendo, JAPAN)", "Age Invaders(MXR Lab, SINGAPORE)", "Xbox $360^{\circ}$+kinect(Microsoft, USA)", "Tangible bicycle game(Donsin Univ., KOREA)", and "3D Gateball game(Soongsil Univ., KOREA)", and these contents can help health care of the elderly. By increasing physical activity through the use of these contents, it will be able to promote physical fitness and body function required in daily life, disease prevention, and maintain health in the elderly.

• Journal of Industrial Convergence
• /
• v.21 no.8
• /
• pp.97-110
• /
• 2023

This study presents a systematic literature review aimed at integrating and analyzing the research findings regarding the components of various self-care intervention programs conducted for individuals with chronic obstructive pulmonary disease (COPD) both domestically and internationally. The paper selection criteria were established based on materials from PubMed, CINAHL, EMBASE, /MEDLINE, RISS, DBpia, KISS, and KMbase databases, covering the period from January 1, 2000, to September 30, 2022. The inclusion criteria included controlled pre-post experimental study designs. A total of 23 studies were included in this systematic review. The intervention-related factors examined included the sample size, type of intervention mediator, intervention frequency, and duration. Additionally, factors associated with intervention effects, such as measurement tools and variables, were analyzed. The findings of the analysis support the notion that self-care intervention programs for COPD can contribute to the prevention of symptom exacerbation and hospital readmissions among patients. Consequently, the development of a tailored self-care intervention program specifically designed for COPD patients in South Korea is warranted, considering aspects such as patient accessibility, convenience, and motivation for long-term sustainability.

• Journal of Yeungnam Medical Science
• /
• v.16 no.2
• /
• pp.141-154
• /
• 1999

Premature birth is the single largest cause of perinatal mortality and morbidity nonanomalous infants in developing countries. Advances in neonatal care have lead to increase survival and reduced short and long term morbidity for preterm infants, but the rate of preter birth has actually increased. This review provides recent multifactorial approaches to treatme and prevention of preterm birth.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.13 no.4
• /
• pp.887-896
• /
• 2018

The purpose of this preliminary study was to investigate the effect of fall prevention program on the occurrence of falls in inpatients at general hospital. Before the intervention, we identified the occurrence of the rate of falls in I hospital at Incheon and 190 patients received rehabilitation treatment. The causes of falls were carelessness of caregivers and therapists, increased burden of therapists, and height of beds. After recognizing the problems, the authors developed a fall prevention program through the PDCA model. The fall prevention program consisted of a video of fall prevention education and education for the patients and caregivers, environmental improvement and education of therapists for two months. After intervention, 230 patients were subjected to be included as analysis of the incidence of falls included As a result, the fall incidence was reduced by 34.1~66.7% in the pain clinic and 21.3~40.8% in the exercise clinic / department of occupational therapy compared to the before intervention. These findings show that the fall prevention program has a positive effect on the fall of inpatients, and it can be used as a model for fall prevention.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.3
• /
• pp.147-155
• /
• 2020

The purpose of this study was to compare the risk factors of pressure sores and preventive intervention strategies and to provide basic data for the management of pressure sores prevention for long-term care facilities. It was a mixed method study using a systematic literature review and focus group interviews for analysis. A PRISMA flow diagram was prepared in accordance with the research selection process for the systemic literature review. The studies were retrieved from domestic and international studies from 2010 to June, 2019. A total of 8 studies were selected according to the selection criteria. The studies were searched electronically using a search engine with the key words of 'pressure ulcers', 'bedsore', 'decubitus ulcers', 'intervention', 'prevention', 'elderly', and 'long term'. Focus group interviews were conducted through a semi-structured questionnaire for nurses who had worked for more than three years in long-care facilities. The study results suggest that position change and pressure reduction device reduced the incidence of pressure sores and were important for prevention. The use of standardized care protocols is necessary. Multidisciplinary cooperation was an important issue.

• Korean Security Journal
• /
• no.11
• /
• pp.129-157
• /
• 2006

With rapid social change, by culminating the social hazards and the safety problems about it are on the increase too. According to the needs for the safety the demand of the private guard & security provided the safety and security service against danger is also increasing. As the need for the safety is increasing, so recently the private guard & security industry is extended. Therefore the purpose of this study is to grasp and carry out researches into the legal structure on the Security contract, is to analyze the formation of contract and find out the ensuing problem in order to prevent or settle the dispute which is apt to occur between the specific client and the security companies. In order to minimize the dispute going with security relationship in particular, it is necessary that one should write down the agreed contents as the document explicitly to make a security contract with the parties. Hereupon in the plan which standardizes the security contract with each parties autonomously, it is suggested that this study should present the model of Dispute Resolution Clause Especially it is the best means that it is amicable consultation or negotiation as the effective way of settlement methods of private dispute arising from the concerned parties. In inevitable case it recommends the method which solves the dispute by means of an arbitration than litigation at administration of justice(in terms of jurisdiction). If the parties wish to settle the disputes by arbitration, they must come to an arbitration agreement in the form of a arbitration clause in the security contract. After the test and evaluation through application utilizing it in actual security field, the security standard contract regulates about it and this terms should widely apply a individual case to whole industry.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.8 no.12
• /
• pp.1941-1948
• /
• 2013

This study aims discover the relations between health promotion behaviors and metabolic syndrome in daytime workers, in order to present importance for health promotion behaviors of patients with metabolic syndrome. Based on Year 1 data of the 5th Korean National Health Nutrition Examination Survey, emrolled were 1,034 daytime workers. This study discovered that the prevalence rate of metabolic syndrome of the Korean daytime workers was significantly higher as they got older, they had less education level and smoking more, increasing number of health promotion practice behavior were decrease the metabolic syndrome prevalence. Effective appropriate lifestyle intervention were considered to management and prevention of daytime workers with the metabolic syndrome for low-cost and efficiently.