• Title/Summary/Keyword: 정기신(精氣神)

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Guidelines for the Management of Hydronephrosis Detected in the Perinatal Period (주산기에 발견된 수신증의 자연 경과와 치료 방침)

  • Chae Soo-Ho;Lee Ji-Hyuk;Jin Dong-Kyu;Park Kwan-Hyun;Paik Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.33-39
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    • 2006
  • Purpose : Neonatal hydronephrosis is diagnosed with an incidence of 4.5-7% of pregnancies. Recently, early detection of neonatal hydroneprosis with antenatal ultrasonography has be-come possible. But consensus about its management has not been reached, especially concerning surgical intervention. The purpose of this study is to analyze the natural course of neonatal hydronephrosis and to determine the guideline of surgical intervention and follow up study. Methods : Sixty nine hydronephrotic kidneys were confirmed from April 2001 to April 2005. All cases were rechecked by ultrasonography once at least and had a minimum follow-up of 6 months. We classified the patients into 4 groups according to the anterior posterior pelvic diameter(APPD) on perinatal ultrasonography. Ultrasonography to measure the APPD diameter and Society for Fetal Urology(SFU) grade, $^{99m}Tc-MAG3$ scan were done to a set protocol. Pyeloplasty was peformed according to the protocol. Results : Pyeloplasty was not needed in most cases where the APPD was below 10 mm and where the SFU grade were less than grade 3. Many cases with APPD 10 mm above or SFU grade III above had undergone pyeloplasty. We found a correlation between obstruction grade on MAG3 scan and whether surgery was performed or not. Conclusion : If APPD is above 10 mm, SFU grade is above grade 3 or urinary tract obstruction is suspected by MAG3 scan, pyeloplasty must be considered. In cases where APPD is below 10mm and SFU grade is less than grade 3, we can observe the natural course of neonatal hydronephrosis with consecutive follow-up. (J Korean Soc Pediatr Nephrol 2006;10:33-39)

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An analysis of current condition of student's selection process in Hansung science highschool (한성과학고등학교 학생 선발과정의 현황 분석)

  • Dong, Hyo-Kwan;Jhun, Young-Seok
    • Journal of Gifted/Talented Education
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    • v.13 no.4
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    • pp.65-94
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    • 2003
  • The purpose of this study is to acquire the information on the current situation of students' selection process in order to renovate the system of picking up the students. As a first step of the study, we examined the validity of the factors of the single-out system such as qualification and the process for the application and the standards and proceeding of the selection. Then we analysed the result of the entrance examination of Hansung Science Highschool in 2002. The analysis was on the correlation between the result of entrance examination and the achievement in the school and the decision of the course after graduation. To know on the achievement of the students, we investigated the records of regular tests and asked the teachers' opinion in math and science classes. As a result, we gained the following points: First, the present single-out system has a danger of excluding students who are much talented in science and math field because it is based on students' achievements in middle schools; Second, the new selection system should consider the character and attitude of the applicants in addition to their knowledge; Third, the continuous observation of the teacher in middle school should be an important factor of the picking up system; Fourth, more questions requiring divergent thinking ability and inquiry skill should be developed as selective examination question. Also examination questions should cover the various contents from mathematics to science, and do not affect pre-learning; Finally, the system of present letting all students stand in one line should be changed into that of letting students in various lines. We can consider using multi-step selection system.

A Study on the Landscape Architecture Historical Significance of Reung Chambong in the Joseon Dynasty (조선시대 능참봉직(陵參奉職)의 조경사적 의의)

  • Shin, Hyun-Sil;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.2
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    • pp.139-148
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    • 2011
  • This study has a purpose of base study for ascertaining landscape architect's role of Reung Chambong through analyzing old literature include Kyungkukdae-Jeon, Sokdae-Jeon, Daejeonhoitong, Joseonwangjo-Sillok, Eugye, Reung-Ji, Ilsung-Rok, Reung Chambong's diary. Reung Chambong was a government post in the Joseon dynasty, who managed Royal Tombs of Joseon Dynasty that has promoted as a World Heritage of UNESCO. the conclusions drawn from this study are as follows. First, Reung Chambong was comprised of two Jong 9 pum Chanmbong members. a position of Reung Chambong was a Eumjik appointed Saengwon, Jinsa, Yuhak completed Sammang. the standards of appointment is a experienced person and too young. it became means for accessing a government post because it had a symbolic representation of Royal Tombs guardian. Second, The management system of Reung Chambong was approved on the basis of ranking. however, due to geographical reasons, they had much authority and various mission than is possible. for example, construction supervisor of the Reung and Bongsim, manager of the Reungsuhogun and filling out Reungji. they performed an important role in management of Royal Tombs in the Joseon dynasty. Third, One of tasks related in landscape architecture, a Bongshim reported Sukmul(stonework), Sacho, Jungja-Gak of Reungsang to Yejo periodically. formational system and method of Bongshim are provided in the Kyungkukdae-Jeon and Sokdae-Jeon detailedly. Fourth, Tree management and construction supervisor of Reungsang, positions among tasks related in landscape architecture, required basic understanding and management ability of botany, various eye for spatial perception includes civil and architectural projects. also, as a site management of Royal Tombs in the Joseon dynasty, Reung Chambong was empowered tacit authorization and responsibility in mobility preoccupancy of vertical relationship with local officials and handling by-product of site. there is a close correspondence with landscape architect of today. A follow-up research is required to ascertain landscape architect historical values of Royal Tombs in the Joseon dynasty and Reung Chambong's role as a site management of Royal Tombs in the Joseon dynasty through historical seeking and research old literature on Reung Chambong's role related in landscape architect.

Market evaluation and marketing strategy to expand the consumption of Pleurotus nebrodensis variety 'Uram' (백령느타리 '우람'의 소비확대를 위한 시장평가와 마케팅 전략)

  • Kim, Yeon-Jin;Lee, Ja-Young;Kim, Jeong-Han;Choi, Jun-Yeong;Lee, Chae-Young;Lee, Chan-Jung;Lim, Gab-June
    • Journal of Mushroom
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    • v.20 no.3
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    • pp.173-177
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    • 2022
  • Mushroom production in Korea is concentrated on five major mushroom types. To create a new source of income for farmers, it is necessary to establish new mushroom production and marketing systems. This study was conducted to evaluate the marketability of and establish a marketing strategy for Pleurotus nebrodensis variety 'Uram'. The evaluation of distributors showed that it was necessary to cultivate mushrooms of uniform shape and size, to compensate for their low storability, and to sell them in small packages. The consumer evaluation showed that the texture of P. nebrodensis had the highest level of satisfaction for quality, but the levels of satisfaction for size and shape were low. In the consumer evaluation, as in the distributor evaluation, improvements in cultivation were found to be necessary, as the storage time is short due to a high moisture content. An evaluation of the market gave the following results regarding the marketing strategy. It was found to be necessary to consider the production of mushrooms of a uniform shape and size and sell them in small packages in the range of 150 to 300 g. The price of the mushrooms should be set using a high-end strategy for high-end sales. The mushrooms should be introduced to local food and eco-friendly stores in the early stages of production. Subsequently, if farmhouse production increases, shipments should be made to wholesale markets through a regular contract. Finally, considering that P. nebrodensis is an unfamiliar mushroom to consumers, it is necessary to promote it by increasing the accessibility of consumers through tasting events and experience groups.

Trends of Dental Treatment under General Anesthesia and Patterns of Repeated General Anesthesia in Children and Adolescents with Severe Disabilities (소아청소년의 전신마취 하 치과 치료의 추세변화 및 치과 영역 중증 장애 유무에 따른 전신마취 재시행 양상에 대한 연구)

  • Ahreum Lee;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.1
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    • pp.75-88
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    • 2023
  • The aim of this retrospective study was to evaluate the demographic characteristics of pediatric dental patients who underwent dental treatment under general anesthesia (DTGA) at the Seoul National University Dental Hospital from January 2011 through December 2020 and compare the patterns of repeated DTGA between dental patients with severe disabilities (DSD) and non-DSD (healthy or medically compromised patients without DSD). There were 1,857 DTGAs among 1,719 patients (mean age = 5.1 years; males = 59.3%; ASA 2 or above = 52.9%; DSD = 26.8%). Overall, 6.6% of patients underwent repeated DTGA, and the rate of repeated DTGA over a 10-year period was 7.4%. ASA 2 or above (p < 0.0001) and DSD (p < 0.0001) were more likely to undergo repeated DRGA compared to ASA 1 and non-DSD. At both GA1 and GA2, DSD received significantly more restorative treatment on permanent teeth than non-DSD (p = 0.002, p < 0.0001, respectively). There has been an increasing demand for DTGA in pediatric dentistry over the last 10 years. Regular check-ups and preventive oral health care are necessary for pediatric dental patients with severe disabilities to reduce the possibility of repeated DTGA.

Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

Categorizing Quality Features of Franchisees: In the case of Korean Food Service Industry (프랜차이즈 매장 품질요인의 속성분류: 국내 외식업을 중심으로)

  • Byun, Sook-Eun;Cho, Eun-Seong
    • Journal of Distribution Research
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    • v.16 no.1
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    • pp.95-115
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    • 2011
  • Food service is the major part of franchise business in Korea, accounting for 69.9% of the brands in the market. As the food service industry becomes mature, many franchisees have struggled to survive in the market. In general, consumers have higher levels of expectation toward service quality of franchised outlets compared that of (non-franchised) independent ones. They also tend to believe that franchisees deliver standardized service at the uniform food price, regardless of their locations. Such beliefs seem to be important reasons that consumers prefer franchised outlets to independent ones. Nevertheless, few studies examined the impact of qualify features of franchisees on customer satisfaction so far. To this end, this study examined the characteristics of various quality features of franchisees in the food service industry, regarding their relationship with customer satisfaction and dissatisfaction. The quality perception of heavy-users was also compared with that of light-users in order to find insights for developing differentiated marketing strategy for the two segments. Customer satisfaction has been understood as a one-dimensional construct while there are recent studies that insist two-dimensional nature of the construct. In this regard, Kano et al. (1984) suggested to categorize quality features of a product or service into five types, based on their relation to customer satisfaction and dissatisfaction: Must-be quality, Attractive quality, One-dimensional quality, Indifferent quality, and Reverse quality. According to the Kano model, customers are more dissatisfied when Must-be quality(M) are not fulfilled, but their satisfaction does not arise above neutral no matter how fully the quality fulfilled. In comparison, customers are more satisfied with a full provision of Attactive quality(A) but manage to accept its dysfunction. One-dimensional quality(O) results in satisfaction when fulfilled and dissatisfaction when not fulfilled. For Indifferent quality(I), its presence or absence influences neither customer satisfaction nor dissatisfaction. Lastly, Reverse quality(R) refers to the features whose high degree of achievement results in customer dissatisfaction rather than satisfaction. Meanwhile, the basic guidelines of the Kano model have a limitation in that the quality type of each feature is simply determined by calculating the mode statistics. In order to overcome such limitation, the relative importance of each feature on customer satisfaction (Better value; b) and dissatisfaction (Worse value; w) were calculated following the formulas below (Timko, 1993). The Better value indicates how much customer satisfaction is increased by providing the quality feature in question. In contrast, the Worse value indicates how much customer dissatisfaction is decreased by providing the quality feature. Better = (A + O)/(A+O+M+I) Worse = (O+M)/(A+O+M+I)(-1) An on-line survey was performed in order to understand the nature of quality features of franchisees in the food service industry by applying the Kano Model. A total of twenty quality features (refer to the Table 2) were identified as the result of literature review in franchise business and a pre-test with fifty college students in Seoul. The potential respondents of our main survey was limited to the customers who have visited more than two restaurants/stores of the same franchise brand. Survey invitation e-mails were sent out to the panels of a market research company and a total of 257 responses were used for analysis. Following the guidelines of Kano model, each of the twenty quality features was classified into one of the five types based on customers' responses to a set of questions: "(1) how do you feel if the following quality feature is fulfilled in the franchise restaurant that you visit," and "(2) how do you feel if the following quality feature is not fulfilled in the franchise restaurant that you visit." The analyses revealed that customers' dissatisfaction with franchisees is commonly associated with the poor level of cleanliness of the store (w=-0.872), kindness of the staffs(w=-0.890), conveniences such as parking lot and restroom(w=-0.669), and expertise of the staffs(w=-0.492). Such quality features were categorized as Must-be quality in this study. While standardization or uniformity across franchisees has been emphasized in franchise business, this study found that consumers are interested only in uniformity of price across franchisees(w=-0.608), but not interested in standardizations of menu items, interior designs, customer service procedures, and food tastes. Customers appeared to be more satisfied when the franchise brand has promotional events such as giveaways(b=0.767), good accessibility(b=0.699), customer loyalty programs(b=0.659), award winning history(b=0.641), and outlets in the overseas market(b=0.506). The results are summarized in a matrix form in Table 1. Better(b) and Worse(w) index indicate relative importance of each quality feature on customer satisfaction and dissatisfaction, respectively. Meanwhile, there were differences in perceiving the quality features between light users and heavy users of any specific franchise brand in the food service industry. Expertise of the staffs was labeled as Must-be quality for heavy users but Indifferent quality for light users. Light users seemed indifferent to overseas expansion of the brand and offering new menu items on a regular basis, while heavy users appeared to perceive them as Attractive quality. Such difference may come from their different levels of involvement when they eat out. The results are shown in Table 2. The findings of this study help practitioners understand the quality features they need to focus on to strengthen the competitive power in the food service market. Above all, removing the factors that cause customer dissatisfaction seems to be the most critical for franchisees. To retain loyal customers of the franchise brand, it is also recommended for franchisor to invest resources in the development of new menu items as well as training programs for the staffs. Lastly, if resources allow, promotional events, loyalty programs, overseas expansion, award-winning history can be considered as tools for attracting more customers to the business.

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The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

The Advancement of Underwriting Skill by Selective Risk Acceptance (보험Risk 세분화를 통한 언더라이팅 기법 선진화 방안)

  • Lee, Chan-Hee
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.49-78
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    • 2005
  • Ⅰ. 연구(硏究) 배경(背景) 및 목적(目的) o 우리나라 보험시장의 세대가입율은 86%로 보험시장 성숙기에 진입하였으며 기존의 전통적인 전업채널에서 방카슈랑스의 도입, 온라인전문보험사의 출현, TM 영업의 성장세 等멀티채널로 진행되고 있음 o LTC(장기간병), CI(치명적질환), 실손의료보험 등(等)선 진형 건강상품의 잇따른 출시로 보험리스크 관리측면에서 언더라이팅의 대비가 절실한 시점임 o 상품과 마케팅 等언더라이팅 측면에서 매우 밀접한 영역의 변화에 발맞추어 언더라이팅의 인수기법의 선진화가 시급히 요구되는 상황하에서 위험을 적절히 분류하고 평가하는 선진적 언더라이팅 기법 구축이 필수 적임 o 궁극적으로 고객의 다양한 보장니드 충족과 상품, 마케팅, 언더라이팅의 경쟁력 강화를 통한 보험사의 종합이익 극대화에 기여할 수 있는 방안을 모색하고자 함 Ⅱ. 선진보험시장(先進保險市場)Risk 세분화사례(細分化事例) 1. 환경적위험(環境的危險)에 따른 보험료(保險料) 차등(差等) (1) 위험직업 보험료 할증 o 미국, 유럽등(等) 대부분의 선진시장에서는 가입당시 피보험자의 직업위험도에 따라 보험료를 차등 적용중(中)임 o 가입하는 보장급부에 따라 직업 분류방법 및 할증방식도 상이하며 일반사망과 재해사망,납입면제, DI에 대해서 별도의 방법을 사용함 o 할증적용은 표준위험율의 일정배수를 적용하여 할증 보험료를 산출하거나, 가입금액당 일정한 추가보험료를 적용하고 있음 - 광부의 경우 재해사망 가입시 표준위험율의 300% 적용하며, 일반사망 가입시 $1,000당 $2.95 할증보험료 부가 (2) 위험취미 보험료 할증 o 취미와 관련 사고의 지속적 다발로 취미활동도 위험요소로 인식되어 보험료를 차등 적용중(中)임 o 할증보험료는 보험가입금액당 일정비율로 부가(가입 금액과 무관)하며, 신종레포츠 등(等)일부 위험취미는 통계의 부족으로 언더라이터가 할증율 결정하여 적용함 - 패러글라이딩 년(年)$26{\sim}50$회(回) 취미생활의 경우 가입금액 $1,000당 재해사망 $2, DI보험 8$ 할증보험료 부가 o 보험료 할증과는 별도로 위험취미에 대한 부담보를 적용함. 위험취미 활동으로 인한 보험사고 발생시 사망을 포함한 모든 급부에 대한 보장을 부(不)담보로 인수함. (3) 위험지역 거주/ 여행 보험료 할증 o 피보험자가 거주하고 있는 특정국가의 임시 혹은 영구적 거주시 기후위험, 거주지역의 위생과 의료수준, 여행위험, 전쟁과 폭동위험 등(等)을 고려하여 평가 o 일반사망, 재해사망 등(等)보장급부별로 할증보험료 부가 또는 거절 o 할증보험료는 보험全기간에 대해 동일하게 적용 - 러시아의 경우 가입금액 $1,000당 일반사망은 2$의 할증보험료 부가, 재해사망은 거절 (4) 기타 위험도에 대한 보험료 차등 o 비행관련 위험은 세가지로 분류(항공운송기, 개인비행, 군사비행), 청약서, 추가질문서, 진단서, 비행이력 정보를 바탕으로 할증보험료를 부가함 - 농약살포비행기조종사의 경우 가입금액 $1,000당 일반사망 6$의 할증보험료 부가, 재해사망은 거절 o 미국, 일본등(等)서는 교통사고나 교통위반 관련 기록을 활용하여 무(無)사고운전자에 대해 보험료 할인(우량체 위험요소로 활용) 2. 신체적위험도(身體的危險度)에 따른 보험료차등(保險料差等) (1) 표준미달체 보험료 할증 1) 총위험지수 500(초과위험지수 400)까지 인수 o 300이하는 25점단위, 300점 초과는 50점 단위로 13단계로 구분하여 할증보험료를 적용중(中)임 2) 삭감법과 할증법을 동시 적용 o 보험금 삭감부분만큼 할증보험료가 감소하는 효과가 있어 청약자에게 선택의 기회를 제공할수 있으며 고(高)위험 피보험자에게 유용함 3) 특정암에 대한 기왕력자에 대해 단기(Temporary)할증 적용 o 질병성향에 따라 가입후 $1{\sim}5$년간 할증보험료를 부가하고 보험료 할증 기간이 경과한 후에는 표준체보험료를 부가함 4) 할증보험료 반환옵션(Return of the extra premium)의 적용 o 보험계약이 유지중(中)이며, 일정기간 생존시 할증보험료가 반환됨 (2) 표준미달체 급부증액(Enhanced annuity) o 영국에서는 표준미달체를 대상으로 연금급부를 증가시킨 증액형 연금(Enhanced annuity) 상품을 개발 판매중(中)임 o 흡연, 직업, 병력 등(等)다양한 신체적, 환경적 위험도에 따라 표준체에 비해 증액연금을 차등 지급함 (3) 우량 피보험체 가격 세분화 o 미국시장에서는 $8{\sim}14$개 의적, 비(非)의적 위험요소에 대한 평가기준에 따라 표준체를 최대 8개 Class로 분류하여 할인보험료를 차등 적용 - 기왕력, 혈압, 가족력, 흡연, BMI, 콜레스테롤, 운전, 위험취미, 거주지, 비행력, 음주/마약 등(等) o 할인율은 회사, Class, 가입기준에 따라 상이(최대75%)하며, 가입연령은 최저 $16{\sim}20$세, 최대 $65{\sim}75$세, 최저보험금액은 10만달러(HIV검사가 필요한 최저 금액) o 일본시장에서는 $3{\sim}4$개 위험요소에 따라 $3{\sim}4$개 Class로 분류 우량체 할인중(中)임 o 유럽시장에서는 영국 등(等)일부시장에서만 비(非)흡연할인 또는 우량체할인 적용 Ⅲ. 국내보험시장(國內保險市場) 현황(現況)및 문제점(問題點) 1. 환경적위험도(環境的危險度)에 따른 가입한도제한(加入限度制限) (1) 위험직업 보험가입 제한 o 업계공동의 직업별 표준위험등급에 따라 각 보험사 자체적으로 위험등급별 가입한도를 설정 운영중(中)임. 비(非)위험직과의 형평성, 고(高)위험직업 보장 한계, 수익구조 불안정화 등(等)문제점을 내포하고 있음 - 광부의 경우 위험1급 적용으로 사망 최대 1억(億), 입원 1일(日) 2만원까지 제한 o 금융감독원이 2002년(年)7월(月)위험등급별 위험지수를 참조 위험율로 인가하였으나, 비위험직은 70%, 위험직은 200% 수준으로 산정되어 현실적 적용이 어려움 (2) 위험취미 보험가입 제한 o 해당취미의 직업종사자에 준(準)하여 직업위험등급을 적용하여 가입 한도를 제한하고 있음. 추가질문서를 활용하여 자격증 유무, 동호회 가입등(等)에 대한 세부정보를 입수하지 않음 - 패러글라이딩의 경우 위험2급을 적용, 사망보장 최대 2 억(億)까지 제한 (3) 거주지역/ 해외여행 보험가입 제한 o 각(各)보험사별로 지역적 특성상 사고재해 다발 지역에 대해 보험가입을 제한하고 있음 - 강원, 충청 일부지역 상해보험 가입불가 - 전북, 태백 일부지역 입원급여금 1일(日)2만원이내 o 해외여행을 포함한 해외체류에 대해서는 일정한 가입 요건을 정하여 운영중(中)이며, 가입한도 설정 보험가입을 제한하거나 재해집중보장 상품에 대해 거절함 - 러시아의 경우 단기체류는 위험1급 및 상해보험 가입 불가, 장기 체류는 거절처리함 2. 신체적위험도(身體的危險度)에 따른 인수차별화(引受差別化) (1) 표준미달체 인수방법 o 체증성, 항상성 위험에 대한 초과위험지수를 보험금삭감법으로 전환 사망보험에 적용(최대 5년(年))하여 5년(年)이후 보험 Risk노출 심각 o 보험료 할증은 일부 회사에서 주(主)보험 중심으로 사용중(中)이며, 총위험지수 300(8단계)까지 인수 - 주(主)보험 할증시 특약은 가입 불가하며, 암 기왕력자는 대부분 거절 o 신체부위 39가지, 질병 5가지에 대해 부담보 적용(입원, 수술 등(等)생존급부에 부담보) (2) 비(非)흡연/ 우량체 보험료 할인 o 1999년(年)최초 도입 이래 $3{\sim}4$개의 위험요소로 1개 Class 운영중(中)임 S생보사의 경우 비(非)흡연우량체, 비(非)흡연표준체의 2개 Class 운영 o 보험료 할인율은 회사, 상품에 따라 상이하며 최대 22%(영업보험료기준)임. 흡연여부는 뇨스틱을 활용 코티닌테스트를 실시함 o 우량체 판매는 신계약의 $2{\sim}15%$수준(회사의 정책에 따라 상이) Ⅳ. 언더라이팅 기법(技法) 선진화(先進化) 방안(方案) 1. 직업위험도별 보험료 차등 적용 o 생 손보 직업위험등급 일원화와 연계하여 3개등급으로 위험지수개편, 비위험직 기준으로 보험요율 차별적용 2. 위험취미에 대한 부담보 적용 o 해당취미를 원인으로 보험사고(사망포함) 발생시 부담보 제도 도입 3. 표준미달체 인수기법 선진화를 통한 인수범위 대폭 확대 o 보험료 할증법 적용 확대를 통한 Risk 헷지로 총위험지수 $300{\rightarrow}500$으로 확대(거절건 최소화) 4. 보험료 할증법 보험금 삭감 병행 적용 o 삭감기간을 적용한 보험료 할증방식 개발, 고객에게 선택권 제공 5. 기한부 보험료할증 부가 o 위암, 갑상선암 등(等)특정암의 성향에 따라 위험도가 높은 가입초기에 평준할증보험료를 적용하여 인수 6. 보험료 할증법 부가특약 확대 적용, 부담보 병행 사용 o 정기특약 등(等)사망관련 특약에 할증법 확대, 생존급부 특약은 부담보 7. 표준체 고객 세분화 확대 o 콜레스테롤, HDL 등(等)위험평가요소 확대를 통한 Class 세분화 Ⅴ. 기대효과(期待效果) 1. 고(高)위험직종사자, 위험취미자, 표준미달체에 대한 보험가입 문호개방 2. 보험계약자간 형평성 제고 및 다양한 고객의 보장니드에 부응 3. 상품판매 확대 및 Risk헷지를 통한 수입보험료 증대 및 사차익 개선 4. 본격적인 가격경쟁에 대비한 보험사 체질 개선 5. 회사 이미지 제고 및 진단 거부감 해소, 포트폴리오 약화 방지 Ⅵ. 결론(結論) o 종래의 소극적이고 일률적인 인수기법에서 탈피하여 피보험자를 다양한 측면에서 위험평가하여 적정 보험료 부가와 합리적 가입조건을 제시하는 적절한 위험평가 수단을 도입하고, o 언더라이팅 인수기법의 선진화와 함께 언더라이팅 인력의 전문화, 정보입수 및 시스템 인프라의 구축 등이 병행함으로써, o 보험사의 사차손익 관리측면에서 뿐만 아니라 보험시장 개방 및 급변하는 보험환경에 대비한 한국 생보언더라이팅 경쟁력 강화 및 언더라이터의 글로벌화에도 크게 기여할 것임.

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