• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Health Policy and Management
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• v.34 no.2
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• pp.196-210
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• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.115-127
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• 2023

Background: This study was conducted to determine the level of job satisfaction and patient safety cultural activities for dental hygienists and to determine the relationship between job satisfaction and patient safety cultural activities. Methods: A survey was conducted on 214 dental hygienists, and data from the final 180 were analyzed. Job satisfaction consisted of a total of 20 questions, and patient safety cultural activities included a total of 25 questions. The survey was conducted on a 5-point scale. Results: The average job satisfaction score of the study subjects was 3.44 points. Among patient safety cultural activities, infection control had the highest average score (4.12 points) and radiation safety management had the lowest average score (3.10 points). Patients with less than 3 years of clinical experience (4.01 points) had higher patient safety culture activity scores than those with 3 to 10 years of clinical experience (3.72 points) and those with more than 10 years of clinical experience (3.69 points). The level of patient safety cultural activities was statistically significantly higher as age, less clinical experience, and job satisfaction increased (p<0.05). Conclusion: In the case of dental hygienists, patient safety cultural activities must be carried out throughout the entire work, so an active will to practice patient safety cultural activities is necessary. In order to improve the performance of patient safety cultural activities, it is necessary to adjust the workload of dental hygienists to improve job satisfaction and create a work environment in which they can focus on patient safety cultural activities.

• The Korean Journal of Coaching Psychology
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• v.7 no.3
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• pp.153-196
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• 2023

The purpose of this study is to development and validate kkondae tendency scale. Kkondae tendencies are defined as "a response pattern to others in a way that values authority in social relationships, is self-centered, and does not accept other people's opinions," and the subjects of the study are workers aged 19 or older who act as seniors, seniors, and bosses in the workplace. In Study 1, 65 preliminary questions were produced with 7 factors for the compositional concept of kkondae tendency through literature review, expert interviews, and open questionnaire survey. In Study 2, a preliminary survey was conducted with 65 questions derived from Study 1. Exploratory factor analysis was conducted based on the responses of a total of 395 people, and 22 items for 4 factors were derived. In Study 3, this survey was conducted with 22 questions derived from Study 2. A total of 880 responses were analyzed, and cross-validation verification was conducted by dividing the data into two groups (Group 1 and Group 2). Exploratory factor analysis was conducted on Group 1 (N=429) to derive 19 items with 4 factors. The four factors are authoritarianism(3 items), egocentrism (5 items), inertial thinking (5 itemss), and one-sided communication (6 items). A confirmatory factor analysis was conducted on 19 questions obtained from Group 1 for Group 2 (N = 451), and 19 questions of four factors were accepted due to the good fit of the model. To verify the convergent validity of the Kkondae tendency scale, the correlation with the Kkondae scale was examined, and to verify the criterion-related validity, the relationship between self-reflection, relationship conflict, social connectedness was examined. All were statistically significant, and convergence validity and criterion-related validity were verified. Finally, discussions on the process and results of this study, differences from related measures, academic significance, practical implications, limitations of the study, and future research directions were presented.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.19 no.1
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• pp.55-73
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• 2024

Unicorn companies are attracting attention around the world as they are recognized for their high corporate value in a short period of time as an innovative business models. Their growth process presents good lessons for the startup ecosystem and have a positive impact on national economic development and job creation. However, previous studies related to unicorn companies are focused on 'event studies' and 'case studies' such as characteristics of founders, environmental factors, business models and success/failure cases of companies already recognized as unicorns rather than a multifaceted approach. The occurrence of unicorn companies and Macroscopic analysis of related factors is lacking. Against this background, this study are considering the characteristics of unicorns examined through previous research and the current status unicorns with a high proportion of technology companies, the purpose was to analyze the impact of the country's technological competitiveness, such as 'technology human resource index', 'R&D index', and 'technology infrastructure index', on the increase in unicorn companies. For statistical analysis, data published by various international organizations, the Bank of Korea, and Statistics Korea from 2017 to 2020 and unicorn company data compiled by CB Insights were used as panel data for 44 countries to be tested by multiple regression analysis. As a result of the study, it was confirmed that the number of science majors had a positive (+) effect on the increase of unicorn companies in the case of technology human resource index, and in the case of R&D index, the total amount of R&D investment had a positive (+) effect on the increase of unicorn companies, while the number of Triad Patents Families and the number of scientific and technological papers published had a negative (-) effect on the increase of unicorn companies. Finally, in the case of technology infrastructure index, it was confirmed that the number of the world's 500th-ranked universities had a positive (+) effect on the increase of unicorn companies. This study is the first to reveal the causal relationship between national technological competitiveness and unicorn company growth based on country-specific and time-series empirical data, which were insufficiently covered in previous studies. and compared to the UN's ranking of the global industrial competitiveness index and the OECD's total R&D investment by country, Korea is considered to have technological and growth potential, while the number of unicorn companies driving growth as leaders of the innovative economy is relatively small, so the research results can be used when establishing policies to discover and foster unicorn companies in the future.

• Journal of Service Research and Studies
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• v.14 no.1
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• pp.63-76
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• 2024

Multi-family housing plays a crucial role as a living and experiencing space, and its environment has a direct impact on the well-being and stability of its residents. Therefore, Crime Prevention Design (CPTED) for multi-family housing is of utmost importance. However, crime-related data in China is not disclosed to the public because of its specificity, making it difficult for researchers to conduct further in-depth studies based on accurate crime data. As a result, the establishment and application of CPTED theory in terms of crime prevention is limited and delayed. This study aims to explore three aspects of CPTED in multi-family housing as perceived by home-buying consumers. It investigated consumer perception of the CPTED, the importance of each element and ways to increase awareness of CPTED in multifamily housing in order to effectively improve multifamily crime prevention design principles and further enhance public safety. This study examined the current state and future trends of CPTED in China by analyzing relevant research reports and literature, aiming to gain insights into the crime prevention awareness of Chinese homeowners. In addition, a survey was conducted on Chinese consumers to unravel the importance of CPTED and increase awareness of its various elements in multifamily-family. This study used a Likert scale and SPSS reliability analysis to determine the cognitive status of multi-family CPTED, the importance of each element, and proposed an improvement plan based on the analysis results. As this study was limited by the difficulty of implementation and the lack of validation of its practical effectiveness, it is recommended that future research needs to validate the effectiveness of crime prevention designs and produce more practical results. Furthermore, it is crucial to utilize this study to inform the implementation of security solutions that are tailored to the unique characteristics of each district. Additionally, it is important to offer guidance on how to enhance community safety by increasing residents' awareness of security through education and information dissemination. The author hopes that the representative multi-family CPTED awareness, the importance of each element, and plans for improvement shall be summarized from this study, and provide foundational data for the future development of CPTED based on the Chinese region.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.127-137
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• 2022

Purpose To assess the prevalence of incidentally detected lumbar spondylolysis in children. Materials and Methods We retrospectively reviewed the data of 809 patients under the age of 11 years (mean age, 7.0 ± 2.7 years; boys:girls = 479:330) who underwent abdominal and pelvic CT between March 2014 and December 2018. We recorded the presence, level, and laterality (unilateral or bilateral) of spondylolysis. Patients were divided into two groups based on the presence of spondylolysis: the spondylolysis (SP) and non-SP groups. Results In total, 21 cases of spondylolysis were detected in 20 patients (20/809, 2.5%). The mean age of the SP group was higher than that of the non-SP group (7.8 ± 1.8 vs. 6.9 ± 2.7 years, p > 0.05). The prevalence of spondylolysis in boys was higher than that in girls (15/479 [3.1%] vs. 5/330 [1.5%], p > 0.05). The prevalence of spondylolysis in school-age children (6-10 year olds) was higher than that in preschool-age children (0-5 year olds) (17/538 [3.2%] vs. 3/271 [1.1%], p > 0.05). L5 was the most common level of spondylolysis (76.2%); one 8-year-old boy had two-level spondylolysis. One case of isthmic spondylolisthesis was detected in a 10-year-old boy (1/809, 0.1%). There were 11 unilateral spondylolysis cases (11/21, 52.4%). Conclusion In our study, the prevalence of spondylolysis in children under the age of 11 was 2.5%. The prevalence was higher in boys than in girls and in school-age than in preschool-age children, despite the lack of any statistically significant differences.

• The Korean Journal of Air & Space Law and Policy
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• v.18
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• pp.135-183
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• 2003

Aerospace force is a determining factor in a modem war. The combat field is expanding to space. Thus, the legitimacy of establishing aerospace force is no longer an debating issue, but "how should we establish aerospace force" has become an issue to the military. The standard limiting on the military use of space should be non-aggressive use as asserted by the U.S., rather than non-military use as asserted by the former Soviet Union. The former Soviet Union's argument is not even strongly supported by the current Russia government, and realistically is hard to be applied. Thus, the multi-purpose satellite used for military surveillance or a commercial satellite employed for military communication are allowed under the U.S. principle of peaceful use of space. In this regard, Air Force may be free to develop a military surveillance satellite and a communication satellite with civilian research institute. Although MTCR, entered into with the U.S., restricts the development of space-launching vehicle for the export purpose, the development of space-launching vehicle by the Korea Air Force or Korea Aerospace Research Institute is beyond the scope of application of MTCR, and Air Force may just operate a satellite in the orbit for the military purpose. The primary task for multi-purpose satellite is a remote sensing; SAR sensor with high resolution is mainly employed for military use. Therefore, a system that enables Air Force, the Korea Aerospace Research Institute, and Agency for Defense Development to conduct joint-research and development should be instituted. U.S. Air Force has dismantled its own space-launching vehicle step by step, and, instead, has increased using private space launching vehicle. In addition, Military communication has been operated separately from civil communication services or broadcasting services due to the special circumstances unique to the military setting. However, joint-operation of communication facility by the military and civil users is preferred because this reduces financial burden resulting from separate operation of military satellite. During the Gulf War, U.S. armed forces employed commercial satellites for its military communication. Korea's participation in space technology research is a little bit behind in time, considering its economic scale. In terms of budget, Korea is to spend 5 trillion won for 15 years for the space activities. However, Japan has 2 trillion won annul budget for the same activities. Because the development of space industry during initial fostering period does not apply to profit-making business, government supports are inevitable. All space development programs of other foreign countries are entirely supported by each government, and, only recently, private industry started participating in limited area such as a communication satellite and broadcasting satellite, Particularly, Korea's space industry is in an infant stage, which largely demands government supports. Government support should be in the form of investment or financial contribution, rather than in the form of loan or borrowing. Compared to other advanced countries in space industry, Korea needs more budget and professional research staff. Naturally, for the efficient and systemic space development and for the prevention of overlapping and distraction of power, it is necessary to enact space-related statutes, which would provide dear vision for the Korea space development. Furthermore, the fact that a variety of departments are running their own space development program requires a centralized and single space-industry development system. Prior to discussing how to coordinate or integrate space programs between Agency for Defense Development and the Korea Aerospace Research Institute, it is a prerequisite to establish, namely, "Space Operations Center"in the Air Force, which would determine policy and strategy in operating space forces. For the establishment of "Space Operations Center," policy determinations by the Ministry of National Defense and the Joint Chief of Staff are required. Especially, space surveillance system through using a military surveillance satellite and communication satellite, which would lay foundation for independent defense, shall be established with reference to Japan's space force plan. In order to resolve issues related to MTCR, Air Force would use space-launching vehicle of the Korea Aerospace Research Institute. Moreover, defense budge should be appropriated for using multi-purpose satellite and communication satellite. The Ministry of National Defense needs to appropriate 2.5 trillion won budget for space operations, which amounts to Japan's surveillance satellite operating budges.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.479-492
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• 1997

Background : Isoniazid(INH) and rifampicin(RFP) are potent antituberculous drugs which have made tuberculous disease become decreasing. In Korea, prescribed doses of INH and RFP have been different from those recommended by American Thoracic Society. In fact they were determined by clinical experience rather than by scientific basis. Even there has been. few reports about pharmacokintic parameters of INH and RFP in healthy Koreans. Method : Oral pharmacokinetics of INH were studied in 22 healthy native Koreans after administration of 300 mg and 400mg of INH to each same person successively at least 2 weeks apart. After an overnight fast, subjects received medication and blood samples were drawn at scheduled times over a 24-hour period. Urine collection was also done for 24 hours. Pharmacokinetics of RFP were studied in 20 subjects in a same fashion with 450mg and 600mg of RFP. Plasma and urinary concentrations of INH and RFP were determined by high-performance liquid chromatography(HPLC). Results : Time to reach peak serum concentration (Tmax) of INH was $1.05{\pm}0.34\;hrs$ at 300mg dose and $0.98{\pm}0.59\;hrs$ at 400mg dose. Half-life was $2.49{\pm}0.88\;hrs$ and $2.80{\pm}0.75\;hrs$, respectively. They were not different significantly(p > 0.05). Peak serum concentration(Cmax) after administration of 400mg of INH was $7.14{\pm}1.95mcg/mL$ which was significantly higher than Cmax ($4.37{\pm}1.28mcg/mL$) by 300mg of INH(p < 0.01). Total clearance(CLtot) of INH at 300mg dose was $26.76{\pm}11.80mL/hr$. At 400mg dose it was $21.09{\pm}8.31mL/hr$ which was significantly lower(p < 0.01) than by 300mg dose. While renal clearance(CLr) was not different among two groups, nonrenal clearance(CLnr) at 400mg dose ($18.18{\pm}8.36mL/hr$) was significantly lower than CLnr ($23.71{\pm}11.52mL/hr$) by 300mg dose(p < 0.01). Tmax of RFP was $1.11{\pm}0.41\;hrs$ at 450mg dose and $1.15{\pm}0.43\;hrs$ at 600mg dose. Half-life was $4.20{\pm}0.73\;hrs$ and $4.95{\pm}2.25\;hrs$, respectively. They were not different significantly(p > 0.05). Cmax after administration of 600mg of RFP was $13.61{\pm}3.43mcg/mL$ which was significantly higher than Cmax($10.12{\pm}2.25mcg/mL$) by 450mg of RFP(p < 0.01). CLtot of RFP at 450mg dose was $7.60{\pm}1.34mL/hr$. At 600mg dose it was $7.05{\pm}1.20mL/hr$ which was significantly lower(p < 0.05) than by 450mg dose. While CLr was not different among two groups, CLnr at 600 mg dose($5.36{\pm}1.20mL/hr$) was significantly lower than CLnr($6.19{\pm}1.56mL/hr$) by 450mg dose(p < 0.01). Conclusion : Considering Cmax and CLnr, 300mg, of INH and 450mg RFP might be sufficient doses for the treatment of tuberculosis in Koreans. But it remains to be clarified in the patients with tuberculosis.