• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.8-17
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• 2017

Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.

• Journal of Teachers' Pension
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• v.1
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• pp.91-127
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• 2016

노후의 경제적 안정이 사회적으로 강조되고 있는 상황에서 2015년 사립학교교직원연금법(사학연금법)이 연금지급개시 연령의 연장과 함께 부담률 인상 및 지급률의 인하를 주된 내용으로 개정되어 사립학교교직원연금(사학연금) 가입자의 소득공백기 발생과 전반적인 소득대체율 하락이 두드러진 문제로 나타나고 있다. 이와 같은 상황에서 사학연금 가입자가 재직 시 소득, 퇴직 시 자산 및 퇴직수당, 그리고 연금급부 등의 활용 가능한 재원을 통해 퇴직 후 소득의 안정을 이룰 수 있는 방안을 다양한 사적연금과의 연계 측면에서 살펴보았다. 한편 사립학교교직원연금공단(사학연금공단)의 업무범위가 법으로 정해져 있기 때문에 새롭거나 필요한 업무를 자유의사에 따라 추진할 수 없는 상황이다. 따라서 사학연금법에 제시되어 있는 사학연금공단 업무에 대한 전향적인 해석을 통해 사학연금 가입자에 대한 생애자산관리서비스의 제공 가능성에 대해서 살펴보았다. 생애자산관리서비스는 사학연금법의 개정으로 인해 가입자가 겪게 되는 소득공백기 및 소득 대체율 하락 문제를 보다 포괄적으로, 그리고 장기적인 관점에서 접근하여 궁극적으로는 퇴직 후 경제적 안정을 지원할 수 있는 방안이라고 판단된다.

• Journal of Labour Economics
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• v.42 no.3
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• pp.75-98
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• 2019

This paper examines the impact of on-the-job training (OJT) programs on turnover rates and employment status in the labor market. Exploiting the administrative data (the Employment Insurance Database), we apply the propensity score matching method to investigate 1) whether OJT participation increases the probability of remaining in the labor market after the job training, and 2) whether trainees are more likely to transition to a new employer. Our findings reveal positive effects of OJT on the continuous employment (2.4~5.3%p). We also observe that trainees show lower rates of turnover for some part of the study period, from 2008 to 2015.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.26-34
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• 2018

Objectives : This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. Methods : The Health Insurance Review and Assessment Service data in 2014-2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. Results : It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. Conclusions : It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.

• Journal of Teachers' Pension
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• v.1
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• pp.13-45
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• 2016

2015년말 사학연금제도의 법 개정이 이루어졌다. 그동안의 연금개혁이 주로 연금보험료 인상으로 이루어졌다면 이번 연금개혁은 연금지급률, 연금보험료률, 연금수급개시연령, 연금수급자에 대한 연금액 동결 등 다각적으로 이루어졌다. 국민연금과 동일한 수준의 가입자 내 소득재분배가 이루어졌다는 점도 특이하다. 본 논문은 사학연금법 개정의 재정효과와 후생효과를 분석하여 사학연금제도 개혁의 의미를 평가하고 정책과제를 도출하고 있다. 사학연금은 특수직역연금 중 유일하게 연기금이 아직 존재하는 제도로서 이번 연금개혁으로 국민연금에 가까운 재정안정화 효과를 거두었다는 점에서 큰 의의가 있다. 소득대체율과 연금수익비 등 후생적 측면에서의 후퇴에도 불구하고 제도의 안정성이 높아졌다는 점에서 의의가 크다. 이번 연금개혁으로 사학연금은 상당부분 국민연금제도와 유사하게 변동하였다는 점에서 국민연금과의 형평성도 제고되었다고 볼 수 있다. 2009년 연금개혁의 미비점을 보완하고 보다 완성도가 높은 개혁이 이루졌다고 볼 수 있다. 향후 국민연금제도의 재정안정화 추이에 맞추어 사학연금제도가 함께 부응해 나간다면 사학연금은 보다 재정적으로도 건전한 제도로 자리잡을 수 있을 것으로 판단된다.

• Journal of dental hygiene science
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• v.15 no.1
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• pp.1-11
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• 2015

This study analyzed the tooth brushing behavior and oral health status of foreigner immigrant workers and obtained the following results. Statistical significance based on different general characteristics. Gender, educational background, period of stay, health insurance, medical expense coverage, and whether or not one has friends or regular gatherings were significant traits for frequency, while age, marital status, income, and health insurance were traits for part (p<0.05). Statistical significance (p<0.05) was found in marital status and health insurance for time used to brush teeth, period of stay and whether or not one attends a regular gathering for tooth brushing training, and gender, educational background, period of stay, roommate status, medical expense coverage, and whether or not one attends a regular gathering for supplemental oral product usage. The averages of decayed, missing, and filled teeth (DMFT) index and community periodontal index of treatment needs (CPITN) for general characteristics were 6.98 and 3.03 respectively, and gender, roommate status, income, health insurance for DMFT index, and gender, age, marital status, educational background, roommate status, income, health insurance for CPITN were statistically significant (p<0.05). Tooth brushing frequency and part showed statistical significance (p<0.05) for DMFT index based on tooth brushing behavior, while tooth brushing part and time used to brush teeth were significant for CPITN. DMFT index was high at 8.34 for '3 times or more' in tooth brushing frequency, while DMFT index was high at 7.91 and CPITN was low at 2.94 for tooth brushing part. '3 minutes or longer' in time used to brush teeth was the lowest in CPITN at 2.88. As a result of analyzing the correlation between tooth brushing behavior and DMFT index, CPITN, tooth brushing frequency and part in DMFT index, and tooth brushing part and time used to brush teeth in CPITN showed significance (p<0.05). Based on the above results, we must promote the significance of brushing teeth and implement continuous training for correct tooth brushing management to enhance the oral health of foreign immigrant workers.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.155-190
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• 2015

The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.12
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• pp.581-588
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• 2017

This study was conducted to determine which factors would predict metabolic syndrome (MetS) perception and exercise by applying a machine learning classifier, or Extreme Gradient Boosting algorithm (XGBoost) from July 2014 to December 2015. Data were obtained from the Korean Community Health Survey (KCHS), representing different community-dwelling Korean adults 19 years and older, from 2009 to 2013. The dataset includes 370,430 adults. Outcomes were categorized as follows based on the perception of MetS and physical activity (PA): Stage 1 (no perception, no PA), Stage 2 (perception, no PA), and Stage 3 (perception, PA). Features common to all questionnaires for the last 5 years were selected for modeling. Overall, there were 161 features, categorical except for age and the visual analogue scale (EQ-VAS). We used the Extreme Boosting algorithm in R programming for a model to predict factors and achieved prediction accuracy in 0.735 submissions. The top 10 predictive factors in Stage 3 were: age, education level, attempt to control weight, EQ mobility, nutrition label checks, private health insurance, EQ-5D usual activities, anti-smoking advertising, EQ-VAS, education in health centers for diabetes, and dental care. In conclusion, the results showed that XGBoost can be used to identify factors influencing disease prevention and management using healthcare bigdata.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.68-75
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• 2018

Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

• The Korean Society of Law and Medicine
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• v.21 no.1
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• pp.107-152
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• 2020

During the main ruling in 2019, a number of rulings that were of interest or meaningful were handed down, such as just because the complication of medical practice has occurred, there is no presumption of negligence, a case involving a fall accident in which a lot of culpability has recently been made. the death of a well-known singer that caused a sensation, a case about damages caused by MERS in 2015, which is more meaningful in connection with damages caused by COVID-19, an infectious disease that has recently hit the world, including Korea. In preaching the principles of the law, just because there has been a complication caused by medical practice, there is no presumption of negligence, 'The scope of the complication without presumption of negligence' was determined differently by the court, the court was not able to specify the criteria. Specific circumstances were presented to limit the responsibility of the medical institution while acknowledging the malpractice of the medical institution in relation to the fall accident. In relation to the scope of damages, judgment was made on issues related to the calculation of lost profits of medical malpractice; criteria for determining celebrities' daily income, criteria for determining daily income in case of receiving survivor's pension due to medical accident, an incident in which the daily income is denied if the labor capacity is already lost at the time of a medical accident. But, it seems that judgments should be made based on clearer and more reasonable standards. Related to Medical Advertise, specific logic of judgment was presented as to whether it was interpreted as being in accordance with the specific prohibition listed in Article 27 paragraph 3 of the Medical Law, which is the criterion for violation of the Medical Law, or if it constitutes a significant harm to the order of the medical market. In response to the prohibition of operating the multiple medical institutions, the Constitutional Court decided that it was constitutional because it did not violate the regulations on excessive funding, and rationally limited the scope of the prohibited 'redundant operation'. The Supreme Court ruled for the first time that even a medical institution established and operated in violation of the Medical Service Act did not make it impossible to receive all medical care benefits implemented by a medical institution under the National Health Insurance Act. Significant rulings were finalized that recognized the existence of specific protection obligations for the people of the country in the management of infectious diseases.