• The Korean Journal of Applied Statistics
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• v.28 no.6
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• pp.1063-1073
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• 2015

In the long-term care insurance (LTCI) system, National Health Insurance Service (NHIS) provide counseling services for beneficiaries and their family caregivers, which help them use LTC services appropriately. The purpose of this study was to develop a Target Selection Model for the Counseling Services based on needs of beneficiaries and their family caregivers. To develope models, we used data set of total 2,000 beneficiaries and family caregivers who have used the long-term care services in their home in March 2013 and completed questionnaires. The Target Selection Model was established through various data-mining models such as logistic regression, gradient boosting, Lasso, decision-tree model, Ensemble, and Neural network. Lasso model was selected as the final model because of the stability, high performance and availability. Our results might improve the satisfaction and the efficiency for the NHIS counseling services.

• The Journal of Society for e-Business Studies
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• v.24 no.4
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• pp.1-16
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• 2019

Blockchain technology prevents tampering of central authorities that manage voting process, enhancing trust in the vote results. This technology enables citizens to participate more directly in the areas where delegation was inevitable due to the difficulties in polling fair and trustworthy public opinions. There are many projects around the world proposing to implement voting system for public decision making using blockchain technology. The blockchain voting system is expected to work as a transparent and fair channel for polling public opinions, which will transform the public decision-making process and governance. Korean National Pension Service (NPS) recently introduced stewardship code to better represent the interest of beneficiaries. However, because of the mistrust in governance of NPS, introduction of stewardship code is facing criticism for potential misuse of their voting rights against the interest of beneficiaries and for government's interference with corporate management. This study proposes a voting system applying blockchain technology for polling the opinions of National Pension Fund's beneficiaries to support public decision-making, and discusses social and institutional conditions for implementation of the proposed system.

• Health Policy and Management
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• v.19 no.4
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• Research in Community and Public Health Nursing
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• v.26 no.3
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• pp.278-291
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• 2015

Purpose: This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences. Methods: Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program. Results: There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution. Conclusion: These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

• Health Policy and Management
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• v.24 no.3
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5430-5441
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• 2015

The purpose of this study is to investigate the effect of Medicaid case management (CM) performed by Medicaid case managers on health management and to examine the overall health care utilization with high risk Medicaid beneficiaries. The subjects involved in this research were 113 Medicaid beneficiaries who were recipients CM in Y-gu between October 1st, 2012 and March 31th, 2013. The results show that there were significant differences in 'recognition of own disease', 'understanding of Medicaid policy', 'medication' and 'healthy lifestyle'. Also there were significant differences in 'appropriateness of health utilization', 'number of medical institutions', 'level of social isolation' and 'general health status'. In addition, significant differences were found in Medicaid days, outpatient days, medication days and Medicaid costs. It was found that the Medicaid CM had a positive effect on health care utilization. The study suggests the need of strengthening and diversifying Medicaid CM as well as supporting the management and monitoring after the termination of Medicaid CM.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.40 no.2
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• pp.104-110
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• 2017

When evaluating effectiveness of a R&D program, there is a tendency to simply compare the performances of the beneficiaries before and after the program or to compare the differences in the performances of the beneficiaries and the non-beneficiaries before-after the program. However, these ways of evaluating effectiveness of a program have some problems because they can not differentiate between complement effect, which facilitates corporate R&D investment, and substitute effect, which, literally, substitutes corporate R&D investment. Therefore, these problems could bring about wrong policies concerning R&D programs. In this paper, a new approach using path analysis is suggested as a means to overcome these problems and it is utilized, as an application, to evaluate the effectiveness of Plant Engineering Program conducted by Ministry of Trade, Industry & Energy, Korea. First, the direct impact of government R&D investment on corporate R&D investment is analyzed, through which it is identified which of crowding-in effect (complement effect) and crowding-out effect (substitute effect) is dominant. Next, the direct effect of government R&D investment on corporate performance and the direct effect of corporate R&D investment on corporate performance is analyzed respectively. Finally, by combining the two previous analysis, the total effect of government R&D investment on corporate performance is identified. As a result, it turns out that, in Plant Engineering Program, crowding-in effect is more dominant than crowding-out effect and that Plant Engineering Program has definitely positive effect on the beneficiary in terms of corporate performance indirectly and directly.

• The Korean Journal of Emergency Medical Services
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• v.11 no.2
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• pp.87-101
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• 2007

Health and disease related characteristics of 226 selected by systematic sampling from 452 personal emergency response system(PERS) beneficiaries and actual conditions of using PERS by them are as follows. Over 86% of PERS beneficiaries have not good health conditions and 70.7% of them have chronic diseases. On social supports family was highest as 52.2% and cases having social workers' assistance were 15.2%, but 53 as 23.7% had not visit or call from anyone and showed very low social supports. 86.2% was given PERS within 3years and 79.1% had it by the recommendation from related agencies and 4.0% was by their demand. On wearing it, 78.3% didn't bring it with them and 92% of them answered they were not sick and then it was found that they didn't use it because they had not special emergency. On satisfaction with paging system's operation, 81.3% answered they were satisfied with it, 48.8% used it for 'acute and emergency diseases' and 29.3% called ambulance for 'appointed medical treatment'. Time required for ambulance to arrive at the field was within 10 min. in 87.8% and after 10 min. in 12.2% and emergency service for beneficiaries by fire service was very good. On satisfaction with use of PERS, 85.4% were satisfied with it, 81.9% who requested repair or replacement of radio paging got it back after one or two days of their request and they answered they were satisfied with A/S. 45.5% answered they powered off it because 'they didn't use it' and 12.1% had 'economical reason of phone charge'.

• The Korean Journal of Applied Statistics
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• v.31 no.6
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• pp.693-706
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• 2018

It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.71-82
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• 2019

Objective : To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson's disease (PD) in Korea and its association with socioeconomic status. Methods : Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest. Results : The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries. Conclusion : The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.