• 경영정보학연구
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• 제7권1호
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• pp.275-295
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• 2005

경제의 세계화와 지식정보화 사회로의 진입과 함께 초래된 경영환경의 급속한 변화는 의료기관들에게도 경쟁력강화를 위한 변신을 강요하게 되었다. 다시 말하면, 의료기관들은 선진 의료기술의 확보, 환자들에 대한 서비스제고와 함께 경영의 효율성 증대라는 세가지 목표를 동시에 달성해야만 하는 상황에 놓이게 된 것이다. 본 연구는 의료기관들이 당면하고 있는 이러한 세가지 과제 중 병원의 경영효율성 증대를 위한 한가지 대안으로 진료비 청구삭감의 빈도 및 발생 가능성을 낮추기 위한 해법의 마련이 시도되었다. 진료비청구삭감이란 의료기관들이 환자들에 대한 의료서비스에 대한 진료비 중 의료보험으로 인해 환자들이 감면 받은 진료비를 건강보험심사원에 청구하면, 심사원이 의료기관의 청구내역의 적정여부를 심사하여 적정하지 않은 내용에 대한 청구금액을 삭감하는 제도를 이른다. 청구금액에 삭감이 발생하면 해당 의료기관의 수입이 감소하는 것은 물론 원인분석이나 재청구 작업등에 비용과 인력이 이중으로 투입되게 되어 의료기관의 경영에 부담을 주게 되고, 이러한 상황이 빈발하게 되면 해당 의료기관에 대한 환자와 건강보험심사평가원의 신뢰에 문제가 발생하게 된다. 그러므로, 효과적인 진료비 청구삭감분석시스템에 의한 사전대비의 필요성이 높아지게 되는 것이다. 이를 위하여 본 연구에서는 진료비 청구삭감분석을 위한 프로토타입의 개발이 시도되었다. 프로토타입은 데이터마이닝 기법 중 연관분석 알고리즘을 적용하여 개발되었으며, 이렇게 개발된 프로토타입을 D의료원에서 10개월간 발생한 실제 진료데이타를 사용하여 성능을 시험하였다.

• 무역상무연구
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• 제65권
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• pp.51-70
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• 2015

The Rotterdam Rules are not phrased in favour of FOB seller's legal status. Whether it will be wise under the Rotterdam Rules to trade on the basis of cash against M/R largely depends on the interpretation of various provisions of the Rotterdam Rules. To protect his interests the M/R holder and his assigns must have a right of delivery of the cargo at the port of destination. The M/R holder and his assigns must be entitled to the bill of lading or at least be able to prevent the carrier from issuing the bill of lading to the shipper. Besides, any additional right of instruction on the part of the shipper must be blocked. Article 35 of the Rules entitles only the shipper to the bill of lading while 47 entitles only the holder of the bill of lading to delivery. When no bill of lading has been issued Article 45 grants to the shipper a right of instruction whereby the shipper is allowed to advise the carrier as to the name and the address of the consignee. I have suggested that by lack of a specific provision to the contrary the Rotterdam Rules have to be considered to be embedded in the system of law as a whole. From the Common Law it follows that a M/R holder, as owner of the cargo, can ask for delivery of the cargo. As owner of the cargo a M/R holder can also claim the bill of lading, if he does so in time, because it must be implied in the contract of carriage that the carrier must deliver the bill of lading to the owner of the goods. It is for the same reason that a M/R holder can prevent the carrier from issuing the bill of lading to any third party but the M/R holder and from taking instructions from the shipper as to name and address of a consignee other than the M/R holder.

• 통상정보연구
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• 제8권4호
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• pp.147-156
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• 2006

In all cargo cases one of the first things the person handling the claim must do is decide who is potentially liable as a carrier of the goods. This issue arises because bills of lading often do not identify the carrier. The "carrier" could be the shipowner or the charterer or both. The issue of the identity of the "carrier" is a question of fact. The question to ask in each case is who undertook or agreed to carry and deliver the goods. The answer to this question will largely depend on the facts. The shipowner is almost always liable as a carrier under Common law provided there is no demise charter of the ship. The more recent case law, however, suggests that in the usual situation both the charterer and shipowner will be liable. Accordingly, both the owner and charterer should be put on notice of any claim and, in the event an extension of suit time is required, the extension should be obtained from both. An alternative method by which the charterer can avoid liability is to insert and 'Identity of Carrier' clause in the bill of lading.

• 무역상무연구
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• 제18권
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• pp.137-157
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• 2002

The clauses of bill of lading(B/L) consist of the terms of contract for the carriage of goods by sea because of clauses of B/L by the mutual agreement of contracting parties. There are some exempted cause of deviation clause in B/L for specific reasons. Then deviation clauses are influenced by Rules of international carriage of goods by sea, because the international rules become the governing law of contract for the carriage of goods by sea. The problem of deviation clauses in B/L is stipulated as follows. "It shall be prerequisite to the Merchant' claim for damages on account of deviation that the merchant's insurance shall first have been cancelled on account of alleged deviation. No deviation shall oust the right to limit liability or damages, and the Carrier shall always be entitled to the full benefit of all privileges, rights and immunities contained in this Bill of Lading and incorporated tariffs." This stipulation should be adjusted according to the confirmed cases, otherwise it will be invalid according to the Hague Rules and Hamburg rules. The sphere of a reasonable deviation in the deviation clause should be interpreted in the connection with the designed voyage and the commercial object of contract for the carriage of goods by sea and the deviation become valid unless the policy, the general object of international rules or the true intention of contracting parties has violated.

• 무역상무연구
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• 제36권
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• pp.29-46
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• 2007

The fraud exception rule allows for the issuing bank to dishonor the claim if it the documents and transactions bear fraud though the documents presented are complied with the terms and conditions of the letter of credit. A question arises whether the fraud exception rule can apply to innocent beneficiary when fraud is made by 3rd party. United City Merchants v. Royal Bank of Canada showed a good example how to handle in case of innocent beneficiary. At this case House of Lord found that innocent beneficiary deserves payment applying nullity exception rule. I believe that the nullity exception rule is employed for the benefit of innocent beneficiary as far as the issuer and applicant get no actual damage by the 3rd party's fraudulent action which is shown on documents.

• 한국IT서비스학회:학술대회논문집
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• 한국IT서비스학회 2009년도 춘계학술대회
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• pp.357-360
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• 2009

본 연구는 데이터마이닝 기법을 이용하여 건강보험청구료에 있어서 이상정도가 심한 요양기관을 탐지하고, 실제 의료영역에 적용하기 위한 시스템 개발을 목적으로 한다. 현재 건강보험 심사평가원의 이상탐지시스템은 평가대상이 되는 항목을 개별적으로 평가하고, 탐지된 기관의 선정 이유에 대한 근거제시가 부족한 단점을 가지고 있다. 따라서 본 연구에서는 항목을 종합적으로 평가할 수 있는 정량적 지표를 설계하고, 항목들의 상대적 중요도를 파악할 수 있도록 항목들에 대한 가중치 부여한다. 또한 지표에서 얻어진 값으로 등급을 구분하고, 의사결정나무기법(decision tree)를 이용하여 해석력을 높이는 방법을 제시한다.

• 산경연구논집
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• 제8권6호
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• pp.25-31
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• 2017

Purpose - This study examines car accidents that occurred in South Korea territory, and analyzes criminal liability of the offender and certain issues of driver's insurance, but a civil liability to the injured is excluded as civil liability belongs to auto insurance. Research design, data, and methodology - With carrying out this research, case study of driver's liability and literature review were adopted throughout. For this, car accidents that occurred in South Korean territory were examined and then criminal liability of the offender and certain issues of driver's insurance were analyzed. Results - From this case study on driver's liability it was found that the offender cannot receive insurance money from the insurer irrespective of the valid drive insurance, if there is no 'bill of agreement of criminal consensus'. This study suggests some ideas, offers suggestions of convenience and assistance of qualified claim staff to overcome a hurdle of drive insurance. Conclusions - As long as the accident is not a fraud and scam by the parties concerned, advance payment of agreement of criminal consensus is required to the insured, the policy holder within the limit of liability of driver insurance, on condition that the drive insurance is valid.

• 한국산학기술학회논문지
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• 제18권6호
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• pp.596-608
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• 2017

2002년 제조물책임법(PL)을 시행하여 소비자가 제조물을 생산하고 판매하는 기업에 대하여 제품의 결함에 따른 손해배상을 청구할 수 있도록 하는 제도적 장치를 마련하였다. 그러나 최근 가습기 살균제 사건 등으로 인해 기업의 제조물책임 강화와 소비자 피해구제를 위한 집단소송제도, 징벌적배상제 도입을 위하여 제조물책임법 개정안 등 현재, 12여건의 관련 법안이 국회에 발의되어 있으나 정작 법안의 이해 당사자인 중소기업의 62.6%는 이에 대해 잘 알고 있지 못한 것으로 나타났다고 하고 있다. 많은 기업들이 PL 방어대책(Product Liability Defense : PLD)으로 문서작성 보관의 적정화, 관련업자와의 책임관계의 명확화, PL 보험의 가입 또는 배상자금의 확보 등으로 대비하고 있으나 이와 같은 대비책은 제품의 설계와 제품의 안전성을 고려한 부분에 대하여 한계점을 느끼게 한다. 이에 본 연구는 먼저 PL의 명확한 개념과 대응방안에 대해 살펴보고 PL 시스템과 개별 경영시스템 간의 관련성을 파악하고 제조물책임법에 대비한 PL 대응시스템을 기업의 개별경영시스템에 통합하고 보다 제품의 안전에 중점을 둔 개별경영시스템 모델을 제시하고자한다. 이 같은 연구목적에 따른 결과는 중소기업의 PL법 대응을 위한 합리적 대응방안으로 평가 받을 것으로 기대된다.

• 무역상무연구
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• 제41권
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• pp.103-132
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• 2009

In international sales of goods, the buyer must pay the price for the goods as required by the contract and CISG, The buyer's this obligation includes taking such steps and complying with such formalities as may be required under the contract, which includes providing the seller with relevant letter of credit through the issuing bank. Where the parties have not stipulated the time limit within which the credit should be opened, but there is an agreed date or period for shipment, the time limit for the L/C opening should be calculated back from the agreed date of shipment or the first date of shipment, while, in addition, the buyer should open the L/C sufficiently earlier than the shipment date in order for the seller to be able to know the L/C's opening before beginning to ship the goods. The L/C provided the buyer should conform to the contract of sale. Therefore, for example, when an unconfirmed L/C is provided violating the agreement or the L/C opened states that, under a FOB contract, a "freght prepaid" bill of lading shall be presented as a required document of the L/C, the buyer has failed to perform his obligation. If the buyer fails to perform his obligations to provide the letter of credit, the seller may require the buyer to perform that obligation; may fix an additional period of time of reasonable length for performance of the obligation; or, the seller may declare the contract avoided, if the failure amounts to a fundamental breach of contract, or if the buyer does not, within the additional period of time fixed by the seller, perform the obligation; and the seller claim damages. However, when a relevant L/C has been issued for the seller, as a rule, he cannot ask directly for the buyer to pay the price before avail himself of the L/C first.

• Journal of Preventive Medicine and Public Health
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• 제26권4호
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• pp.614-627
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• 1993

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.