• Title/Summary/Keyword: Catastrophic

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The Trend in Household Catastrophic Medical Expenditure according to Healthcare Coverage Types and Its Associated Factors (의료보장 형태에 따른 연간 가구 과부담 의료비 지출 추이와 관련요인)

  • Lee, Seon Hwa;Kam, Sin;Lee, Won Kee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.6
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    • pp.4067-4076
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    • 2015
  • This study aims to examine the trend in household catastrophic medical expenditure according to the healthcare coverage types and its associated factors based on the raw data of the Korean Health Panel over the years 2008 to 2011. Correspondence analysis was used to investigate the trend in the incidence rates of annual catastrophic medical expenditure and generalized estimating equation to examine the factors influencing the incidence of catastrophic medical expenditure. The annual mean incidence rates of household catastrophic medical expenditure were 25.1%, 15.4%, 10.1%, 5.4% and 3.2% in the threshold levels of 10%, 15%, 20%, 30%, and 40% respectively. The incidence rate of household catastrophic medical expenditure was higher when the total annual household income was lower, the education level of the householder was lower, the healthcare coverage type was National Health Insurance, the householder had disability, the age of the householder was older, the number of household members was smaller, the subjective health status of household members was lower, and the prevalence rate of the chronic disease of the household was higher(p<0.05). Therefore, a policy for vulnerable households with older or patient members of chronic diseases should be established.

Numerical Modeling for Effect on Bund Overtopping Caused by a Catastrophic Failure of Chemical Storage Tanks (저장시설의 순간 전량 방출 시 방류벽의 월파 효과에 대한 수치모델링)

  • Min, Dong Seok;Phark, Chuntak;Jung, Seungho
    • Korean Chemical Engineering Research
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    • v.57 no.1
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    • pp.42-50
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    • 2019
  • As the industry develops in Korea, the use of hazardous chemicals is increasing rapidly and chemical accidents are increasing accordingly. Most of the chemical accidents are caused by leaks of hazardous chemicals, but there are also accidents in which all the substances are released instantaneously due to sudden high temperature/pressure or defection of the storage tanks. This is called catastrophic failure and its frequency is very low, but consequence is very huge when it occurs. In Korea, there were 15 casualties including three deaths due to catastrophic rupture of water tank in 2013, and 64 instances of failures from 1919 to 2004 worldwide. In case of catastrophic failure, it would be able to overflow outside the bund that reduces the evaporation rate and following consequence. This incident is called overtopping. Overseas, some researchers have been studying the amount of external overflow depending on bund conditions in the event of such an accident. Based on the previous research, this study identified overtopping fraction by condition of bund in accordance with Korea Chemicals Controls Act Using CFD simulation. As a result, as the height increases and the distance to the facility decreases while meeting the minimum standard of the bund capacity, the overtopping effect has decreased. In addition, by identifying the effects of overtopping according to atmospheric conditions, types of materials and shapes of bunds, this study proposes the design of the bund considering the effect of overtopping caused by catastrophic failure with different bund conditions.

The Financial Burden of Catastrophic Health Expenditure Among Older Women Living Alone (여성독거노인가구의 과부담 의료비 지출에 관한 연구)

  • Shin, Serah
    • Journal of Family Resource Management and Policy Review
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    • v.23 no.1
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    • pp.17-34
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    • 2019
  • Older women who live alone are among society's most vulnerable people, since they experience increased risk of multiple chronic diseases and have limited financial protection. This can lead older women living alone to catastrophic health expenditure(CHE), which is defined as a healthcare expenditure that exceeds a certain portion of a household's ability to pay. Using the Korean Longitudinal Study of Ageing(KLoSA), this study investigated the incidence of CHE among older women living alone and identified the factors related to this incidence. Applying health expenditure thresholds of 10%, 20%, 30% and 40% of ability to pay, the proportions of those with CHE were 41.3%, 22.9%, 14.6%, and 9.4%, respectively. Logistic regression models were used to identify factors related to CHE incidence, which include demographics, income, the number of chronic diseases, perceived health status, and health insurance type. The results show that the health care safety net in South Korea is insufficient for older women living alone. The findings can guide policymakers in improving healthcare and welfare policies to protect people from catastrophic payments. Particularly, welfare policies should be established for poor non-recipients who are not included within the benefits scope of the National Basic Livelihood Security System due to the unrealistic criteria of income recognition and family support obligation.

Effect of Expanding Benefit Coverage for Cancer Patients on Equity in Health Care Utilization and Catastrophic Expenditure (암 질환 대상 산정특례제도가 의료이용 및 의료비 부담 형평성에 미친 영향)

  • Kim, Ji Hye;Kim, Su Jin;Kwon, Soon Man
    • Health Policy and Management
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    • v.24 no.3
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    • pp.228-241
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    • 2014
  • Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

Factors Affecting the Catastrophic Health Expenditure of BabyBoomer Generation (베이비부머세대의 과부담 의료비 지출에 미치는 영향)

  • Kim, Yun-Jeong
    • The Journal of the Korea Contents Association
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    • v.22 no.1
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    • pp.484-492
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    • 2022
  • In this study, we used the Korea Health Panel Study for 2017 raw data as analytical data to understand the factors that affect the catastrophic health expenditures of the baby boomer generation and the final number of analyzed was 808 people. Analysis methods performed frequency analysis, crosstabulation, and multiple regression analysis, with p = .05 at the significance level for all validations. The statistically significant differences among the baby boomer generation were education level, marriage status, health insurence, household income, drinking, smoking, subjective health, outpatient care, and inpatient care. The average number of illnesses in the baby boomer generation was 8.14, of which 7.97 for male and 7.97 for female. The average number of outpatient visits was 16.81, of which 14.81 recalls for male and 26.89 for female. More than 40% of the ability to pay the catastrophic health expenditures rate was 15.3% for male and 26.3% for female. The factors affecting the catastrophic health expenditure of babyboomer generation are as follows. that influence the widow's fence medical expenses are as follows. Male were private insurance, household income, drinking, and inpatient care, and female were private insurance, household income, and drinking.

Analysis of Influencing Factors of High-Cost Beneficiaries of Catastrophic Health Expenditure Support Project (재난적의료비 지원사업의 고액수급자 영향요인 분석)

  • Nayoung Kim;Haejong Lee;Seungji Lim
    • Health Policy and Management
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    • v.33 no.4
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    • pp.400-410
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    • 2023
  • Background: As the government has recently been discussing the expansion of the disaster health expenses support project, we would like to confirm the characteristics of beneficiaries of the support project, particularly those of high-cost beneficiaries. Methods: Using the database of catastrophic health expenditure support project from 2019-2020, this study aims to confirm the characteristics of high-cost beneficiaries focusing on the overlap of the relieved out-of-pocket systems, known as the out-of-pocket ceiling system and the system for rare incurable diseases. Logistic regression analysis is used to examine this issue. Results: In order to analyze the factors influencing high-cost beneficiaries, five models were created and analyzed, including the status of duplicated beneficiaries for relieved out-of-pocket systems, sociodemographic and economic factors, and individual health status as sequential independent variables. All five models were statistically significant, of which economic factors had the greatest impact on the model's predictions. The main results indicated that those who benefited from multiple systems in duplicate were more likely to be high-cost beneficiaries, and there is a higher probability of incurring high health expenses among the underage. In addition, within the beneficiaries of catastrophic health expenditure support project, it was observed that higher health insurance premium percentiles are associated with a higher proportion of high-cost beneficiaries. Conclusion: This study examined the characteristics of high-cost beneficiaries by encompassing reimbursement and non-reimbursement. According to this study, it is expected to be used as basic data for setting priorities and improving the current criteria of catastrophic health expenditure support project, aiming to sequentially expand the program.

Maximizing Mean Time to the Catastrophic Failure through Burn-In

  • Cha, Ji-Hwan
    • Journal of the Korean Data and Information Science Society
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    • v.14 no.4
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    • pp.997-1005
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    • 2003
  • In this paper, the problem of determining optimal burn-in time is considered under a general failure model. There are two types of failure in the general failure model. One is Type I failure (minor failure) which can be removed by a minimal repair and the other is Type II failure (catastrophic failure) which can be removed only by a complete repair. In this model, when the unit fails at its age t, Type I failure occurs with probability 1 - p(t) and Type II failure occurs with probability p(t), $0{\leq}p(t)\leq1$. Under the model, the properties of optimal burn-in time maximizing mean time to the catastrophic failure during field operation are obtained. The obtained results are also applied to some illustrative examples.

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Test-Generation-Based Fault Detection in Analog VLSI Circuits Using Neural Networks

  • Kalpana, Palanisamy;Gunavathi, Kandasamy
    • ETRI Journal
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    • v.31 no.2
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    • pp.209-214
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    • 2009
  • In this paper, we propose a novel test methodology for the detection of catastrophic and parametric faults present in analog very large scale integration circuits. An automatic test pattern generation algorithm is proposed to generate piece-wise linear (PWL) stimulus using wavelets and a genetic algorithm. The PWL stimulus generated by the test algorithm is used as a test stimulus to the circuit under test. Faults are injected to the circuit under test and the wavelet coefficients obtained from the output response of the circuit. These coefficients are used to train the neural network for fault detection. The proposed method is validated with two IEEE benchmark circuits, namely, an operational amplifier and a state variable filter. This method gives 100% fault coverage for both catastrophic and parametric faults in these circuits.

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A Study on the Development of Assessment Index for Catastrophic Incident Warning Sign at Refinery and Pertrochemical Plants (정유 및 석유화학플랜트 중대사고 전조신호 평가지표 개발에 관한 연구)

  • Yun, Yong Jin;Park, Dal Jae
    • Korean Chemical Engineering Research
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    • v.57 no.5
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    • pp.637-651
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    • 2019
  • In the event of a major accident such as an explosion in a refinery or a petrochemical plant, it has caused a serious loss of life and property and has had a great impact on the insurance market. In the case of catastrophic incidents occurring in process industries such as refinery and petrochemical plants, only the proximate causes of loss have been drawn and studied from inspectors or claims adjustors responsible for claims of property insurers, incident cause investigators, and national forensic service workers. However, it has not been done well for conducting root cause analysis (RCA) and identifying the factors that contributed to the failure and establishing preventive measures before leading to chemical plant's catastrophic incidents. In this study, the criteria of warning signs on CCPS catastrophic incident waning sign self-assessment tool which was derived through the RCA method and the contribution factor analysis method using the swiss cheese model principle has been reviewed first. Secondly, in order to determine the major incident warning signs in an actual chemical plant, 614 recommendations which have been issued during last the 17 years by loss control engineers of global reinsurers were analyzed. Finally, in order to facilitate the assessment index for catastrophic incident warning signs, the criteria for the catastrophic incident warning sign index at chemical plants were grouped by type and classified into upper category and lower category. Then, a catastrophic incident warning sign index for a chemical plant was developed using the weighted values of each category derived by applying the analytic hierarchy process (pairwise comparison method) through a questionnaire answered by relevant experts of the chemical plant. It is expected that the final 'assessment index for catastrophic incident warning signs' can be utilized by the refinery and petrochemical plant's internal as well as external auditors to assess vulnerability levels related to incident warning signs, and identify the elements of incident warning signs that need to be tracked and managed to prevent the occurrence of serious incidents in the future.

Catastrophic Bronchial Spasm Due to a Severe Anaphylactic Reaction to Protamine

  • Kim, Jae-Bum;Kim, Jae Hyun;Song, Kyung Sub
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.472-474
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    • 2016
  • Fatal anaphylactic reactions to protamine sulfate during cardiac surgery are very rare. We report a case of catastrophic bronchial spasm due to an anaphylactic reaction to protamine. The patient was managed successfully using a bronchodilator, steroid treatment, and extracorporeal membrane oxygenation.