• Title/Summary/Keyword: Claims Analysis

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The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly (노인의 외래본인부담제도에 따른 의료이용의 변화)

  • Kim, Myung-Hwa;Kwon, Soon-Man
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.6
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    • pp.496-504
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    • 2010
  • Objectives: The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. Methods: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. Results: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. Conclusions: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.

Optimization for Component Noise Validation Test by Evaluation of Noise Control Factors for Suspension (현가장치 소음 발생인자 평가를 통한 부품소음 검증시험 최적화)

  • Son, Myungkoon;Lee, Taeyong;Lee, Sangbok;Lee, Seul
    • Transactions of the Korean Society of Automotive Engineers
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    • v.25 no.3
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    • pp.344-349
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    • 2017
  • Suspension noise from under a passenger car is one of the important factors that impact the perceptual quality for drivers. However, it is difficult to validate this by component level testing in the early stage of development, because suspension noise caused by interaction of the related parts has been found at saleable vehicles late during development or at the manufacturing stage, when many customers have already filed for claims. This study proposed a validation testing under research by the DFSS process that enables reproduction of vehicle level noise by component level testing using a shock absorber with the related parts, such as urethane bumper and top mount. This study also developed a compromised test matrix while analyzing the noise factors through experimental design and analysis of variance to determine what factors can affect noise. Based on this study, we expect that the vehicle level and customer claim can be validated during initial development timing by a more reliable component noise validation test.

Analysis of Factors Influencing Patent Citations (특허 인용에 영향을 미치는 요인 분석)

  • Yoo, Jae-Bok;Chung, Young-Mee
    • Journal of the Korean Society for information Management
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    • v.27 no.1
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    • pp.103-118
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    • 2010
  • Recently, the valuation of patented technology has been greatly emphasized, and patent citation has been accepted as a very useful index of this technology. In this study, we performed correlation analyses between the patent citation counts and 17 explanatory variables of morphological, technological, and conceptual factors with a test dataset of U.S. patents in five subject fields. Seven variables having 5% or more standardized variances($r^2$) with patent citation counts were identified; number of pages, number of claims, reference-average-citation rate, patent increase/decrease rate, strength of bibliographic coupling, co-citation counts and document similarity. The result of the ANOVA test shows that the mean values of these variables vary among most subject fields.

Patent Trend Analysis on Natural Feed Additive for Avian Influenza Prevention and Immune Enhancement (조류 인플루엔자 예방 및 면역 증진을 위한 천연 사료 첨가제 특허동향 분석)

  • Park, Chanjeong
    • The Journal of the Korea Contents Association
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    • v.18 no.3
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    • pp.62-69
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    • 2018
  • This study investigate the patent trend of natural feed additives for avian influenza prevention and immunity enhancement. The search scope is Korean and Chinese patents published before December 31, 2017. As a result, I found 53 Korean patents and 105 Chinese patents. Korea and China has increased the number of patent applications since late 2000. In particular, China filed the most patent applications in 2016. Both Korea and China, the oriental medicine materials were mainly used in patent claims. Korea has many patent applications that are submitted by universities, research institutes and bio companies, but China has a high proportion of individual patent applicants.

Improved An RFID Mutual Authentication Protocol Based on Hash Function (개선된 해시기반의 RFID 상호인증 프로토콜)

  • Shin, Ju-Seok;Oh, Se-Jin;Jeong, Cheol-Ho;Chung, Kyung-Ho;Ahn, Kwang-Seon
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.37 no.3C
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    • pp.241-250
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    • 2012
  • In 2010, Jeon-Kim proposed HMAP(Hash-based Mutual Authentication Protocol for RFID Environment) to resolve a variety of problem related to security using Mutual authentication scheme, the hash function and secret key is used to update in RFID system. Jeon-Kim proved RMAP was safe for a variety of attacks including eavesdropping attacks through safety analysis. However, unlike the claims of the proposed protocol is vulnerable to next session of the secret key exposure due to eavesdropping. In this paper, we analyze the problem of RMAP and proves it through security analysis. And we also propose improved an RFID Mutual Authentication Protocol based on Hash Function to solve problems of HMAP.

A Structure of Passive Constructions in Korean and their meaning 'Potential' (한국어 피동문의 구조와 가능(potential)의 의미 해석 -대조적 관점에서-)

  • Mok, Jung-Soo;Kim, Yeong-Jung
    • Lingua Humanitatis
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    • v.8
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    • pp.369-387
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    • 2006
  • Which syntactic function should we assign to the 'ga-type' constituent which occurs in the morphological passive constructions in Korean, [N0-neun N1-i Vpass-ending]? This problem is very important in two respects. First, a small change of status of the particle 'i/ga' can exert an overall influence on the Korean grammar. Second, the particle '-i/ga' cannot guarantee that 'ga-type' constituents are subject of the sentence, so that the concept of syntactic category should be distinguished from that of syntactic function. This paper claims that the analysis of sentence has long been focused on the structure of proposition, namely the argument structure and that the direction of analysis should be turned to the 'person structure' which can be revealed on the pragmatic level. On the basis of this, this paper suggests that the specific type of the morphological passive constructions in Korean, [N0-neun N1-i Vpass-ending] should be analysed in line with the psych-verb constructions and that the modal meaning 'potential' of the passive constructions is correlated with sentence pattern and 'person structure'.

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An Analysis of the Trends of Korean National Health Insurance Administrative Cost (건강보험 관리운영비 추이 분석)

  • Park, Chong Yon;Suh, Nam Kyu;Um, Eui Hyeon
    • Health Policy and Management
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    • v.15 no.3
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    • pp.17-39
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    • 2005
  • Social solidarity, equity in financing, and efficiency in administration have been core issues in the development of Korean health insurance reformation since 1988. This study is to investigate the trend of administrative cost in Korean National Health Insurance from various aspects. For the analysis of administrative cost, the expenditures of each insurance society and the National Health Insurance Corporation are divided into 4 items of (1) insurance benefit, (2) administrative cost, (3) an agency provision accounts, (4) other expenses, and then they are reorganized. The analyses based on 5 types of the health insurance administrative cost showed that efficiency in administration has been improved generally. We, however, should consider qualitative aspects such as customer's satisfaction with health insurance administration, prompt service, control of unjust expenditure (unjust claims), and provision of medical service including health consultation in assessing efficiency of administration. And, in order to connect the administrative costs of health insurance with efficiency, we need to give a fundamentally new definition, which can contain elaborateness of expenditure in details including the structure and evaluation method of administrative costs. It may be necessary to develop new indicators or analyzing methods hereafter.

Improving Patient Safety and Control in Operating Room by Leveraging RFID Technology

  • Su, Chuan-Jun
    • Industrial Engineering and Management Systems
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    • v.8 no.1
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    • pp.37-46
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    • 2009
  • Patient safety has become a growing concern in health care. The U.S. Institute of Medicine (IOM) report "To Err Is Human: Building a Safer Health System" in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. However, many adverse events and errors occur in surgical practice. Within all kinds of surgical adverse events, wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events are the most devastating, unacceptable, and often result in litigation. Much literature claims that systems must be put in place to render it essentially impossible or at least extremely difficult for human error to cause harm to patients. Hence, this research aims to develop a prototype system based on active RFID that detects and prevents errors in the OR. To fully comprehend the operating room (OR) process, multiple rounds of on site discussions were conducted. IDEF0 models were subsequently constructed for identifying the opportunity of improvement and performing before-after analysis. Based on the analysis, the architecture of the proposed RFID-based OR system was developed. An on-site survey conducted subsequently for better understanding the hardware requirement will then be illustrated. Finally, an RFID-enhanced system based on both the proposed architecture and test results was developed for gaining better control and improving the safety level of the surgical operations.

An Integrated Expert Model for Delay Management in Construction Projects

  • jalal, Majid Parchami;Yousefi, Elham
    • Journal of Construction Engineering and Project Management
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    • v.7 no.3
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    • pp.1-14
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    • 2017
  • Delay claim should actually be supported by a set of proper information so that the contractors could prove their validity. The so-called information should be able to clarify the relationship between delay events and how they impact on the whole project. Therefore, exploiting an integrated system by people who are involved in construction business would certainly prove helpful. In the present study, delay analysis methods have been investigated along with selecting a relatively comprehensive method which has been modified, and eventually, a novel model and its required modules have been proposed for evaluating delay claims. The suggested integrated model is formed to identify delayed events, to classify delays, to measure the impacts of delays on the project scheduling, and finally to estimate the damages which were caused by those so-called delays. A decision support system (DSS) model which is related to the integrated system is actually extracted from Iran's general contract conditions, that is, 4311 magazine (equivalent to red FIDIC book). It is then programmed and coded by C# program. This DSS model can be used as an input of Easy Plan program. In addition, at the end of this research, the coded DSS has been used along with the so-called program so that a modified and developed model could be generated.

Developing an Instrument of Assessing the Middle School Students' Perceptions of Mathematics Teachers' PCK

  • Xu, Yanhui
    • Research in Mathematical Education
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    • v.23 no.1
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    • pp.23-45
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    • 2020
  • Many researches proposed different models and concepts for the PCK. It is important to understand its composition. Most studies investigated the development of PCK and its influence on students' learning from the teachers' perspectives. We developed an instrument for assessing middle school students' perceptions of mathematics teachers' PCK (SPOMTPCK) to investigate the nature of PCK. Theoretical claims and empirical research in PCK were used to design questions and sub-scales for the SPOMTPCK. The face validity of the instrument was established by the expert mathematics teachers and students. A questionnaire consisting of 38 items on a five-point Likert-type scale was used for data collection from 799 middle school students. The exploratory factor analyses resulted in the development of a three-factor scale of 17 items that was proved valid and reliable, that is, pedagogical representation, understanding students and curriculum, and encouraging students' engagement. The Cronbach α coefficients of the scale was 0.935, and the Cronbach α coefficient of three factors were ranged from 0.721 to 0.912. The confirmatory factor analysis showed that the questionnaire has good construct validity and the fit indexes are good. MANOVA analysis of variance revealed that the differences in mathematics teachers' PCK identified by students of different school types and grades were statistically significant. It is a validate measurement to evaluate the perceived mathematics teachers' PCK for middle school students.