• Title/Summary/Keyword: Claims Analysis

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Constitutional Issue Review of Compensation for Inevitable Medical Accidents During Delivery (불가항력 의료사고 보상사업에 대한 헌법적 쟁점 검토)

  • JUN, HYUN JUNG
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.153-185
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    • 2020
  • In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

A Study on the Medical Insurance Utilization of Workers Suffering from Low Back Pain in an Area (일부지역 근로자의 요통으로 인한 의료보험 이용 조사)

  • Lee, Chul-Gab;Ahn, Hyun-Ok;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon;Kim, Yang-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.764-778
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    • 1997
  • To find the medical insurance utilization of workers when suffering from low back pain, an analysis was made toward the data of medical insurance benefits matched with the general characteristics of 10,183 workers, who were registered continuously from 1993 to 1995 at a medical insurance cooperation for industrial workers. The results were as follows; 1. The period prevalence of the medical insurance utilization for low back pain for 3 years from 1993 to 1995 was calculated as 17.1% for male workers and 19.4% for female workers. Most common cause of utilization was other dorsopathies including the herniation of lumbar discs. 2. The utilization rate increased significantly as the present age and the age joining the company got older(p<0.001). As the duration of employment got longer, the utilization rate of the male showed the tendency to increase and that of the female increased significantly(p<0.05). Among male workers employed at cement and concrete manufacturing companies showed higher utilization rate and among female laborers showed significantly higher utilization rate than clerical workers(p<0.01). 3. Annual utilization rate for low back pain didn't show any difference, but the portion of other dorsopathies among cause of utilization showed the tendency to increase from 1993 to 1995. 4. The mean number of claims for outpatient medical care for low back pain differed significantly by age, working duration, type of industries, income level(p<0.05), and the mean of total visiting days for care of low back pain differed significantly by working duration. In conclusion, considering the fact that the medical insurance utilization for low back pain increased annually and other dorsopathies including the herniation of dorsopathies were increasing, an effective preventive or management program for low back pain toward worker employed at industries were required.

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Attention to the Internet: The Impact of Active Information Search on Investment Decisions (인터넷 주의효과: 능동적 정보 검색이 투자 결정에 미치는 영향에 관한 연구)

  • Chang, Young Bong;Kwon, YoungOk;Cho, Wooje
    • Journal of Intelligence and Information Systems
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    • v.21 no.3
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    • pp.117-129
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    • 2015
  • As the Internet becomes ubiquitous, a large volume of information is posted on the Internet with exponential growth every day. Accordingly, it is not unusual that investors in stock markets gather and compile firm-specific or market-wide information through online searches. Importantly, it becomes easier for investors to acquire value-relevant information for their investment decision with the help of powerful search tools on the Internet. Our study examines whether or not the Internet helps investors assess a firm's value better by using firm-level data over long periods spanning from January 2004 to December 2013. To this end, we construct weekly-based search volume for information technology (IT) services firms on the Internet. We limit our focus to IT firms since they are often equipped with intangible assets and relatively less recognized to the public which makes them hard-to measure. To obtain the information on those firms, investors are more likely to consult the Internet and use the information to appreciate the firms more accurately and eventually improve their investment decisions. Prior studies have shown that changes in search volumes can reflect the various aspects of the complex human behaviors and forecast near-term values of economic indicators, including automobile sales, unemployment claims, and etc. Moreover, search volume of firm names or stock ticker symbols has been used as a direct proxy of individual investors' attention in financial markets since, different from indirect measures such as turnover and extreme returns, they can reveal and quantify the interest of investors in an objective way. Following this line of research, this study aims to gauge whether the information retrieved from the Internet is value relevant in assessing a firm. We also use search volume for analysis but, distinguished from prior studies, explore its impact on return comovements with market returns. Given that a firm's returns tend to comove with market returns excessively when investors are less informed about the firm, we empirically test the value of information by examining the association between Internet searches and the extent to which a firm's returns comove. Our results show that Internet searches are negatively associated with return comovements as expected. When sample is split by the size of firms, the impact of Internet searches on return comovements is shown to be greater for large firms than small ones. Interestingly, we find a greater impact of Internet searches on return comovements for years from 2009 to 2013 than earlier years possibly due to more aggressive and informative exploit of Internet searches in obtaining financial information. We also complement our analyses by examining the association between return volatility and Internet search volumes. If Internet searches capture investors' attention associated with a change in firm-specific fundamentals such as new product releases, stock splits and so on, a firm's return volatility is likely to increase while search results can provide value-relevant information to investors. Our results suggest that in general, an increase in the volume of Internet searches is not positively associated with return volatility. However, we find a positive association between Internet searches and return volatility when the sample is limited to larger firms. A stronger result from larger firms implies that investors still pay less attention to the information obtained from Internet searches for small firms while the information is value relevant in assessing stock values. However, we do find any systematic differences in the magnitude of Internet searches impact on return volatility by time periods. Taken together, our results shed new light on the value of information searched from the Internet in assessing stock values. Given the informational role of the Internet in stock markets, we believe the results would guide investors to exploit Internet search tools to be better informed, as a result improving their investment decisions.

Dynamic Changes of Urban Spatial Structure in Seoul: Focusing on a Relative Office Price Gradient (오피스 가격경사계수를 이용한 서울시 도시공간구조 변화 분석)

  • Ryu, Kang Min;Song, Ki Wook
    • Land and Housing Review
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    • v.12 no.3
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    • pp.11-26
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    • 2021
  • With the increasing demand for office space, there have been questions on how office rent distribution produces a change in the urban spatial structure in Seoul. The purpose of this paper is to investigate a relative price gradient and to present a time-series model that can quantitatively explain the dynamic changes in the urban spatial structure. The analysis was dealt with office rent above 3,306 m2 for the past 10 years from 1Q 2010 to 4Q 2019 within Seoul. A modified repeat sales model was employed. The main findings are briefly summarized as follows. First, according to the estimates of the office price gradient in the three major urban centers of Seoul, the CBD remained at a certain level with little change, while those in the GBD and the YBD continued to increase. This result reveals that the urban form of Seoul has shifted from monocentric to polycentric. This shows that the spatial distribution of companies has gradually accelerated decentralized concentration implying that the business networks have become significant. Second, contrary to small and medium-sized office buildings that have undertaken no change in the gradient, large office buildings have seen an increase in the gradient. The relative price gradients in small and medium-sized buildings were inversely proportional among the CBD, the GBD, and the YBD, implying their heterogeneous submarkets by office rent movements. Presumably, those differences in the submarkets were attributed to investment attraction, industrial competition, and the credit and preference of tenants. The findings are consistent with the hierarchical system identified in the Seoul 2030 Plan as well as the literature about Seoul's urban form. This research claims that the proposed method, based on the modified repeat sales model, is useful in understanding temporal dynamic changes. Moreover, the findings can provide implications for urban growth strategies under rapidly changing market conditions.

Effect of Gastric Cancer Screening on Patients with Gastric Cancer: A Nationwide Population-based Study (위암 환자에서 국가암검진의 효과)

  • Cho, Young Suk;Lee, Sang Hoon;So, Hyun Ju;Kim, Dong Wook;Choi, Yoon Jung;Jeon, Han Ho
    • Journal of Digestive Cancer Reports
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    • v.8 no.2
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    • pp.102-108
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    • 2020
  • Background: This study was performed to evaluate the effect of gastric cancer screening through analysis of screening-related data. Methods: We investigated claims data of gastric cancer from 2009 to 2015. We evaluated whether the screening was performed to prior to registration as patients with gastric cancer. The effect of gastric cancer screening was also analyzed by gender. Results: We collected total 196,293 patients with gastric cancer. 74% of them had previous experience of gastric cancer screening. In patients with screening, early gastric cancer was 33.4% and advanced gastric cancer was 17.3%. 22,548 (15.5%) patients were diagnosed with gastric cancer within 2 years after screening. In the case of patients without screening, early gastric cancer was 15.1% and advanced gastric cancer was 25.3%. In case of men, 76% of them confirmed gastric cancer through screening, and 70.2% of women confirmed the gastric cancer. In both men and women, the rate of early gastric cancer was higher among those with screening than those without screening. Conclusion: In this study, we were able to indirectly confirm the stage shift of gastric cancer screening. However, within 2 years after screening, not a few patients with gastric cancer were diagnosed. Therefore, more studies are warranted to in the future.

A Study on the Current State of Pediatric Dentists and the Adequacy of Supply and Demand Based on Covered Services (소아치과 전문의 인력 현황 및 공급 적정성에 관한 연구 - 급여 진료 항목을 기준으로)

  • Yeo Won Lim;Yong Kwon Chae;Ko Eun Lee;Ok Hyung Nam;Hyoseol Lee;Sung Chul Choi;Mi Sun Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.3
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    • pp.360-372
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    • 2023
  • The aim of this study was to identify the current state of pediatric dentists, evaluate the adequacy of pediatric dentist supply and demand, and find out the perception of all pediatric dentists on the current state of pediatric dentists and policy establishment. An Online survey was conducted among pediatric dentists. The questionnaire was subdivided into 'general characteristics', 'number of dental treatments and working days per year', 'proportion of covered services', 'perceptions of supply and demand of pediatric dentists'. Through the Korean Academy of Pediatric Dentistry, the Health Insurance Review and Assessment Services, the National Health Insurance Service (NHIS), and the Korean Statistical Information Service, the current state of pediatric dentists, the number of claims for covered services, and the decrease in births per year were investigated. Dental clinics claiming to be pediatric dentistry reached half of all medical institutions, but only 3.78% of pediatric dentists actually worked. 61.36% of all pediatric dentists were concentrated in the metropolitan area, showing a national imbalance. Although the population of children and adolescents have continuously decreased over the past 20 years, the number of NHIS-covered services has shown a continuous increase. Over the past 10 years, the optimal supply of pediatric dentists has been maintained at around 4,000. According to the analysis, 92.15% of pediatric dentists thought that it was necessary to prepare policies and support measures at the government level. This study is expected to be used as basic data for establishing a demand estimation method for pediatric dentistry specialists in the future.

Possibility of Establishing an International Court of Air and Space Law (국제항공우주재판소의 설립 가능성)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.2
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    • pp.139-161
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    • 2009
  • The idea of establishing an International Court of Air and Space Law (hereinafter referred to ICASL) is only my academic and practical opinion as first proposal in the global community. The establishment of the International Court of Air and Space Law can promote the speed and promote fairness of the trial in air and space law cases. The creation of an ICASL would lead to strengthening of the international cooperation deemed essential by the global community towards joint settlement in the transnational air and space cases, claims and would act as a catalyst for the efforts and solution on aircraft, satellite and space shuttle's accidents and cases and all manpower, information, trial and lawsuit to be centrally managed in an independent fashion to the benefit of global community. The aircraft, satellite and spacecraft's accidents attributes to the particular and different features between the road, railway and maritime's accidents. These aircraft, satellite and spacecraft's accidents have incurred many disputes between the victims and the air and space carriers in deciding on the limited or unlimited liability for compensation and the appraisal of damages caused by the aircraft's accidents, terror attack, satellite, space shuttle's accidents and space debris. This International Court of Air and Space Law could hear any claim growing out of both international air and space crash accidents and transnational accidents in which plaintiffs and defendants are from different nations. This alternative would eliminate the lack of uniformity of decisions under the air and space conventions, protocols and agreements. In addition, national courts would no longer have to apply their own choice of law analysis in choosing the applicable liability limits or un-limit for cases that do not fall under the air and space system. Thus, creation of an International Court of Air and Space Law would eliminate any disparity of damage awards among similarly situated passengers and shippers in nonmembers of air and space conventions, protocols, agreements and cases. Furthermore, I would like to explain the main items of the abovementioned Draft for the Convention or Statute of the International Court of Air and Space Law framed in comparison with the Statute of the International Court of Justice, the Statue of the International Tribunal for the Law of the Sea and the Statute of the International Criminal Court. First of all, in order to create the International Court of Air and Space Law, it is necessary for us to legislate a Draft for the Convention on the Establishment of the International Court of Air and Space Law. This Draft for the Convention must include the elected method of judges, term, duty and competence of judge, chambers, jurisdiction, hearing and judgment of the ICASL. The members of the Court shall be elected by the General Assembly and Council of the ICAO and by the General Assembly and Legal Committee of the UNCOPUOS from a list of persons nominated by the national groups in the six continent (the North American, South American, African, Oceania and Asian Continent) and two international organization such as ICAO and UNCOPUOS. The members of the Court shall be elected for nine years and may be re-elected as one time. However, I would like to propose a creation an International Court of Air and Space Law in extending jurisdiction to the International Court of Justice at the Hague to in order to decide the air and space convention‘s cases. My personal opinion is that if an International Court on Air and Space Law will be created in future, it will be settled quickly and reasonably the difficulty and complicated disputes, cases or lawsuit between the wrongdoer and victims and the injured person caused by aircraft, satellite, spacecraft's accidents or hijacker and terrorists etc. on account of deciding the standard of judgment by judges of that’s court. It is indeed a great necessary and desirable for us to make a new Draft for the Convention on a creation of the International Court of Air and Space Law to handle international air and space crash litigation. I shall propose to make a new brief Draft for the Convention on the Creation of an International Court of Air and Space Law in the near future.

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Analysis of Health Functional Foods Advertisements Effects according to the Delivery Tool for Efficacy Information and Consumers' Attitudes (기능성 정보 전달 방법 및 소비자 태도에 따른 건강기능식품 광고 효과 분석)

  • Lee, Yeonkyung;Kim, Ji Yeon;Kwon, Oran;Hwang, In-Kyeong
    • The Korean Journal of Food And Nutrition
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    • v.29 no.6
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    • pp.835-848
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    • 2016
  • The purpose of this study was to find efficient and customized tools for delivering the benefit of health functional foods (HFFs). Delivery tools which could influence the impact of advertising were images, explanations of ingredients, diagrams of health benefit, patents, and comments from authority. Six advertisements were developed using these tools: "A": relevant image + explanation of ingredients + scientific diagram of efficacy; "B": relevant image + explanation of ingredients; "C": relevant image; "D": irrelevant image; "E": irrelevant image + explanation of ingredient + patent; "F": irrelevant image + explanation of ingredient + comments from authority. To analyze the consumer perceptions on HFFs and advertisement effects, 300 respondents were requested to answer a questionnaire comprising of the following questions: 5 questions of attitudes (necessity of HFFs, trust in HFFs, gathering information, watching advertisements and trust in advertisement claims) and 6 questions on the 6 developed advertisements (attention, understanding, sufficiency of information, sympathy, trust, and purchase). Scoring was done as per the 5 Likert scale. There was a higher proportion of females and the elderly, as compared to males and youngsters. The overall consumer attitudes were positive. Explanation of ingredients, scientific diagram of health benefit, patents and expert comments were helpful factors in increasing the advertisement evaluation by consumer, but the images were not. Advertisement evaluation of consumer did not differ with gender and age. However, differences were observed between some of the consumer attitudes (necessity of HFFs, trust in HFFs, gathering information and trust in advertisements claim) and advertisement evaluations (attention, understanding, sympathy and purchase). Our results indicate that for consumers utilizing the HFFs, advertisements with concrete tools such as diagrams, patent, and expert comments are more helpful. However, for consumers who do not have interest in HFFs, the scientific information was irrelevant. We believe that to maximize the effect of health information in advertisements, consumers should be segmented, and customized tools for each segment needs to be developed.