• Title/Summary/Keyword: Claims problem

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보증 클레임 시계열 데이터를 위한 퍼지 PID 제어 (Fuzzy PID Control of Warranty Claims Time Series)

  • 이상현;이상준;문경일;조성의
    • 한국IT서비스학회지
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    • 제8권4호
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    • pp.175-185
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    • 2009
  • Objectifying claims filed during the warranty period, analyzing the current circumstances and improving on the problem in question is an activity worth doing that could reduce the likelihood of claims to occur, cut down on the costs, and enhance the corporate image of the manufacturer. Existing analyses of claims are confronted with two problems. First, you can't precisely assess the risks of claims involved by means of the value of claims per 100 products alone. Second, even in a normal state, the existing approach fails to capture the probabilistic conflicts that escape the upper control limit of claims, thus leading to wrong control activities. To solve the first problem, this paper proposed that a time series detection concept where the claim rate is monitored based on the date when problems are processed and a hazard function for expression of the claim rate be utilized. For the second problem, this paper designed a model whereby to define a normal state by making use of PID (Proportion, Integral, Differential) and infer by way of a fuzzy concept. This paper confirmed the validity and applicability of the proposed approach by applying methods suggested in the actual past data of warranty claims of a large-scaled automotive firm, unlike hypothetical simulation data, in order to apply them directly in industrial job sites, as well as making theoretical suggestions for analysis of claims.

Claims problem을 활용한 부문별 온실가스 감축목표 분석 (Allocating CO2 Emission by Sector: A Claims Problem Approach)

  • 허윤지
    • 자원ㆍ환경경제연구
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    • 제31권4호
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    • pp.733-753
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    • 2022
  • 우리나라는 2015년 국가 온실가스 감축목표(Nationally Determined Contribution, 이하 NDC)를 수립한 이래, 2019년 한 차례 수정 후 지난해 말 상향안을 발표하였다. 전환, 산업, 건물 등 각 부문별 탄소배출량은 NDC 목표 달성을 위해 설정된다. 본 연구는 협조적 게임이론의 claims problem 또는 파산문제(bankruptcy problem)를 활용하여 부문별 온실가스 감축목표를 분석한다. Claims problem에서 다루는 대표적인 5개의 분배규칙을 정의하고 각 규칙의 특성을 공리적으로 확인하였다. 또한, NDC 목표 달성을 위한 부문별 탄소배출량 분배문제에 각 분배규칙을 적용하고 그 결과를 정부목표와 비교분석하였다. 전환 부문에 책정된 정부목표는 5개 분배규칙에서 할당하는 배출량보다 낮은 반면, 산업 부문의 정부목표 배출량은 5개 분배규칙의 결과보다 높은 것으로 확인되었다. 그 외 부문은 정부목표가 클레임 수준에 비례하여 배출량을 할당하는 분배규칙의 결과와 유사한 것으로 나타났다.

클레임보험의학 (Claims Insurance Medicine)

  • 이신형
    • 보험의학회지
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    • 제30권2호
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    • pp.8-11
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    • 2011
  • Insurance medicine has been known to medical risk selection. The role of insurance medicine is sound maintenance of insurance system. So it's function is medical underwriting of life risks. However, emerging market has insufficient medical epidemiological research that is necessary for estimation of extra-risk and such market is usually lack of full understanding of life insurance among insurance customers. This problem makes difficult of performing the medical underwriting, as an original insurance medicine. Medical contributions at the stage of claims adjudication comparing the coverage provided in the product, with the information provided in the claims, based on medical records and the agreement between them. This is called medical verification. The insurance doctors can also use their medical knowledge to help the claims staff with informing claimants about the medical basis of claims decisions.

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화학 탐구 맥락에서 중등 과학 교사가 제시한 주장과 증거 분석 (An Analysis of Written Claim and Evidence Produced by Secondary Science Teachers in a Context of Chemistry Inquiry)

  • 김다은;최애란
    • 대한화학회지
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    • 제61권6호
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    • pp.359-368
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    • 2017
  • 본 연구에서는 중등 과학 교사가 화학 탐구 맥락의 결과를 해석하여 제시하는 주장과 증거의 수준이 어떠한지 알아보고자 하였다. 본 연구에 참여한 53명의 과학 교사가 화학 탐구의 결과를 해석하여 제시한 주장과 증거를 분석한 결과 3가지 문항 중에서 여러 개념이 통합된 화학 주제의 경우 1-2수준의 주장과 증거가 상당수 있었고, 화학 교과서에 명시적으로 제시된 화학 개념과 직접 관련된 내용의 경우 3-4수준의 주장과 증거가 많았다. 본 연구의 결과는 과학 탐구의 핵심인 논증, 즉 주장과 증거 제시에 대하여 과학 교사가 적절한 지식과 이해를 함양할 수 있도록 현장 과학 교사 교육이 필요함을 시사한다.

의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로- (The Legal Consideration in Emergency Medical Service System)

  • 강병우
    • 한국응급구조학회지
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    • 제3권1호
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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파산절차에 관한 경제학적 분석

  • 류근관
    • KDI Journal of Economic Policy
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    • 제23권1_2호
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    • pp.149-191
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    • 2001
  • In this paper, we propose a new bankruptcy algorithm. The proposed algorithm is comprised of four tasks. Task A is the procedure of soliciting bids, Task B is the procedure of allocating claims, Task C is the procedure of trading claims, and Task D is the procedure of exercising options and holding shareholders' meeting. Tasks A, B, and D are based on Bebchuk(1988) and Aghion, Hart, ad Moore(1992). This paper adds Task C, the procedure of trading claims. Claims are in the form of options which are written on the new shares of the bankrupt firm. Trading options expedites the process of finding the value of the bankrupt firm, and also it mitigates the problem of incomplete capital market by expanding the pool of new investors.

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체지방에 대한 아로니아 추출물의 효과: 무작위배정, 이중눈가림, 위약-대조 임상연구 (The Effects of Aronia Extract on Body Weight and Body Fat: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial)

  • 하기찬;박유경;백향임;김혜미;김영미;정다영;신상욱;배정식;안지혜;전연정;박지은;권영달
    • 한방재활의학과학회지
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    • 제30권1호
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    • pp.105-113
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    • 2020
  • Objectives Excess weight and obesity are a crucial public health problem worldwide and are considered as the main cause of many chronic diseases. The present study evaluated the effects of Aronia melanocarpa extract (AMEX) supplementation on body compositions in overweight or obese people. Methods This randomized, double-blind, placebo-controlled clinical trial was carried out on 66 healthy overweight or obese peoples. The eligible subjects were divided into AMEX and placebo supplement treatment for 12 weeks. Anthropometrics, body composition (dual-energy X-ray absorptiometry), and blood analysis were performed preand post intervention. Results We observed significant reductions in the body weight and body mass index in both groups; however, the decrease was higher in the AMEX group. Body fat mass and percent body fat showed a tendency to decreases after AMEX supplementation. No clinically significant changes were observed for any safety parameter. Conclusions In conclusion, the data of this trial indicate that AMEX were not effective in reducing body compositions, but as a safe supplement, it may help weight loss in overweight or obese people.

KDRG를 이용한 건강보험 외래 진료비 분류 타당성 (On Feasibility of Ambulatory KDRGs for the Classification of Health Insurance Claims)

  • 박하영;박기동;신영수
    • 보건행정학회지
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    • 제13권1호
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    • pp.98-115
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    • 2003
  • Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4% of KDRGs had a CV of charges from tertiary care hospitals less than 100% and 95.43% of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80% for non-outlier claims from tertiary care hospitals, 51.98% for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

논증강화교육이 의학과 학생의 문제바탕학습 경험에 미치는 영향 (Effect of Argumentation Instruction on Medical Student Experiences with Problem-Based Learning)

  • 주현정
    • 의학교육논단
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    • 제19권2호
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    • pp.101-108
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    • 2017
  • When participating in problem-based learning (PBL), it is important for medical students to generate claims and provide justifications for their claims in small group discussions. This study aimed to investigate the effect of argumentation instruction on medical student learning experiences with PBL. A total of one hundred first-year preclinical students from Inje University College of Medicine, who had attended argumentation instruction, participated in this study. All of the participants completed a 5-point Likert scale questionnaire regarding their learning experiences with PBL, before and after the argumentation instruction. The questionnaire comprised 22 items with eight subcategories: argumentation activity, reflection, integration of basic and clinical science, identification of lack of knowledge, logical thinking, self-directed study, communication, and attitude toward discussion. The collected data were analyzed through a paired-sample t-test. The results of this study found that the argumentation instruction promoted the preclinical students' experiences with argumentation activities, reflection, an integration of basic and clinical science, the identification of their lack of knowledge, logical thinking, and self-directed study, and it increased positive attitudes toward group discussion. The findings suggest argumentation instruction can enhance medical student group discussions and help students achieve the objectives of PBL, including acquisition of basic and clinical science knowledge and development of clinical reasoning and self-directed learning abilities, which can highlight the meaningful learning experiences students have with PBL.

화재사례분석을 통한 화재피해자 지원체계 구축방안 (Strategy about Support System for Victims of Fire Cases through the Analysis of A Fire Cases)

  • 차종호
    • 산업경영시스템학회지
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    • 제41권4호
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    • pp.196-202
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    • 2018
  • There have been more than 40,000 cases of fires in Korea in the last three years. However, as 'Accidental Fire Liability Act' was judged to be non-conform to the Constitution in 2007, the damages by light mistakes should be compensated. Accordingly, disputes such as compensation claims, litigations and indemnification cases of the victims of fire increased. However, it is so difficult for victims of fire cases to take proper action. So, this study is to help victims of fire cases in the disputes and compensation claims of the victims, and to find actual and practical support system based on the analysis of compensation status. To help victims of fire cases, we need to survey about victims of fire cases with multiple victims. That survey is analyzed to find support plan for victims. Furthermore, to find support plan the current law is needed to be analyzed and reviewed to revision. It is also tried to identify problems in the operation of the Center for victims of Fire currently operated by fire stations and to find countermeasures. In addition, the status of subscription and problem of fire insurance for the compensation for the victims and the method to increase fire insurance subscription rate will be studied.