• Title/Summary/Keyword: Current health expenditure

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18FDG Synthesis and Supply: a Journey from Existing Centralized to Future Decentralized Models

  • uz Zaman, Maseeh;Fatima, Nosheen;Sajjad, Zafar;Zaman, Unaiza;Tahseen, Rabia;Zaman, Areeba
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10057-10059
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    • 2015
  • Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. $^{18}$Flourodeoxyglucose ($^{18}FDG$) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of $^{18}F$ (110 minutes) have paved the path of a centralized model in which $^{18}FDG$ is produced by commercial PET radiopharmacies and the finished product (multi-dose vial with tungsten shielding) is dispensed to customers having only PET scanners. This indeed reduced the cost but has limitations of dependence upon timely arrival of daily shipments as delay caused by any reason results in cancellation or rescheduling of the PET procedures. In recent years, industry and academia have taken a step forward by producing low energy, table top cyclotrons with compact and automated radiochemistry units (Lab-on-Chip). This decentralized strategy enables the users to produce on-demand doses of PET probe themselves at reasonably low cost using an automated and user-friendly technology. This technological development would indeed provide a real impetus to the availability of complete set up of PET based molecular imaging at an affordable cost to the developing countries.

The Riboflavin Status in Insulin-Dependent Diabetes Mellitus During Growing Period (성장기 인슐린 의존성 당뇨병 환자의 리보플라빈 영양상태)

  • 이정희
    • Journal of Nutrition and Health
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    • v.27 no.7
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    • pp.729-739
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    • 1994
  • Riboflavin status of 17 insulin-dependent diabetic mellitus(IDDM) patients in growing period was evaluated as a function of energy intake and expenditure, biochemical nutritional status and diabetic control indicators. Compared with recommended dietary allowances for Koreans(RDA, 1989), only 35.3% of subjects was at good levels of all nutrients intakes and 52.9% of subjects was below normal level of height and weight. Nutrients consumed below RDA levels were energy(=88.5% of subjects), niacin(64.7%), iron(52.9%) and protein(23.5%) respectively. The riboflavin status was within normal range by urinary riboflavin excretion but 17.6% of subjects was evaluated as showed riboflavin deficiency by erythrocyte glutathione reductase activity coefficient(EGRAC). Correlation between riboflavin intake, urinary riboflavin excretion, EGRA level and diabetic duration were not statistically significant. Correlation analyses indicated that EGRA level was inversely correlated with thiamin, niacin and cabohydrate intake. No significant correlations were found between the EGRA and glycosylated hemoglobin A1(HbA1) (r=-0.464, p=0.129). From this study, it is suggested that IDDM subjects need to maintain balanced diet containing nutrients above RDA for individual activity during growing period. It needs more study whether the current recommended riboflavin allowance is adequate for diabetic patients.

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Anti-Obesity Drugs: A Current Research Insight

  • Son Eun-hwa;In San-Whan;Kim Byung-Oh;Pyo Suhkneung
    • Biomedical Science Letters
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    • v.11 no.2
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    • pp.89-101
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    • 2005
  • Obesity is increasing worldwide and has become a major health burden in Western societies affecting every third American and every fifth European. Obesity makes a major contribution to morbidity and mortality, predisposing individuals to cardiovascular disease and diabetes. Many new substances are currently being investigated for their usefulness in the pharmacotherapy of obesity. Most anti-obesity drugs can be divided into four groups: those that reduce food intake; those that alter metabolism; those that increase thermogenesis; and those that regulate hormone involved in feeding behavior. In this article we review these and other agents available in various countries for the treatment of obesity. Perhaps more importantly, we have focussed on areas of potential productivity in the future. Over the last 5 or so years, this impetus in obesity research has provided us with exciting new drugs targets involved in the regulation of feeding behavior and cellular mechanism involved in energy expenditure. Recent development in the quest for control of human obesity include the discovery of hormones, neuropeptides, receptors and transcription factors involved in feeding behavior, metabolic rate and adipocyte development. For developing new, perhaps even more specific pharmacological agents, further research is needed to understand the individual different genetic and physiological basis of obesity. It remains the hope of research scientists that in the not too distant future we shall see a new class of anti-obesity drugs arising logically from the molecular biology revolutions.

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A Study on the Appropriate Size of Stores and Countermeasures in Decline Commercial Area in the Original Downtown

  • Ryu, Tae-Chang
    • Journal of Distribution Science
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    • v.19 no.11
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    • pp.49-57
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    • 2021
  • Purpose: In this study, we try to figure out the appropriate size of commercial districts in the original downtown area through empirical studies targeting the Jinju Central Commercial Area in Gyeongnam and Cheonan Station in Chungnam, which are trying to regenerate a specific space that has been lost through government projects. Research design, data and methodology: The current status and characteristics of the shopping district were examined through on-site surveys of the central business district of Jinju, Gyeongnam Province, and Cheonan Station, Chungnam Province, and the size of the empty stores was determined. In addition, the standard median income was used as the survey data along with the survey of the mobile population in the commercial area. Result: The analysis result shows that 883 stores should be maintained considering the overall expenditure and gross sales profit within Cheonan Station in South Chungcheong Province. Currently, considering spending and margins in the Commercial Area, Jinju Central Commercial Area is a place where 222 stores can be sold excessively, and a proper commercial supply plan is needed. Conclusions: In this study, we conducted a demand prediction study in the commercial sector of the most basic sector to regenerate the commercial sector through major regional commercial districts.

On the models for the distribution of examination score for projecting the demand for Korean Long-Term Care Insurance

  • Javal, Sophia Nicole;Kwon, Hyuk-Sung
    • Communications for Statistical Applications and Methods
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    • v.28 no.4
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    • pp.393-410
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    • 2021
  • The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

Estimation of the Minimum Cost of Living in Seoul (서울시 지역최저생계비 계측에 관한 연구)

  • Kim, Kyung-Hye
    • Korean Journal of Social Welfare
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    • v.38
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    • pp.7-32
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    • 1999
  • Providing the income support program for people under the poverty level has been regarded as the basic obligational role of modern government. The target population of this program should include all the poor who are unable to maintain the minimum health and decency level with their own income. The minimum living cost, however, varies within a country because there are regional differences in consumer price and the mode of living. The current program does not count for the regional differences, leaving a significant portion of Seoul's poor needy people being ineligible for this public care. Recognizing these regional differences, this paper attempts to estimate the minimum living cost in Seoul area, comparing it to the national one. It employs the data and method that the Korea Institute of Health and Social Affairs adopted in its 1994 study, since it has been served as a basis of the current public assistance program. The minimum cost of living in Seoul is estimated to be \887,611 per month for a 4-person household. It is 1.33 times greater than the national monthly minimum of \666,684. Based upon the '94 urban household expenditure survey data, some 5.9 percent of Seoul's population, 636,132 people, are found to be under the Seoul's minimum living level. This number is 5.2 times greater than those 123,304 people who are eligible for the current public assistance program in Seoul.

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Analysis on Factors Influencing Welfare Spending of Local Authority : Implementing the Detailed Data Extracted from the Social Security Information System (지방자치단체 자체 복지사업 지출 영향요인 분석 : 사회보장정보시스템을 통한 접근)

  • Kim, Kyoung-June;Ham, Young-Jin;Lee, Ki-Dong
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.141-156
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    • 2013
  • Researchers in welfare services of local government in Korea have rather been on isolated issues as disables, childcare, aging phenomenon, etc. (Kang, 2004; Jung et al., 2009). Lately, local officials, yet, realize that they need more comprehensive welfare services for all residents, not just for above-mentioned focused groups. Still cases dealt with focused group approach have been a main research stream due to various reason(Jung et al., 2009; Lee, 2009; Jang, 2011). Social Security Information System is an information system that comprehensively manages 292 welfare benefits provided by 17 ministries and 40 thousand welfare services provided by 230 local authorities in Korea. The purpose of the system is to improve efficiency of social welfare delivery process. The study of local government expenditure has been on the rise over the last few decades after the restarting the local autonomy, but these studies have limitations on data collection. Measurement of a local government's welfare efforts(spending) has been primarily on expenditures or budget for an individual, set aside for welfare. This practice of using monetary value for an individual as a "proxy value" for welfare effort(spending) is based on the assumption that expenditure is directly linked to welfare efforts(Lee et al., 2007). This expenditure/budget approach commonly uses total welfare amount or percentage figure as dependent variables (Wildavsky, 1985; Lee et al., 2007; Kang, 2000). However, current practice of using actual amount being used or percentage figure as a dependent variable may have some limitation; since budget or expenditure is greatly influenced by the total budget of a local government, relying on such monetary value may create inflate or deflate the true "welfare effort" (Jang, 2012). In addition, government budget usually contain a large amount of administrative cost, i.e., salary, for local officials, which is highly unrelated to the actual welfare expenditure (Jang, 2011). This paper used local government welfare service data from the detailed data sets linked to the Social Security Information System. The purpose of this paper is to analyze the factors that affect social welfare spending of 230 local authorities in 2012. The paper applied multiple regression based model to analyze the pooled financial data from the system. Based on the regression analysis, the following factors affecting self-funded welfare spending were identified. In our research model, we use the welfare budget/total budget(%) of a local government as a true measurement for a local government's welfare effort(spending). Doing so, we exclude central government subsidies or support being used for local welfare service. It is because central government welfare support does not truly reflect the welfare efforts(spending) of a local. The dependent variable of this paper is the volume of the welfare spending and the independent variables of the model are comprised of three categories, in terms of socio-demographic perspectives, the local economy and the financial capacity of local government. This paper categorized local authorities into 3 groups, districts, and cities and suburb areas. The model used a dummy variable as the control variable (local political factor). This paper demonstrated that the volume of the welfare spending for the welfare services is commonly influenced by the ratio of welfare budget to total local budget, the population of infants, self-reliance ratio and the level of unemployment factor. Interestingly, the influential factors are different by the size of local government. Analysis of determinants of local government self-welfare spending, we found a significant effect of local Gov. Finance characteristic in degree of the local government's financial independence, financial independence rate, rate of social welfare budget, and regional economic in opening-to-application ratio, and sociology of population in rate of infants. The result means that local authorities should have differentiated welfare strategies according to their conditions and circumstances. There is a meaning that this paper has successfully proven the significant factors influencing welfare spending of local government in Korea.

An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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PRESENT SITUATION AND PROSPECT OF PEDIATRIC DENTISTRY IN KOREA - FOCUSED ON MANAGEMENT OF DENTAL CARIES - (한국 소아치과의 현재와 전망 - 치아우식증관리 분야를 중심으로 -)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.206-225
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    • 2012
  • General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

A survey of the training of student for future dietitian at various food-service institutions (단체급식실습생 훈련에 대한 조사연구)

  • 심영자
    • Journal of the Korean Home Economics Association
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    • v.32 no.1
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    • pp.199-210
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    • 1994
  • My purpose in the paper is to research on what is the most productive education method for the Students for Future Dietitian(SFD) to be applied during there field training & practice. Furthermore it is an attempt to elucidate what is the most necessary education program for the field training & practice for SFDs. Five questionnaires were given to SFDs dealing with nutrition purchase hygienic facilities and official management in order to check and evaluate the current situation and problems on the education of field training & practice for SFDs Also I chose 140 SFD's who had been working in the field for at least one week or one month in 1992 and statistical processing were utilized and analyzed by SAS package. One of the most notable problems SDFs faced with during meal planning it is the fact that they had been educated and requested for the cut of food expenditure rather than the supply of scientifically balanced-nutrition meals for working people, SFDs also faced with of information on the quantity and facilities management from the dietitian in the company. my research revealed that dietitian's teaching method for SFDs still remains in a very primitive way and accordingly the efficient way to solve these problems shall be established by a computerized education program through which dietitians can provide well-balanced meals for working people when they are assigned to the company. In this regard we must consider that we have to enact certain law to be applied to a dietitian. In another words we should emphasize actual experiences of SFDs' knowledge accumulated through the field training & practice before they work at the company. Consequently it is a time to reconsider the importance of well-balance dietitian program offering an opportunity for SFD which can contribute to improvement of health's condition for the working people.

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