• 보건행정학회지
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• 제16권2호
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• 현장농수산연구지
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• 제13권1호
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• pp.173-183
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• 2011

1. Gabensis 마을은 3천여명의 인구를 가진 Morobe 지역의 Wampar 지방 정부 수준 영역에서 가장 큰 마을 중 하나이다. 2. 주식은 바나나를 비롯하여 마, 카사바, 토란과 고구마가 있다. 그 외에도 마을 사람들이 그들의 생계를 보완하기 위해 야채, 코코아 가루, 코코넛, 목재, 닭고기, 생선, 돼지고기 생산 및 판매에 종사하고 있다. 3. Gabensis 마을 호수 Wanam호수의 자연적인 매력은 농촌관광 사업으로 개발 가능한 잠재력이 있다. 특히, 에코빌리지를 중심으로 지역 사회를 위한 거대한 경관농업의 가치 창조가 필요하다. 정부 서비스 제공과 개발, 교육 및 건강 문제의 일환으로 중요한 지역이다. 4. 넓은 경지면적을 지니고 있지만 경지 정리 및 수리시설 미비로 농업용수가 부족하고 농사에서도 기술수준이 낮아 농업 생산성이 떨어진다. 생산 기술만 제공되면 마가 향후 마을의 중심 작목으로 주민들의 중요한 소득원이 될 것을 기대하고 있다.