• The Journal of Korean Institute for Practical Engineering Education
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• v.3 no.2
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• pp.53-62
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• 2011

The elliptical trainers(ET) can be a good tool for educating engineers by analyzing physical responses in terms of Respiratory Exchange Ratio (RER, epm) and Heart Rate (HR, bpm). For the various energy expenditure, exercise speed, and weight loss both RER and HR are studied in order to study the blood circulations based on the health training cardiorespiratory. As the results, (1) RER increases gradually as the energy expenditure, however, HR increases gradually up to a critical value and then increases rapidly. The critical value of the energy expenditure in our studies was 275 Cal. (2) RER increases gradually as the ET speed increases, however, HR increases gradually up to a critical value and then increases rapidly. The critical value of the ET speed in our studies was about 6.7km/h. (3) RER increases gradually as the weight loss increases (or, the metabolic cost increases), however, HR is almost nothing to do with the increase of the weight loss.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.2
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• pp.183-192
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• 2006

Predicting energy expenditure (EE) is important to prevent work-related musculoskeletal disorders (WMSDs). The problem to predict EE is that the standard of EE is based on western data. The authors checked average EE by job categories to provide basic data for suggesting proper work intensity for Korean workers. This study was conducted from 2003 to 2005. Study subjects were recruited from 4 car parts assembly plant, 2 car assembly plant, 2 Heavy machine manufacturing plant and 2 shipyards. Total study subjects were 515 male workers. To estimate VO2max, sub-maximal test was conducted to measure VO275%max by bicycle ergometer (Combi Co, Aerobike 75XL II). Heartbeats were recorded with heartbeat recorder (Polar Electro Co, Finland, S810) during work. EE of work was calculated by recorded heartbeat and individual regression equation which was derived from sub-maximal test. Subjects were classified into 4 industry and 8 work posture, 23 job task categories. Mean EEs (S.D.) according to industry classification (kcal/min) were 4.9 (0.7), 4.8 (0.7), 4.9 (0.7), 5.0 (0.9), and 4.0 (0.5) for Car Part manufacture, Car Assembly, Ship Building, Heavy Machinery Manufacture, and Hospital Office, respectively. The results suggest that Korean male workers of exceeding to the NIOSH criteria will be needed to plan for job rescheduling to maintain $worker^{\circ}$Øs health. Further study to establish Korean work intensity standard would be needed.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Health Policy and Management
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• v.30 no.4
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• pp.451-459
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• 2020

Background: Although Korean government have been adopting several policies to expand coverage of National Health Insurance (NHI) program, the coverage rate is still below average across Organization for Economic Cooperation and Development countries. This study was to identify public perception on appropriateness of coinsurance rate and factors associated with coinsurance rate in National Health Insurance. Methods: For this cross-sectional study, 507 participants over aged 20 years were recruited from telephone surveys. Respondents experienced at least one and more visiting medical facilities due to medical problems in last 12 months. Demographic factors, socioeconomic positions, and experiences on medical utilization were measured in order to identify factors associated with perception appropriateness of coinsurance rate. Results: The 49.9% (n=209) of the public responded that the coinsurance rate of NHI program was appropriate. There were no differences in positive perception according to socio-demographic factors and experiences on medical utilization except for gender, residential area, and felt expensive when using medical services. People who felt burden of medical expenditure were more likely to perceive coinsurance rate inappropriate (odds ratio, 2.33; 95% confidence interval, 1.52-3.58) Conclusion: In spite of the relatively low coverage rate of NHI, this study identified that 49.9% of the public perceived the current coinsurance rate was adequate. However, people who felt the burden of medical expenditure were still had a negative perception of the coinsurance rate needed to decrease the coinsurance rate.

• 한국노년학
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• v.39 no.3
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• pp.467-484
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• 2019

The purpose of this study is to explore latent classes of longitudinal medical expenses of older people and to analyze its predictors and its effects on subjective health. Among participants of the Korean Health Panel, the sample of this study includes 1,119 people who is 65-year-old or older and reported their medical expenses for nine consecutive years. The analyses were conducted in three steps. First, Growth Mixture Model (GMM) was applied to find distinct subgroups showing similar patterns in medical expenses. The results showed four groups which were classified as high medical expenditure maintenance group, medical expenditure increase group, low medical expenditure maintenance group, and medical expenditure reduction group. Second, the multinominal logistic regression found that the presence of spouse, economic participation, the number of chronic diseases, and the type of health insurance were significant predictors of latent classes in medical expenses. In particular, the greater the number of chronic diseases, the higher the likelihood of belonging to the high medical expenditure maintenance group. In addition, medical benefit recipients are more likely to belong to the low medical cost maintenance and medical cost reduction groups. Third, multiple regression analysis revealed that the older people in the groups with low or reducing expenses reported better subjective health than people with higher expenses. This study has its meanings in exploring the heterogeneity in longitudinal medical expenses among older people and its predictors and its associations with health outcome. The results of this research provide background information in establishing public health policy for older people.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Journal of Nutrition and Health
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• v.26 no.4
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• pp.390-404
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• 1993

The purpose of this paper is to determine the percentage of body fat by measurement of skin-fold thickness of the triceps and the subscapular area to investigate the relationship between the daily energy intake and expenditure among obese women and nonobese women based on the percentage of body fat and age. This survey included 422 females in Cheju. 1) The age distribution of the 422 females surveyed was : 26.8% were in their 20's, 20.6% in their 30's, 21.3% in their 40's, 19.0% in their 50's and 12.3% were above 60 years of age. The 422 females consisted consisted of 78% housewives, 12.8% college student and 9.2% single working women. 2) The average height and weight of the surveyed women were respecitively 159.0$\pm$4.2cm and 56.0$\pm$7.2kg, the percentage of body fat of the surveyed women was 24.8$\pm$9.8%, and the BMI of those surveyed was 22.7$\pm$2.7. If higher than 30% body fat was defined as being obese, 15.6% of the surveyed women were assessed to be obese. 3) Total daily food consumption and energy intake of the group of women aged 60 and older was significantly small. Food consumption and nutrient intake of obese women was greater than that of the nonobese group, but not significant. Carbohydrate intake of the obese group in their 40's was significantly higher than the nonobese group. Total food consumption, energy and carbohydrate intake of the obese group in their 50's was significantly higher than the nonobese group. Vegetable intake of the obese group in their 60's and older was significantly higher than the nonobese group. 4) The total time of physiological activity of women aged 60 and older was significantly higher than for the other age groups and the total work time was significantly lower. The total work time of women in their 20's was not lower than the other groups. Considering the low energy expenditure of physical activity for women in their 20's, they appeared to have light activity. However, there was not a significant difference in the physical activity time among middle aged women groups(from 30 to 50). The entire energy expenditure of the obese group was greater than the nonobese group. However, the energy expenditure per body weight in the obese group was significantly less than that of the nonobese group in terms of the basal metabolic rate in consideration of the fat free mass. 5) There was a positive correlation between the percentage of body fat and the factors of age, sleeping time, total time of physiological activity, housework time, time spent watching TV, energy expenditure, energy intake, carbohydrate and cereal consumption. On the other hand, the percentage of body fat was negatively correlated with energy expenditure per body weight based on the basal metabolic rate in consideration of the free mass.

• The Journal of the Korea Contents Association
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• v.5 no.6
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• pp.230-237
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• 2005

In this paper, we are suggested a method that's a major topics in sports medicine. It is disease control, control and management of chronic degenerative disease, and promotion of health. We are analyze physical activity to scientific and quantitative a trainee at Wu-Shu gymnasium, for a suggested method. We are measured a quantity of physical activity by SenseWear-PRO2-Armband which develop body-media company. Armband include to skin temperature sensor, near-body temperature sensor, accelerometer, heat flux sensor, galvanic skin response sensor. Acquired data was recorded to storage in Armband. We are analyzed using InnerView Wearer Software in the Stored data to skin temperature, calorie expenditure, quantity of physical activity. The result of this analyzed, we are know that a man of long-term exercise expenditure energy at short time and if liveliness of physical activity was Increase in expenditure energy with increase skin temperature. Also, we are know that the heat flux after increase expenditure energy with increase skin temperature. And, know that GSR was not affected a factors that physical activity, expenditure energy, increase skin temperature, and others.

• Journal of Nutrition and Health
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• v.45 no.6
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• pp.511-521
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• 2012

The purposes of this study were to assess the physical activity level (PAL) and the total daily energy expenditure (TEE) as well as to evaluate the validity of prediction equation for the estimated energy requirement (EER) in normal weight and overweight or obese children and adolescents. The subjects comprised of 100 healthy Korean students aged between 7-18. The anthropometric data was collected. PAL was calculated from the physical activity diary by the 24-hour recall method, and the resting metabolic rate (RMR) was measured by an open-circuit indirect calorimetry using a ventilated hood system. Daily energy expenditure was PAL multiplied by RMR. EER was calculated by using the prediction equation published in KDRIs. There was no significant difference in the means of age and height between the 46 obese subjects and 54 nonobese subjects. The weight and BMI of the obese group (60.2 kg, $25.3kg/m^2$) were significantly higher than those of the nonobese group (42.4 kg, $18.4kg/m^2$). However, PAL was not significantly different between the two groups (nonobese 1.45, obese 1.46). TEE of the obese group (2,212 kcal/day) was significantly higher than that of the nonobese group (1,774 kcal/day). EER (individual PA) and EER (light PA) were significantly higher than TEE (p < 0,001); however, EER (sedentary PA) was not significantly different with TEE in the two groups. These results showed that the levels of physical activity were the same as the sedentary activity both in the nonobese and obese Korean students; moreover, the predictive equation for EER published in KDRI overestimated the TEE of Korean children and adolescents. Therefore, in further research, a new predictive equation for EER should be developed for Korean children and adolescents through the doubly labeled water method.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.6
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• pp.3534-3547
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• 2014

Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.