• Journal of Society of Preventive Korean Medicine
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• v.28 no.1
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• pp.13-30
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• 2024

Objectives : This study aimed to investigate the history, current status, and regulation of complementary medicine in Australia. Methods : To investigate complementary medicine in Australia, we searched domestic and overseas academic databases, and websites of public and private organizations related to the Australian health care. Results : Complementary medicine consists of numerous services, among which massage and chiropractic care are significantly utilized by Australians. Since 2010, Australian healthcare practitioners, in the field of complementary medicine, have been supervised by the Australian Health Practitioner Regulation Agency (AHPRA). Those who AHPRA is responsible for managing acupuncturists, chiropractors, and osteopaths. Other professions are regulated by their own respective associations. Not only aforementioned services offered by specialists, but also consumption of oral supplements accounts for considerable portion of complementary medicine in Australia. Complementary medicine products, vitamins, and minerals are managed by the Therapeutic Goods Administration (TGA). In terms of insurance policy, the reimbursement of complementary medicine expenses in Australia is covered by the public healthcare insurance system, Medicare. Medicare covers acupuncture, chiropractic, and osteopathy services. Other complementary therapies are continuously reviewed to update their coverage under this scheme. Conclusion : In Australia, practitioner qualifications, education standards, and scope of procedures related to complementary medicine are systematically managed through legal regulations of the federal and state governments.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.419-430
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• 1988

This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

• Communications for Statistical Applications and Methods
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• v.16 no.6
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• pp.1055-1066
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• 2009

Many articles have considered a hybrid censoring scheme, which is a mixture of Type-I and Type-II censoring schemes. We introduce a double hybrid censoring scheme and derive some approximate maximum likelihood estimators(AMLEs) of the scale parameter for the half logistic distribution under the proposed double hybrid censored samples. The scale parameter is estimated by approximate maximum likelihood estimation method using two different Taylor series expansion types. We also obtain the maximum likelihood estimator(MLE) and the least square estimator(LSE) of the scale parameter under the proposed double hybrid censored samples. We compare the proposed estimators in the sense of the mean squared error. The simulation procedure is repeated 10,000 times for the sample size n = 20(10)40 and various censored samples. The performances of the AMLEs and MLE are very similar in all aspects but the MLE and LSE have not a closed-form expression, some numerical method must be employed.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.441-458
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• 1991

The objective of this study was to provide basic reference data for stabilization scheme of medical insurance benefits through forecasting of the medical care utilization rate, the medical expence per case, and the treatment days per case in medical insurance program for government employees & private school teachers and for industrial workers. For the achievement of above objective, this study was carried out by Box-Jenkins time series analysis (ARIMA Model), using monthly statistical data from Jan. 1979 to Dec. 1989, of medical insurance program for government employees & private school teachers and for industrial workers. The results are as follows ; ARIMA model of the medical care utilization rate in medical insurance program for government employees & private school teachers was ARIMA (1, 1, 1) and it for outpatient in medical insurance program for industrial workers was ARIMA (1, 1, 1), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the medical expense per case in medical insurance program for government employees & private school teachers and for outpatient in medical insurance program for industrial workers were ARIMA (1, 1, 0), while it for inpatient in medical insurance program for industrial workers was ARIMA (1, 0, 1). ARIMA model of the treatment days per case of both medical insurance program for government employees & private school teachers and industrial workers were ARIMA (1, 1, 1). Forecasting value of the medical care utilzation rate for inpatient in medical insurance program for government employees & private school teachers was 0.0061 at dec. 1989, 0.0066 at dec. 1994 and it for outpatient was 0.280 at dec. 1989, 0.294 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 0.0052 at dec. 1989, 0.0056 at dec. 1994 and it for outpatient was 0.203 at dec. 1989, 0.215 at 1994. Forecasting value of the medical expense per case for inpatient in medical insurance program for government employees & private school teachers was 332,751 at dec. 1989, 354,511 at dec. 1994 and it for outpatient was 11,925 at dec. 1989, 12,904 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 281,835 at dec. 1989, 293,973 at dec. 1994 and it for outpatient was 11,599 at dec. 1989, 11,585 at 1994. Forecasting value of the treatment days per case for inpatient in medical insurance program for government employees & private school teachers was 13.79 at dec. 1989,13.85 at an. 1994 and in for outpatient was 5.03 at dec. 1989, 5.00 at dec. 1994, while it for inpatient in medical insurance program for industrial workers was 12.23 at dec. 1989, 12.85 at dec. 1994 and it for outpatient was 4.61 at dec. 1989, 4.60 at 1994.

• Journal of Korean Academy of Rural Health Nursing
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• v.15 no.2
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• pp.66-73
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• 2020

Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.

• Korean Journal of Occupational Health Nursing
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• v.16 no.2
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• pp.168-176
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• 2007

Purpose: This study was to investigate the factors influencing on the quality of life (QOL) among herniation of nucleus pulposus (HNP) patients caused by occupational accidents. Method: 203 patients of HNP were recruited. 106 patients were occupationally injured workers who benefited from workmen's compensation scheme (PWCS group), and 43 patients were non-occupationally injured workers benefiting from national health insurance (PNHI group). Questions of QOL items were used by Korean version of SBQOL (SmithKlein Beecham's Qality of Life). Result: The quality of life of PWCS group measured by SBQOL was significantly lower than that of PNHI group. In PWCS group, SBQOL was significantly lower in patients with 40s of their age, 5 years or longer of treatment duration, no expectation of return to work, no expectation of recovering subject's health, and with loss of employment than rest of the patients in each category. Expectations of recovering subject's health showed to be affect factors on QOL both the PWCS and PNHI groups. Conclusion: It suggested that betterment of expectation of recovering patient's health and an administrative system for returning to work of the occupationally injured HNP patients during treatment be necessary for improvement of their quality of life.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.1
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• pp.83-91
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• 2008

Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.

• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.89-96
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• 2013

This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.2
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• pp.105-114
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• 2017

Objectives: The Ministry of Employment and Labor's enforcement programs, such as workplace monitoring inspection, are one of the major public efforts to protect worker's health. Therefore, a more effective inspection method is required for workplace monitoring, which is helpful for controlling health hazards in the workplace. Methods: For this study, we investigated the related safety and health laws, regulations, and inspection guidelines from the USA, Japan, and Korea. We also analyzed the provisions of industrial safety and health acts, which are related to enhancing the reliability of workplace monitoring. We applied the process of opinion convergence through an experts meeting for our research. Results: We proposed an efficient inspection scheme for workplace monitoring that includes how to select companies(mainly randomized inspections by using a workplace measurement database and workers' compensation insurance database), how to proceed with the inspection process(mainly unannounced visits), and who should carry out this project. Conclusions: We conclude that our proposal for the inspection of workplace monitoring could be a very effective tool for reducing the numbers of companies that do not undertake workplace monitoring and could produce reliable monitoring results.