• Title/Summary/Keyword: Health Services

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Variation of Hospital Costs and Product Heterogeneity

  • Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.123-127
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    • 1978
  • The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

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Estimation Analysis of the Value of Welfare Facilities for the Aged Management (노인복지시설의 경영가치 추정 분석)

  • Kim, Keum Hwan;Pak, Ae Kyung;Joe, Soon Joem
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.1
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    • pp.193-203
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    • 2013
  • The social welfare service is expanding to different field as the social welfare budget is increasing. By this opportunity, it needs to make clear of the basis of argument that the necessity of development of korean government's support and aid by social policy should be worked. Welfare economics perspective, this study used by the operating expenditure in welfare facilities for the elderly old people to effect social benefits to be gained, in other words, business value analysis. Local elderly people, provide opportunities to participate in the economic activities of the family welfare services offered to attainment of the elderly welfare policy, and provide disease prevention and health promotion opportunities, to enhance the satisfaction of life, including a wide range of impact will cause. In this study, elderly people use the welfare facilities for the elderly when they get the benefits by applying the AHP analysis techniques operating value was calculated. Elderly Welfare Center operated by the result of applying P senior welfare center Case of the metropolitan area value was estimated 248.4 billion won. Contribute to the effects caused by the cost factor of the analysis was 23.1% of the total 57.3 billion won. Independence elements 57.6 billion (23.2%), the analysis of the therapeutic elements 133.4 billion (53.7%) of the net was. The result of the study anticipates the role of basic research material for the necessity of intervention, support, and aid by the Welfare facilities for the elderly field at this point in time where the welfare budget policy in terms of universal social service is reinforced, rather than the trend, until recently, of realizing the Elderly welfare budget and service as Consumption expenditure and consumable benefits and the function of performing the effect and evaluation in tentative action of social conflict.

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Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer (동병하치 확산을 위한 전략적 방향과 이행방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.

Visual Image Analysis on the Types of Natural Funeral (자연장의 유형별 시각적 이미지 분석)

  • Kim, Chuljae;Lee, Shiyoung
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.1
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    • pp.75-88
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    • 2014
  • This research aims to introduce the external type of natural funeral landscape facilities and to examine the effect of its visual image factor on the preference for them. For this purpose, a survey was conducted among 549 persons including 224 experts on the funeral services. The majority of respondents in this research live in the Seoul, Daejeon, Jeonju, and Busan areas. Burial place facilities and memorial facilities among natural funeral landscape facilities for the study are selected and categorized into five types, respectively. Of these, the funeral area type includes a woody style, a garden style, a flower style, a grass style and a scattered ashes style. As a result, firstly, from the factor analysis, three image factors are extracted such as a physical factor, an external-appearing factor and a symmetrical factor from the burial place facilities. Secondly, the most flavored among 5 burial palace facilities is woody style, followed a flower style, a garde style, a grass style and a scattered ashes style. Third, we draw a perception map based on the average values of each image factors. Forth, we find some significant difference in the evaluation of the image factors of burial place facilities by characteristics of the respondents. The gender, age, the education level and the facilities type reveal the significant difference in a physical factor. Moreover, we find a significant difference in the level of an external-appearing factor according to a gender, religion, a group members, and in the level of a symmetrical factor according to the gender, the education level, and the facilities type. Fifth, we execute a regression analysis in order to analyze the effect of the image factors on its preference for the burial place and memorial facilities. We find a positive effect of a physical, an external appearing and a symmetrical factor on its preference. Finally, we examine a moderating effect of a group member between the image factors and its preference. We find a significant positive moderating effect of an external-appearing factor for a garden style in the case of the burial place facilities. In this study are suggests that fix the problem of natural funeral landscape facilities typical naming contribute to the development of the early beginning natural funeral landscape facilities and study on development of natural funeral landscape facilities suitable for domestic. In addition, this study has shown that having rational guideline when people use natural funeral that develop a funeral culture through preference natural funeral standard visual image analysis such as preserve the traditional funeral philosophy and a new aesthetic needs.

Impact of a Brand Image Matching with the Advertising Model on Price Fairness Perceptions: Focus on Sports Advertising (브랜드 이미지와 광고모델의 일치성이 가격공정성 지각에 미치는 영향 : 스포츠 광고를 중심으로)

  • Hwang, Hee-Joong;Shin, Seung-Ho
    • Journal of Distribution Science
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    • v.10 no.3
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    • pp.43-50
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    • 2012
  • This study sets out to examine how a brand image that matches the advertising model has a positive impact on brand attitude and price fairness perceptions. We reviewed the constructs on the basis of previous studies and each of the concepts has been redefined. One such concept, "image congruence," refers to the harmony, fitness, and matching quality of images. For example, how well celebrity advertising model is matches the brand image shows image congruence. Results are summarized as follows: First, the congruence of brand image and sports advertising model has no significant impact on brand attitude certainty and persistence. Second, the individual's brand attitude certainty and brand attitude persistence has a positive impact on the perceptions of price fairness. Third, the congruence of brand image and sports advertising model has a positive impact on the perceptions of price fairness. The first and the third results suggest that the positive impact on the price fairness perceptions is temporary but it has insignificant effects on the formation of brand attitude causing ongoing purchases. In other words, in order to influence consumers' long-term confidence on the brand, improving the quality of products or services has to precede promotional strategies such as advertising. When an advertising model is inappropriate for the brand image, consumers perceive product price changes as a negative issue in the short term. However, in the long term, attitude formation such as consumers' repurchase intentions and word of mouth will be not affected. The second result suggests that an already existing positive brand attitude can contribute more positively to change the perceptions of price fairness. In particular, attitude persistence has greater influence than attitude certainty on the price fairness. It suggests that persistence issues such as the trading period and the frequency of transactions must be managed and controlled because they are more important than the certainty issues such as strength of belief or trust. For example, when a commercial model for expensive sporting goods matches up with the brand image, consumer feels less pressure on the price changes. However, it does not determine the consumer's repeated purchases or sustainable transactions and it also has no absolute impact on the brand trust. In other words, consumer brand attitude should be recognized and approached as a routine strategy in view of the result that it is of great value as a causal variable in the process of consumer decision-making.

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National Management Measures for Reducing Air Pollutant Emissions from Vessels Focusing on KCG Services (선박 대기오염물질 배출 현황 및 저감을 위한 국가 관리 대책 연구: 해양경찰 업무를 중심으로)

  • Lee, Seung-Hwan;Kang, Byoung-Yong;Jeong, Bong-Hun;Gu, Ja-Yeong
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.26 no.2
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    • pp.163-174
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    • 2020
  • Particulate matter levels are rapidly increasing daily, and this can affect human health. Therefore, air pollutant emissions from sea vessels require management. This study evaluates the status of air pollutants, focusing on air pollutant emissions from the vessels of the Korea Coast Guard (KCG), and proposes national management measures to reduce emissions. According to a report recently released (2018) by the National Institute of Environmental Research (NIER), emissions from vessels constituted 6.4 % of the total domestic emissions, including 13.1 % NOx, 10.9 % SOx, and 9.6 % particulate matter (PM10/PM2.5). Among the rates of pollutant emission from vessels, the emission rates of domestic and overseas cargo vessels were the highest (50.6 %); the ratio of fishing boats was 42.6 %. With respect to jurisdictional sea area, 44.1 % of the emissions are from the south sea, including the Busan and Ulsan ports, and 24.8 % of the emissions are from the west sea, including the Gwangyang and Yeosu ports. The KCG inspects boarding lines to manage emission conditions and regulate air pollutant emissions, but it takes time and effort to operate various discharge devices and measure fuel oil standards. In addition, owing to busy ship schedules, inspection documents are limited in terms of management. Therefore, to reduce the air pollutant emissions of such vessels, regulations will be strengthened to check for air pollutants, and a monitoring system based on actual field data using KCG patrol ships will be established, for each sea area, to manage the emissions of such vessels. Furthermore, there is a need for technological development and institutional support for the introduction of environmentally friendly vessels.

Selection of Optimum Filter Media in Small-Scale Livestock Wastewater Treatment Apparatus by Natural Purification Method (자연정화공법을 이용한 소형 축산폐수처리장치의 최적여재 선정)

  • Kim, Ah-Reum;Kim, Hong-Chul;Seo, Dong-Cheol;Park, Jong-Hwan;Kim, Sung-Hun;Lee, Seong-Tae;Jeong, Tae-Uk;Choi, Jeong-Ho;Kim, Hyun-Ook;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.2
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    • pp.285-292
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    • 2011
  • In order to develop livestock wastewater treatment technology by natural purification method, the optimum filter media in small-scale livestock wastewater treatment apparatus for treating livestock wastewater were studied. Removal rates of pollutants under different filter media were in the other of coarse sand ${\fallingdotseq}$ broken stone > zeolite > calcite for COD, zeolite >> broken stone ${\fallingdotseq}$ coarse sand ${\fallingdotseq}$ calcite for T-N, and calcite > coarse sand ${\fallingdotseq}$ broken stone ${\fallingdotseq}$ zeolite for T-P. Based on the above results, the optimum filter media was coarse sand in small-scale livestock wastewater treatment apparatus. To meet acceptable effluent quality standard for livestock wastewater and to improve T-N and T-P removal efficiencies, removal efficiencies of pollutants in small-scale livestock wastewater treatment apparatus with mixed filter media were studied. The removal rates of COD, SS, T-N and T-P in effluent were 84, 94, 65 and 98% in small-scale livestock wastewater treatment apparatus with mixed filter media, respectively. For increasing the T-N and T-P removals in small-scale livestock wastewater treatment apparatus, the mixed filter media are recommended.

Optimum Configuration Method and Livestock Wastewater Loding for Treating Livestock Wastewater in Constructed Wetlands by Natural Purification Method (자연정화공법에 의한 인공습지 축산폐수처리 시스템의 최적 조합방법 및 부하량)

  • Park, Jong-Hwan;Seo, Dong-Cheol;Kim, Ah-Reum;Kim, Sung-Hun;Lee, Seong-Tae;Jeong, Tae-Uk;Choi, Jeong-Ho;Kim, Hyun-Ook;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.2
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    • pp.278-284
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    • 2011
  • To obtain optimum configuration method and livestock wastewater loading in small-scale livestock wastewater apparatus by natural purification method for treating livestock wastewater, the small-scale livestock wastewater apparatuses were constructed with 9 kinds of combined systems such as aerobic bed (ae)-anaerobic bed (an), ae-ae, ae-anoxic bed (ox), an-an, an-ae, an-ox, ox-ae, ox-an and ox-ox livestock wastewater treatment apparatuses. Under different configuration methods, the removal rate of COD in Ae-Ae and Ae-An livestock wastewater treatment apparatus was higher than that in other configuration methods. The removal rate of T-N in Ae-An livestock wastewater treatment apparatus was higher than that in other configuration methods. Removal rates of SS and T-P were not different regardless of configureation methods in small-scale livestock wastewater treatment apparatus. Under different livestock wastewater loading, the removal rates of pollutants were higher in the order of $50L\;m^{-2}\;day^{-1}{\fallingdotseq}100L\;m^{-2}\;day^{-1}\;>\;200L\;m^{-2}\;day^{-1}$. Therefore, optimum configuration method was Ae-An livestock wastewater treatment apparatus, and optimum livestock wastewater loding was $100L\;m^{-2}\;day^{-1}$ in small-scale livestock wastewater treatment apparatus.

Sexuality, Contraception, and Induced Abortion among Adolescents and Young Adults in the Export Processing Zones of Korea (미혼여성의 성, 피임, 그리고 인공유산 - 수출공단지역의 사례연구)

  • 조성남
    • Korea journal of population studies
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    • v.19 no.1
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    • pp.93-122
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    • 1996
  • This is a study of the determinants of sexual, contraceptive, and abortion behavior among unmarried female adolescents and young adults, which has emerged as a growing and serious health problem in Korea. As part of a larger project, data were gathered in three export zones: Kuro (Seoul), Kumi (Kyngbuk) Masan Changwon (Kyongnam) ; and the study samples are regrouped into three categories: 1) factory workers, i.e. , the reference group serving as program participants, 2) entertainment workers, and 3) ob-gyn patients. This study indicates that entertainment workers are at highest risk of experiencing premarital sex, STDs, contraceptive failure, unwanted pregnancies, and induced abortion. Of them, 20 percent had STDs as a result of first sexual experience: and about seven tenths had two or more pregnancies due to the adoption of low-efficacy methods. The proportion of those who had ever been pregnant was 60 percent for the group as a whole: 36 percent for the program participants: 64 percent for the entertainment workers ; and 91 percent four the ob-gyn patients. These proportions are exactly the same for abortion in each group, which means that all pregnancies ended in induced abortion. Of the respondents who said that they were sexually active at the time of survey, abortions were very high: 1.6 for the program participants, 2.3 for the entertainment workers, and 1.9 for the ob-gyn patients. About 80 percent of the women had abortions during the first trimester, and two thirds of the first abortions took place between the ages of 20 and 23. About one fourth experienced post-abortion complication, which was highest among the program participants (39 percent). Sixty percent of those with complications visited a hospital or took medicine to treat the problem. Even after the experience of induced abortion, the use of contraception was very low, except among the entertainment workers, whose level of use reached 53 percent. The most obvious recommendation, arising from this research, is that 'good-quality' counselling and family planning services be established under the auspices of both national and local government, particularly targeted for the entertainment workers as well as the factory workers in various textile, electronic, manufacturing, and other industrial sectors. We believe that entertainment sectors should be restructured radically so that young women who work for amusement bars and other entertainment sectors obtain protection from the risk of having unwanted pregnancies, STDs, and induced abortion.

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A Study on the Applicability of Social Security Platform to Smart City (사회보장플랫폼과 스마트시티에의 적용가능성에 관한 연구)

  • Jang, Bong-Seok
    • Journal of the Korea Convergence Society
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    • v.11 no.11
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    • pp.321-335
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    • 2020
  • Given that with the development of the 4th industry, interest and desire for smart cities are gradually increasing and related technologies are developed as a way to strengthen urban competitiveness by utilizing big data, information and communication technology, IoT, M2M, and AI, the purpose of this study is to find out how to achieve this goal on the premise of the idea of smart well fair city. In other words, the purpose is to devise a smart well-fair city in the care area, such as health care, medical care, and welfare, and see if it is feasible. With this recognition, the paper aimed to review the concept and scope of smart city, the discussions that have been made so far and the issues or limitations on its connection to social security and social welfare, and based on it, come up with the concept of welfare city. As a method of realizing the smart welfare city, the paper reviewed characteristics and features of a social security platform as well as the applicability of smart city, especially care services. Furthermore, the paper developed discussions on the standardization of the city in terms of political and institutional improvements, utilization of personal information and public data as well as ways of institutional improvement centering on social security information system. This paper highlights the importance of implementing the digitally based community care and smart welfare city that our society is seeking to achieve. With regard to the social security platform based on behavioral design and the 7 principles(6W1H method), the present paper has the limitation of dealing only with smart cities in the fields of healthcare, medicine, and welfare. Therefore, further studies are needed to investigate the effects of smart cities in other fields and to consider the application and utilization of technologies in various aspects and the corresponding impact on our society. It is expected that this paper will suggest the future course and vision not only for smart cities but also for the social security and welfare system and thereby make some contribution to improving the quality of people's lives through the requisite adjustments made in each relevant field.