• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.175-209
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• 2019

The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.158-163
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• 2020

This study examines and presents reasonable improvement measures for the operation and revision of the relative value scoring system, and the basis for performance of a medical technologist. Seven hospitals were enrolled in the study, and included 5 resident laboratory medicine specialists and 53 medical technologists, giving a ratio of 10.6 technologists per laboratory medicine specialist. The average of professional manpower scores was 18, and the average of each medical institution's total score was 78. Ratings and additional rates were in the range 2~3%, and quality-added ratios were 2~3%, with no significance. Excluding pathological testing and assessing physiological functions, the average number of diagnostic tests for health insurance claims were 9,618,062, including 4,378,146 points for 5% of the total relative value scores. According to the DEA, the appropriate number of medical technologist is one person per 49,974 points of relative value. In conclusion, our study results indicate that it would be desirable to set the appropriate workforce for medical technologist to one person per 50,000 points of relative value. Our data could be used as a basis for enhancing productivity of the workforce and balancing health care resources.

• 한국노년학
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• v.29 no.2
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• pp.477-488
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• 2009

Purpose: This study was conducted to investigate newly admitted nursing home resident's experience and adjustment problems in the early stage of institutionalization. Method: In depth interviews was done on 6 elderly residents who were newly admitted. Data from the interview were analyzed using theme analysis method. Results: Results showed that reasons for Institution admission were decreasing physical health and cognitive functioning. Residents reported that difficulties they experienced in institution life were lack of individualized care, loss of autonomy and privacy associated with the demands of group living, and loss of control over activities of daily living. Conclusion: Efforts need to be made to maintain the residents' decision-making and autonomy. Listening intentionally, offering choices, and promoting personal identity might be utilized to reduce relocation stress and enhance adaptation to nursing home living.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Health Policy and Management
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• v.12 no.3
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• pp.1-22
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• 2002

Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.

• Journal of the Korean Dietetic Association
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• v.8 no.1
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• pp.9-18
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• 2002

This study was reviewed databases and outcomes of national/international off-line and on-line(Internet) nutrition softwares to identify the present conditions of nutrition softwares, and investigated user's needs and determine which component should be included in nutrition software. The most frequently used databases for the national programs were the food composition table provided from the National Rural Living Science Institution in Rural Development Administration and the food composition table and the nutrient contents of foods provided from the Korean Nutrition Society. For international programs, the food composition table from the USDA was commonly used. The analysed outcomes included the degree of obesity, nutrient analysis and nutrient intake compared with RDA, food intake from each by food group, food habits and the frequency of food consumption. As to the result of needs assessment for the Internet nutrition softwares, it was suggested that the needs of the Internet nutrition softwares were high because most of the respondents replied that 3-point('it is needed') or 4-point('it is necessary') on 4-points likert scale. As to the databases, the needs of 'food composition analysis' and 'the suggestion of the Korean RDA' were high. For the basic information for foods, the respondents replied that 'the classification of foods', 'foods codes', 'the amount of ingredients' and 'nutrient analysis' should be included. The needs of 'nutrient analysis of meal', 'diet therapy' and 'meal plan by caloric requirements' were high. As for utilizing the Internet meal planning programs, the respondents replied that 'it should be easy to use' most and demand for 'data saving and the saved data should be usable later' and 'meal planning education tools' were high. In conclusion, the Internet nutrition software that satisfies various needs of users should be developed for policy making that promote public health, nutritional care and self-supporting of foods.

• International Commerce and Information Review
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• v.17 no.2
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• pp.95-120
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• 2015

Under the stiff competition in the health care industry, the long run survival of medical institution depends on building up customer loyalty. The purpose of this study is to figure out the influencing factors on customer loyalty. This new model is based on Bettman(1979)'s customer purchasing decision making process(awareness-interest-final decision). The key characteristics of this model reflects the psychological change of customer purchasing decision The influencing factor at each purchasing stage must need to be identified because the inner decision making process is generally carried out by multistage. In this respect, this study shows the brand awareness of hospital plays an important role at the first stage. In a second stage, the servciescape and service quality of hospital must be considered. Finally, customer's perceived value is adopted. By using a sample of 116 Chinese tourists, this study empirically examines the influencing factors of customer loyalty. The results that the brand awareness and perceived value have a positive effect on customer loyalty.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.141-178
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• 2012

Korea's medical law prohibited medical advertisements in principle and permitted them on an exceptional cases. However, the decision of the Constitutional Court of 20005. 10. 27. 20003 Heonga 3, it was changed to a negative system which allows advertisements in principle and restricted only exceptionally. Dramatic increase of medical advertisements was made after that and many argued more deregulation because there was actually heavy regulations. In particular, there is almost no actual regulation on the article type advertisement due to the reason of protection of the freedom of press, media and occupation. However, there may be an unjust result if a specific article or specialists' opinion is made using a newspaper, broadcasting or magazine as a form of article type advertisement to specific medical specialists or medical institution or medical treatment method that falsifies consumers or makes consumers confused by unjust medical expectations or reliability, that also deteriorates just competition and that causes the misrecognition of consumers. In fact, there were actual damages of article type advertisements on the eye whitening surgery not long after the transfer to a negative system of medical advertisements. Victims raised a medical proceeding against the doctor who carried out the surgery, but there is actually no systematic warranty except for the indemnity request. Thus, this case demonstrated a vulnerable result of a negative system. As such, it is problematic that there is no proper regulations defined in the current law and regulations because of the reason of the protection of the freedom of press, publication and occupation despite damages of such article type advertisements. Accordingly, it is urgent to apply the current prevention regulations on the article type advertisements strictly, and to set up specific regulations.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.3
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• pp.401-412
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• 2000

Like other livestock, monogastric animals are essential components of the farming systems in the tropical countries. Pigs, chicken and ducks are by far the most important animals in the culture of the peoples of developing countries in the tropics. Traditionally these animals are raised in small farms and they are also the bulk producers of meat, eggs etc. in the tropics. In many countries the farmers of these small farms are unable to meet the requirement set by financial institution and other loan giving agencies for agricultural loan. Thus, the small farmers can get neither the opportunity to generate sufficient income to support the family nor to extend the livestock activities. The production systems are characterized by small number of animals with no or minimal inputs, low outputs and periodic destruction of animals by disease. Typically the litter size or flocks are small in number with each household containing 5-6 pigs and 7-10 poultry. Animals are owned by individual households and mostly maintained under a scavenging systems with little or no inputs for housing, feeding or health care. Because of the nature of this production system, productivity of these animals is rather low. The low level of inputs is due to a lack of capital and a low risk oriented outlook. The feed resource base for monogastric is scavenging and consists of household waste, roots and tuber, grain by-products and anything edible found in the immediate environment. Usually farmers select breeding gilts from their own female piglets or to a lesser extent, buy them from neighbors for natural mating. As regards poultry attempts have been made to increase egg and meat production by improving local poultry birds by upgrading and crossbreeding with exotic germ plasma in the tropics. Animal disease present a major constraint to animal production in the tropical region and the extent of the losses due to disease is very high.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.33-39
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• 2005

Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.