• 한국식품위생안전성학회지
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• 제23권1호
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• pp.51-61
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• 2008

본 연구는 건강기능식품에 대한 소비자 연구를 통하여 신뢰도를 향상시키기 위한 표시 제도를 제안하기 위해 수행되었다. 소비자가 쉽게 건강기능식품을 확인할 수 있도록 공모를 통하여 인증마크를 개발하고 소비자 조사를 실시하였다. 조사대상자는 대도시, 중소도시 등 2000명으로 하여 1:1 면접조사를 실시하였다. 조사결과 건강기능식품 인증마크의 필요도가 매우 높았고, 텍스트 형태보다 텍스트/그래픽이 혼합된 형태의 영양 기능정보의 신뢰도가 높았다. 또한 인체에 작용하는 기전을 포함한 영양 기능정보가 소비자의 신뢰도를 높이는 데 도움이 되는 것으로 조사되었다. 따라서 건강기능식품 인증마크는 소비자로 하여금 제품을 선택하는데 도움을 줄 수 있을 것으로 사료되며, 또한 건강기능식품의 신뢰도를 높일 수 있는 표시제도의 개선에 기여할 것으로 사료된다.

• 의료법학
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• 제16권2호
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• pp.87-130
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• 2015

국민건강보험공단이 인신사고의 피해자에게 요양급여를 시행한 후 가해자에게 요양급여비용 중 공단부담금을 구상하는 사건에서 판례는 국민건강보험법이 정하는 청구권대위와 산업재해보상보험법이 정하는 청구권대위를 동일하게 취급하면서, 상계 후 공제설에 따른 공제 범위로부터 국민건강보험공단의 구상 범위를 도출하여 피해자의 손해배상채권액 내에서 공단이 부담한 요양급여비용 전부의 구상을 인정하고 있다. 그러나 국민건강보험법과 산업재해보상보험법은 모두 사회보험을 규율하는 법이지만, 국민건강보험법 요양급여는 '보장비율을 정한 일부 보험'의 성격을 띠고 있는데 비하여 산업재해보상보험법상 보험급여는 전부 보험의 성격을 보이거나 사회보험적 성격에 따라 손해액과 무관하게 산재를 당한 피보험자가 기존 생활에 가까운 생활을 영위하도록 보조하는 데 중점이 있다. 따라서 건보법상 청구권대위와 산재법상 청구권대위를 동일하게 취급할 이유는 없다. 피보험자는 보험금을 수령하는 대신 보험자가 대위에 의하여 취득하는 청구권을 상실하게 되므로 그 범위에서 보험금의 수령으로 인한 이익이 없다. 따라서 피보험자가 가해자를 상대로 손해배상을 구하는 소송에서 손익상계의 법리는 적용될 여지가 없고, 청구권대위의 범위나 손해배상에서 공제할 공제액은 당사자 사이의 약정이나 관계 법령에 따라 정하여야 한다. 따라서 판례가 상계 후 공제설로부터 국민건강보험공단의 구상 범위를 도출하는 것은 타당하지 않다. 국민건강보험공단의 구상 범위를 정한 국민건강보험법 제58조 제1항을, 손해배상이 먼저 이루어진 경우 국민건강보험공단의 면책 범위를 정한 같은 조 제2항과 결합하여 통일적, 체계적으로 해석하면, 국민건강보험공단의 구상 범위는 지급한 요양급여비용에 가해자의 책임 비율을 곱하여 정하는 것이 타당하다. 이는 산업재해보상보험법 제87조 제1항과 제2항의 해석상 근로복지공단의 구상 범위가 지급한 보험급여 내에서 피보험자의 청구권 전액에 미치는 것과 대비된다. 한편, 판례가 국민건강보험공단의 구상 범위를 판단하면서 그 전제로 삼은 상계 후 공제설은 피해자에게 손해액 이상의 이익을 귀속시키지 않는다는 목적을 이루기 위해서 피해자가 얻은 이익을 손해액에서 공제하면 족한데도 왜 그 이익을 손해배상채권액에서 공제하여야 하는지, 피해자가 입은 손해는 공평하게 분배하면서도 피해자가 얻은 이익은 모두 가해자에게 귀속시키는 것이 타당한지, 실제 사례에서 구체적 타당성이 있는지에 관하여 의문이 있다. 따라서 국민건강보험공단의 구상범위에 관한 판례 법리와 상계 후 공제설을 따르는 판례 법리는 재검토되어야 한다.

• 한국병원경영학회지
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• 제8권2호
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• pp.93-110
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• 2003

Fiscal crisis in the medical insurance has put the pressure upon hospitals by increasing the rate of curtailment, since the implementation of the separation between prescription and dispensing of Drug. The purpose of this study is to analyze the curtailment for antibiotics, injected drug and other drugs expenditure before and after the system of separation between prescribing and dispensing. Data were gathered from 13 general hospitals and used for analysis of trends on antibiotics and injected drug expenditure, and curtailment in 2000-2001 at three months intervals. The results were as follows; The curtailment rate of antibiotics expenditure has been increased in outpatient and inpatient since 2000. The curtailed antibiotics cost and injected drug cost in outpatient under the prescription within the hospital and in inpatient increased. The ratios of curtailment versus expenditure had increased in antibiotics, injected drugs, anticancer drugs, antiulcer drugs, albumine, antiinflammatory drugs. These results suggest that claim review system in social health insurance were over-focused mainly to control the cost and it might to impede the validity of claim review function in health insurance system. Therefore, it's needed to develope the scientific and reasonable parameter & criteria for claim review of drug expenditure.

• 한국치위생학회지
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• 제5권1호
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• pp.1-13
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• 2005

The study aimed to estimate the importance of job tasks, job training requirement and work satisfaction felt by dental hygienists to help dental hygienists work efficiently and effectively. A total of 142 dental hygienists working in dental hospitals located in J participated in the study. A SPSS 10.10 for Windows was used for statistical analysis. The statistical significance was defined as ${\alpha}$=.05. The results of the study are summarized as follows: 1. The mean score for the importance of job tasks was 4.09. The respondents considered dental clinic management and assistance to dentists the most important among their job descriptions showing the mean score of 4.44. The need for job training was 4.15 in average. The respondents wanted to have training on how to make a dental health insurance claim to receive payment other than any training with the mean score of 4.42. The work satisfaction of the respondents was 3.65 in average. The respondents were most satisfied with their work in dental assistance. 2. By the category of job tasks, the levels of importance of job tasks, job training requirement and work satisfaction were higher in plague removal with an ultrasonic scaler related to clinical oral prophylaxis, pit and fissure sealants related to preventive dental treatment and instruction in the correct usage of toothbrush related to public dental health education 3. In dealing with dental radiation machines, the radiation protection was considered the most important. While the training for periapical radiography was most needed, the respondents were satisfied with working in the same area. The levels of job importance, training requirement and work satisfaction were high in preventive dental care in the community performed in relation to the public dental health care. 4. In the dental health insurance claim category, the levels of importance of job task, training requirement and work satisfaction were higher in insurance claiming. The levels of job importance and training requirement were high in dental clinic management and assistance to dentists performed for preventive dental treatment. The work satisfaction was higher in maintaining medical chart records. The levels of job importance, training requirement and work satisfaction were higher in dental assistance in relation to dental protection. 5. There was significant relationship between the level of importance and work experience. Those with a longer period of work experience had higher levels of job importance in dental health insurance claim, dental clinic management and assistance to dentists and the overall task(pE0.05). 6. A significant relationship was observed between the need for job training in dental cleaning and preventive dental treatment and work experience. Those with more than 8 years of work experience demonstrated that job training is most needed(pE0.05). 7. The work satisfaction level was higher in the group with more than 8 years of work experience, compared with those in other work experience periods(pE0.05). 8. A positive correlation was seen between the level of importance and the need for job training among three variables.

• 한국산업보건학회지
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• 제25권4호
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• pp.433-445
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• 2015

Objectives: The major objectives of this study are to review the issues surrounding trade secret claims in the Chemicals Control Act and Amendment on Occupational Safety and Health Act(1917-227) and to propose a way of improving the reliability of chemical information in MSDSs, labels and National Chemical Survey results. Materials: To review the issues on trade secret claims, we made an analysis frame which was divided into three steps: Value and Problem Recognition; New Regulation Design; and Enforcement and Amendment. We then compared Korean issues with issues from the United States' Hazard Communication Standard and Emergency Planning & Community Right-to-Know Act, Canada's Workplace Hazardous Materials Information System and Hazardous Materials Information Review Act and the European Union's Regulation on Classification, Labelling and Packaging of substances and Mixtures. Results: The stage of right-to-know development in Korea has passed the Value and Problem Recognition phase, so efforts are needed to elaborately design new regulation. Conclusions: We recommend two ways to improve right-to-know in Korea. First, strict examination of the quality of documents for trade secret claims is very important. Second, trade secrets should be limited to less-hazardous substances.

• 한국임상약학회지
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• 제22권4호
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• 한방재활의학과학회지
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• 제27권2호
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• pp.67-75
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• 2017

Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2004년도 제56차 추계 학술대회 연제집
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• pp.47.2-48
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• 2004

• 보건의료산업학회지
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• 제9권4호
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• pp.183-196
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• 2015

Objectives : The purpose of this study was to analyze the factors affecting the level of subjective health recovery among injured workers. The aim in this study was to find an efficient worker's compensation service for subjective health recovery among injured workers. Methods : From the 1st panel study of worker's compensation insurance, data for 2,000 injured workers was analyzed with SPSS 22.0 and AMOS 22.0. Results : There was a statistically significant difference in the level of self-perceived health recovery depending on socio-demographic characteristics, disability characteristics and medical care services. Factors such as gender, education level, socio-economic level, disability level, claim duration, and treatment duration appropriacy affected the level of self-perceived health recovery. Conclusions : Worker's compensation services should take into consideration the factors that affect the health recovery of injured workers.

• 한국병원경영학회지
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• 제21권2호
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• pp.37-49
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• 2016

The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.