• 지역사회간호학회지
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• 제23권4호
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• pp.415-426
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• 2012

Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(역학)
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• pp.7-11
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• 1994

Twenty years ago, the American Journal of Epidemiology published David Sackett's brief description of. clinical epidemiology and its practitioners [1]. This commentary was a useful focal point for an emerging discipline. By 1983, with clinical epidemiology already thriving in many academic medical centres, Walter Holland called into question both the term, 'clinical epidemiology', and the nature of the discipline [2]. More recently, clinical epidemiology has drawn strong criticism from John Last, a noted academician whose contributions include the editorship of the Maxcy-Rosenau Textbook of Public Health. Writing in the Journal of Public Health Policy in 1988 [3], Last referred to the 'uncritical enthusiasm' for clinical epidemiology in medical schools as 'a danger to health', and staked. a claim to the term 'epidemiology' as appropriate only to the description of what classical or population epidemiologists do. Faced with such views, practitioners and proponents of clinical epidemiology can respond in three ways. They can ignore the criticism, and go on about their business. They can reaffirm their differences and resort to defensive rhetoric. Or, the critique can become an opportunity for reflection about the nature of clinical epidemiology and its relations with sister disciplines in modem medical schools. The latter course is followed here by four physicians who-despite diverse backgrounds and interests-all consider their work to be in the field of clinical epidemiology.

• 대한치과의료관리학회지
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• 제8권1호
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• pp.37-40
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• 2020

The background of this study is the observation that there is an increase in the number of elderly persons and the decrease in fertility rates, which may be related to the increase in the average age of the Korean people; accordingly, the national health insurance system changes every year following this pattern. However, this study investigates whether these changes are reflected in the dental hygiene curriculum. Data from the national health insurance system is reviewed for the last three years, and the recently published dental hygiene curriculum is selected, compared, and analyzed using a literature survey. The study is divided into two parts: information that is reflected in the dental hygiene curriculum and information that is not reflected in the dental hygiene curriculum, but which it is believed should be included. In addition, as the part reflected in the dental hygiene curriculum, it was stated in three subjects of dental implantology, dental prosthesis, and conservative dentistry, and there were four cases. Therefore, efforts should be made to ensure that the curriculum for dental hygiene students should reflect the changes in the national health insurance system so that students can more easily understand dental insurance claim processes.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• 제21권2호
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• pp.75-79
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• 2017

This paper approaches the subject of consciousness and unconsciousness from a mathematical point of view. It sets up a hypothesis that when unconscious state becomes conscious state, high density energy is released. We argue that the process of transformation of unconsciousness into consciousness can be expressed using the infinite recursive Heaviside step function. We claim that differentiation of the potential of unconsciousness with respect to time is the process of being conscious in a world where only time exists, since the thinking process never have any concrete space. We try to attribute our unconsciousness to a special solution of the multi-dimensional advection partial differential equation which can be represented by the finite recursive Heaviside step function. Mathematical language explains how the infinitive neural process is perceived and understood by consciousness in a definitive time.

• 한국IT서비스학회:학술대회논문집
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• 한국IT서비스학회 2009년도 춘계학술대회
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• pp.357-360
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• 2009

본 연구는 데이터마이닝 기법을 이용하여 건강보험청구료에 있어서 이상정도가 심한 요양기관을 탐지하고, 실제 의료영역에 적용하기 위한 시스템 개발을 목적으로 한다. 현재 건강보험 심사평가원의 이상탐지시스템은 평가대상이 되는 항목을 개별적으로 평가하고, 탐지된 기관의 선정 이유에 대한 근거제시가 부족한 단점을 가지고 있다. 따라서 본 연구에서는 항목을 종합적으로 평가할 수 있는 정량적 지표를 설계하고, 항목들의 상대적 중요도를 파악할 수 있도록 항목들에 대한 가중치 부여한다. 또한 지표에서 얻어진 값으로 등급을 구분하고, 의사결정나무기법(decision tree)를 이용하여 해석력을 높이는 방법을 제시한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5237-5242
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• 2016

Background: Cancer screening rates are lower in Japan than those in western countries. Health professionals publish procancer screening messages on the internet to encourage audiences to undergo cancer screening. However, the information provided is often difficult to read for lay persons. Further, anti-cancer screening activists warn against cancer screening with messages on the Internet. We aimed to assess and compare the readability of pro- and anti-cancer screening online messages in Japan using a measure of readability. Methods: We conducted web searches at the beginning of September 2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as "anti", "pro", or "neutral" depending on the claims, and "health professional" or "non-health professional" depending on the writers. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way ANOVA. Results: In the total 159 websites analyzed, anti-cancer screening online messages were generally easier to read than pro-cancer screening online messages, Messages written by health professionals were more difficult to read than those written by non-health professionals. Claim ${\times}$ writer interaction was not significant. Conclusion: When health professionals prepare pro-cancer screening materials for publication online, we recommend they check for readability using readability assessment tools and improve text for easy comprehension when necessary.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• 한국임상약학회지
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• 제18권2호
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• pp.124-131
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• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• 한국응급구조학회지
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• 제3권1호
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• pp.91-101
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• 1999

The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제12권4호
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• pp.1832-1853
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• 2018

The personal health record (PHR) system is a promising application that provides precise information and customized services for health care. To flexibly protect sensitive data, attribute-based encryption has been widely applied for PHR access control. However, escrow, exposure and abuse of private keys still hinder its practical application in the PHR system. In this paper, we propose a coordinated ciphertext policy attribute-based access control with user accountability (CCP-ABAC-UA) for the PHR system. Its coordinated mechanism not only effectively prevents the escrow and exposure of private keys but also accurately detects whether key abuse is taking place and identifies the traitor. We claim that CCP-ABAC-UA is a user-side lightweight scheme. Especially for PHR receivers, no bilinear pairing computation is needed to access health records, so the practical mobile PHR system can be realized. By introducing a novel provably secure construction, we prove that it is secure against selectively chosen plaintext attacks. The analysis indicates that CCP-ABAC-UA achieves better performance in terms of security and user-side computational efficiency for a PHR system.