• 한국IT서비스학회지
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• 제8권2호
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• pp.189-204
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• 2009

Our study aims to investigate the determinants of international competitiveness and international specialization in services, using OECD service trade data. Real exchange rates, world demand, economies of scale, diffusion of IT, human capital, R&D expenditure and institutional variables are introduced as explanatory variables in regressions for 29 OECO countries over $1996{\sim}2003$. Some of major findings from the study can be summarized as follows. First, economies of scale play important role in transport and business services. Second, the index of freedom to trade measured by Faster Institute has a positive and significant impact on international competitiveness in telecommunication, finance and insurance and business services. Third, IT provides favorable condition to build international competitiveness in finance and insurance and business services. Fourth, R&D expenditure contributes to the amelioration of international competitiveness in transport services, while investment in new equipments contributes to increasing the competitiveness in telecommunication services. Thus, our results show the importance of the industrial base for developing a competitive service economy.

• East Asian mathematical journal
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• 제35권3호
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• pp.305-318
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• 2019

Over the past decades, the Lee-Carter model [1] has attracted much attention from various demography-related fields in order to project the future mortality rates. In the Lee-Carter model, the speed of mortality improvement is stochastically modeled by the so-called mortality index and is used to forecast the future mortality rates based on the time series analysis. However, the modeling is applied to long time series and thus an important structural change might exist, leading to potentially large long-term forecasting errors. Therefore, in this paper, we are interested in detecting the structural change of the Lee-Carter model and investigating the actuarial implications. For the purpose, we employ the tests proposed by Coelho and Nunes [2] and analyze the mortality data for six countries including Korea since 1970. Also, we calculate life expectancies and whole life insurance premiums by taking into account the structural change found in the Korean male mortality rates. Our empirical result shows that more caution needs to be paid to the Lee-Carter modeling and its actuarial applications.

• 보건행정학회지
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• 제5권2호
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• pp.155-172
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• 1995

This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

• International Journal of Advanced Culture Technology
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• 제8권2호
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• pp.1-5
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• 2020

As the world gradually advances to an aging society, the quality of human life is valued. Among them, 'quality of sleep' is very closely related to quality of life. Recently, Korea expanded health insurance coverage for "sleep disorders". Particularly, as the number of sleep multiple tests and prescriptions for sleep aids has increased rapidly, much attention has been focused on the related medical service environment. Therefore, this study looked at an in-depth interview of 11 hospitals to see what treatment delivery system is being established when the government applies health insurance for 'sleep disorders'. In conclusion, the organizations with the most average number of sleep polyp tests per day were found to have more sleep polyp labs (hardware) and more full-time specialists. Also, the polysomnography lab (hardware) and the specialist's full-time status (software) did not necessarily result in a "positive pressure regulator prescription" that can solve "sleep apnea" caused by "sleep ailments". Rather, it was found that the number of days of sleep multiple laboratories (hardware), the number of full-time specialists (software) or the specialty majors (software) had a greater impact. In particular, the higher the specialist's full-time personnel (software) index (=6.000), the higher the sleep-inducing agent prescription rate(=1.000), and the lower the specialist's full-time personnel (software) index (=1.000), the higher the sleep-inducer's prescription rate(= 0.010) Was low. In addition, even if the professional full-time personnel(software) index was the same (=1.000), the hospital type was lower as it was closer to the public hospital(=0.067) and higher at the specialized hospital (= 0.933). In the case of university hospitals, when the full-time specialists (software) are in the same condition (= 1.000), the frequency of use of the sleep laboratory (=1.000) and the sleep test rate (= 1.000) were all the same.

• 보건행정학회지
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• 제25권3호
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

• 중환자간호학회지
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• 제17권2호
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• pp.25-41
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• 2024

Purpose : This study aimed to investigate changes in critical nursing activities from 2009 to 2020 and explore the relationship between nurse staffing and such activities in intensive care units. Methods : A total of 446,445 adult patients admitted to intensive care units in tertiary and general hospitals from 2009 to 2020 were identified using the National Health Insurance claims database. The Critical Nursing Activities Index was calculated based on the following critical nursing activities: ventilator, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT). Trend analysis was performed to analyze changes in critical nursing activities over 12 years and to assess linear trends across different staffing levels. Results : The annual utilization days for ventilators, ECMO, and CRRT, as well as the Critical Nursing Activities Index significantly increased over the study period (p-for-trend<.001) in tertiary and general hospitals, except for ventilator use in general hospitals. Ventilator, ECMO, and CRRT utilization exhibited a significant upward trend with higher nurse staffing levels (Bonferroni adjusted p-for-trend<.001). The Critical Nursing Activities Index was significantly higher in hospitals with higher staffing levels compared to those with lower staffing levels (Bonferroni adjusted p <.05). Conclusion : The findings underscore the need for improved nurse staffing levels in intensive care units. Government policies should ensure that staffing levels align with critical nursing activities among critically ill patients to uphold the quality of care.

• 한국안전학회지
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• 제32권5호
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• pp.96-102
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• 2017

The highest fatal accident ratio was recorded in the construction industry. According to the industrial insurance premium rate & business type example, among the construction industry, the architectural work has the highest fatal and loss time accident ratio. Previous literature has investigated various aspects of accident occurrence and prevention in architectural work. However, those studied were limited in that they only focused on the fatal accident without considering the loss time accident. But non fatal accidents were recorded more than 50 times of fatal accidents. Therefore non fatal accidents must be controlled to lessen industrial accidents. Based on this, the goal of this study was to investigate the nature of the loss time accident and derive the risk index of work type in architectural work. In this study, opinions of safety experts were gathered and the risk index of work type was derived using AHP(Analytic Hierarchy Process). And verification was accomplished by comparing the results of this study with the risk index derived by analysis of accident records. Results showed that the risk index of work type was significantly higher in steel frame work, temporary installation work, earth & foundation work, facilities work, concrete work. And statistical analysis for verification showed that coefficient of Pearson correlation was 0.686 and P-value was 0.001.

• 보건행정학회지
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• 제21권4호
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• pp.541-564
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• 2011

This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

• 보건행정학회지
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• 제18권2호
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• pp.67-85
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• 2008

This study evaluated the specialization status of Korean hospitals by applying index measures that were developed to determine how hospitals are specialized. In addition, multivariate regression analysis was applied to assess how the measures responded to the internal and external factors of hospitals. National Health Insurance claims for 2004 were used to calculate the information theory index, internal Herfindahl index, number of distinct diagnosis-related groups (DRGs) treated, and percent of the five most common DRGs. Data from the Ministry of Health and Welfare and Korean Hospital Association were used to determine the size, ownership, teaching status, organization type, and location of the hospitals. The four indexes analyzed showed that there were significant differences in the specialization status of providers, depending on the provider size, organization type, and location. Hospitals that were smaller and located in metropolitan areas tended to provide specialized services; this is considered to constitute a competitive strategy for hospitals. It is expected that specialized hospitals will increase given the current market structure. Therefore, policy makers will need an index for measuring how hospital services are specialized. Information from such an index could provide a picture of how hospital services are mixed and change over time.

• 보건행정학회지
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• 제3권1호
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• pp.84-101
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• 1993

The current method of rate adjustment is based on the evaluation of the financial performance of hospitals. The method has the disadvantages such as too complicated, expensive process as well as low reliability due to small sample size. This study, therefore, develops a new model for the rate adjustment with the use of the composite index. In addition to that, it examines the validity of the model by comparing the result of the new method with that of the conventional method. The idea of the new model comes from the Medicare Economic Index(MEI) on which physician fees for the Medicare patients are adjusted periodically in the United States. Medical costs are classified into three groups : labor costs, materials and other expenses. Labor costs are subdivided into physicians and other personnels. Materials are subdivided into drugs and others. Other expenses are subdivided into 5 items. Macro economic indices are selected for each cost item in order to reflect the cost inflation during the specific period. Then the composite index which integrate all items according to the ration of each item in the total costs is calculated. The result from the application of empirical data to the new model is very similar to that of the current method. Furthermore, this method is very simple and also to easy to get social concensus. This model can be replaced the current method based on the analysis of the financial performance for the adjustment of medical fees.