Recently, the problem of air pollution has become a global concern due to industrialization and overcrowding. Air pollution can cause various adverse effects on human health, among which respiratory diseases such as asthma, which have been of interest in this study, can be directly affected. Previous studies have used clinical data to identify how air pollutant affect diseases such as asthma based on relatively small samples. This is high likely to result in inconsistent results for each collection samples, and has significant limitations in that research is difficult for anyone other than the medical profession. In this study, the main focus was on predicting the actual asthmatic occurrence, based on data on the atmospheric environment data released by the government and the frequency of asthma outbreaks. First of all, this study verified the significant effects of each air pollutant with a time lag on the outbreak of asthma through the time-lag Pearson Correlation Coefficient. Second, train data built on the basis of verification results are utilized in Deep Learning algorithms, and models optimized for predicting the asthmatic occurrence are designed. The average error rate of the model was about 11.86%, indicating superior performance compared to other machine learning-based algorithms. The proposed model can be used for efficiency in the national insurance system and health budget management, and can also provide efficiency in the deployment and supply of medical personnel in hospitals. And it can also contribute to the promotion of national health through early warning of the risk of outbreak by atmospheric environment for chronic asthma patients.
Corporations look for their competitiveness in many different areas, and one of them is customer call center, which provides professional, special service to the customers. The importance and the value of realization of customer satisfaction at each call center have become significant as it plays a leading role and is responsible for customer recreation and follow-up services. This study held in-depth interviews with 3 groups of professional call representatives (categorized by experience) from popular property and life insurance companies in Korea who operate in and outbound calls. Three variables, emotional quotient, organizational citizenship behavior (OCB), and IT utilization skill, were selected and it was observed how these variables affect the job performance of in and outbound call center representatives. The importance of the relationship between the variables and the key factors in the future direction of improvement of the call center representative organization was analyzed. Emotional quotient refers to the ability to recognize and use the emotion of oneself and others. It was considered it would be effective in enhancing the counseling ability of call center representatives, This study identifies the effect of emotional quotient on job performance and organizational citizenship behavior, which is defined as actions outside of normative roles in the organization. Also, the study aims to prove the effect of emotional quotient on the rapidly developing IT utilization ability in relation to job performance. As a result, it was found that service career (3 months, 3 years, 10 years) had a significant effect on the key factors that affect the organization-emotional quotient, IT utilization skill, and OCB. Especially for OCB, it was considered relatively less important to the new employees, while it greatly affected the job performance, rate of settlement, and sustainment of the working life for those with longer experience. Also, the result of the interview for each variable differed by the service career. Emotional quotient, IT utilization skill, and OCB were close connection for the representatives with longer experience than for those with shorter experience. And the level of intimacy of their relationship with job performance was in proportion to the years of service. Thus, to secure stability for the call center representatives and enhance their job performance continually, the importance of emotional quotient and IT utilization skill shall be reflected in the operation process actively. In particular, in order to lead a organization with outstanding culture, a management system shall apply OCB from the recruitment process.
Kang, Moon Hae;Park, Eun-Cheol;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Cho, Eun
Asian Pacific Journal of Cancer Prevention
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v.14
no.3
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pp.2059-2065
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2013
This goal of this research was to evaluate the cost-effectiveness of the National Cancer Screening Program (NCSP) for breast cancer in the Republic of Korea from a government expenditure perspective. In 2002-2003 (baseline), a total of 8,724,860 women aged 40 years or over were invited to attend breast cancer screening by the NCSP. Those who attended were identified using the NCSP database, and women were divided into two groups, women who attended screening at baseline (screened group) and those who did not (non-screened group). Breast cancer diagnosis in both groups at baseline, and during 5-year follow-up was identified using the Korean Central Cancer Registry. The effectiveness of the NCSP for breast cancer was estimated by comparing 5-year survival and life years saved (LYS) between the screened and the unscreened groups, measured using mortality data from the Korean National Health Insurance Corporation and the National Health Statistical Office. Direct screening costs, indirect screening costs, and productivity costs were considered in different combinations in the model. When all three of these costs were considered together, the incremental cost to save one life year of a breast cancer patient was 42,305,000 Korean Won (KW) (1 USD=1,088 KW) for the screened group compared to the non-screened group. In sensitivity analyses, reducing the false-positive rate of the screening program by half was the most cost-effective (incremental cost-effectiveness ratio, ICER=30,110,852 KW/LYS) strategy. When the upper age limit for screening was set at 70 years, it became more cost-effective (ICER=39,641,823 KW/LYS) than when no upper age limit was set. The NCSP for breast cancer in Korea seems to be accepted as cost-effective as ICER estimates were around the Gross Domestic Product. However, cost-effectiveness could be further improved by increasing the sensitivity of breast cancer screening and by setting appropriate age limits.
Park, Hey-Jeong;Yi, Chung-Hwi;Cho, Sang-Hyun;Kwon, Hyuk-Cheol
Physical Therapy Korea
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v.7
no.1
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pp.1-21
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2000
The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.
The Information Committee of the Korean Gastric Cancer Association sent questionnaires to 31 laparoscopic gastric surgeons about their personal experiences with laparoscopic gastric surgery from 2001 to 2003. Twenty-four surgeons responded to the questionnaires (response rate: $77.4\%$).The number of laparoscopic gastric surgeries from 2001 to 2003 was 1,130 and increased from 209 in 2001 to 593 in 2003. The number of operations for a gastric adenocarcinoma also increased from 87 cases in 2001 to 403 cases in 2003. Laparoscopic radical procedures, such as a laparoscopyassisted distal gastrectomy or total gastrectomy (LADG or LATG), have increased rapidly during this period. (55 cases in 2001, 150 cases in 2002, and 364 cases in 2003). Laparoscopic function-preserving gastrectomies were not performed until 2003, during which year one pylorus- preserving gastrectomy and six proximal gastrectomies were performed laparoscopically. A wedge resection for a gastric submucosal tumor was performed in 71 cases in 2001, 82 in 2002, and 103 in 2003. Hand-assisted laparoscopic surgery (HALS) was performed in 39 cases in 2001, 55 in 2002, and 49 in 2003. As for personal indications for a LADG, 14 surgeons performed a LADG only for a T1 lesion, and 5 surgeons extended their indications to T2N0 lesions. In the near future, laparoscopic procedures for gastric cancer will be widely adopted in Korea if the medical-insurance obstacle is overcome and the long-term survival results are verified.
In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.
Kim, Sang-Soon;Kim, Youn-Hwa;Kim, Ok-Lan;Choi, Youn-Hee
Research in Community and Public Health Nursing
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v.1
no.1
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pp.299-317
/
1989
This study was attempted to find out the distribution of industrial nurses, analyze job performance by function and utilization state of medical dispensary among workers. The subjects for this study were 32 nurses working at industry located in Kyungpook and Taegu area. The data was collected through questionaire during the period of August 5-31, 1986, and analysed by the method of frequency and percentage. The following is the main findings of the study; 1. 72.2% of respondents was engaged in manufacturing industry, 33.3% in workplace whose regular workers was more than 2,000 workers. 67.7% in occupational health physicians was part-time system. 2. 93.1% of respondents was 20-29 years age group, 93.1% was graduates of junior nursing college, 96.6% was unmarried. 448% had 1-4 years of total working experiences. 3. For the motives which made them becomes industrial health nurse, 'good employment condition' was 62.1%. For the job satisfaction, 'moderate' was 586%. For the interest about the industrial health, 'moderate' was most frequent (58.6%). In the inservice education, 86.2% of the subjects was received education. 4. For the attitude of the dispensary and industrial nursing of employer, 'necessary' was most frequent (72.4%, 62.6%). 5. All establishment had dispensary facilities, 65.5% of them had independent dispensary. 6. In duty shift, 93.1% of respondents was working in one shift system. 41.4% of respondents was received from 250,000 won to 290,000 Won and 41.4% was belong to personnel section and 24.1% was direct controlled by general business section chief. 7. In the main health problem of their factories, 48.3% of respondents was work-environmental state, 24.1% was health education. 8. In the Dispensary budget, 60% of respondents was under 3,000 won per worker. 9. In the job performance rate by function, nursing service 73.1%, industrial health and nursing management 63.7%, environmental hygiene and safety management 54.5%, medical insurance 44.9%, welfare 38.4%. 10. Main health complaints among workers utilizing medical dispensary was 35.9% of respiratory system, 21.5% of gastro-intestinal system, 11.0% of skeletomuscular system.
Objectives : There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. Methods : To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. Results : The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. Conclusions : This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.
The Journal of the Convergence on Culture Technology
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v.3
no.2
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pp.21-30
/
2017
This study investigated the total annual direct cost of cerebrovascular disease patients. For this study, 265 respondents who answered that they used more than one emergency, inpatient, and outpatient services for cerebrovascular disease during the year of 2012 among Korean medical panel investigators in 2012 were included. In general, patients with cerebrovascular disease responded to cerebrovascular disease among Korean medical panel respondents in 2012. Percentage of respondents using inpatient and outpatient services. Total direct cost was calculated. According to the results of the study, the per capita annual medical expenditure per person is about 561,934 won, 669,557 won for men and 448,696 won for women. In the case of health insurance subscribers, the per capita self burden due to cerebrovascular disease averaged 634,459 won and the medical benefit recipients 160,236 won. The average total direct cost of 265 people with cerebrovascular disease is about 162,165,690, 193,223,955 won for men and 129,486,685 for women. The total direct cost per person due to cerebrovascular disease was 183,095,125 won and the medical benefit recipient was 46,241,705 won. According to household income, the highest rate of 672,268 won in the third income group of the household income, and 108,970,650 won in the fifth income group, the lowest total direct cost of the patients with cerebrovascular disease.
Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.
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