• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.57
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• pp.283-303
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• 2013

When a trade conflict arises related to an officially supported export credit programme, The World Trade Organization(WTO), decides on whether the programme is a forbidden subsidy stipulated in the Agreement on Subsidies and Countervailing Measures(the ASCM Agreement). Korea was taken to the WTO panel two times for the export credit programme. One is the semiconductor case in 2002 and the other was the shipbuilding disputes in 2004. And, In 2012, the U.S. Commerce Department ruled K-SURE's export insurance for Korean refrigerator manufacturers as a forbidden subsidy even if the case was not taken to the WTO. This paper examines the significance of export credit programmes on the WTO ASCM Agreement and discusses how to operate these programmes so they would not infringe upon the Agreement by analyzing the actual cases of WTO subsidy conflicts that involved Korean enterprises in relation to export credit programmes for the purpose of determining the related issues and impacts. From this research the results were as follows: First, on whether export credit is a prohibited subsidy, the deciding factor was whether a benefit has been conferred to the beneficiary. On the presence of a benefit, the WTO panel used market benchmarks as the main criteria. Thus, official export credit agencies(ECAs) should be careful not to provide export credit support which had been granted to the beneficiary at better than market terms. Second, in the case of export credit, the special status of ECA as a public body receiving government support itself does not constitute a subsidy. However, caution must be taken not to provide export credit that may lead to WTO ASCM subsidy conflicts involving a certain exporter or industry by setting up clear and valid regulations and fair work processes in the operation of export credit programmes. Third, item (j) of Annex I cannot be interpreted reversely as this item is for interpreting the presence of a prohibited subsidy, not the presence of a benefit. Thus, an export credit program that confers a financial contribution, a benefit and specificity, could qualify as a prohibited subsidy. Fourth, ECAs not only have to maintain long-term account balance but also introduce additional measures to meet this long-term balance such as a clear and systematic premium system. Finally, export credit programmes that are not defined in item (j) of Annex I of the ASCM Agreement would not deemed as an prohibited export subsidy as long as the continued support of the programmes are not being forced.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.82-92
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• 2005

Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

• Journal of Korean Neurosurgical Society
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• v.54 no.6
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• pp.489-495
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• 2013

Objective : To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA). Methods : A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 $mg/m^2/day$) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed. Results : TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (${\geq}$grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01). Conclusion : For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.75-103
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• 2017

There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court's decision, the existence of procedural difficulty, the medical necessity and the patient's consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor's explanation and the patient's fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor's explanation and the patient's consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.

• Journal of Korean Society of Disaster and Security
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• v.5 no.1
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• pp.1-6
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• 2012

This study analyzed the direct costs of fall accidents, which have the highest accident rate, for domestic construction industry workers. Firstly, the average insurance payment per person due to fall accidents in the construction industry is around 19 million won (18,971,000 won). Given that the average number of workers suffering fall accidents over ten years is 5,863, the total cost of losses from fall accidents is about 1.1 trillion won (111,360,000,000 won). Secondly, a cost-based economic feasibility analysis was done to develop nonstructural preventive measures for fall accidents. Since there was no data expressing the costs and effects of preventive measures in terms of monetary value, the economic feasibility analysis was attempted with a focus on how much the newly introduced preventive measures can reduce the accident loss costs due to fall accidents. Thirdly, if the accident loss size is grasped and the preventive measures for the causes of fall accidents are developed and strictly implemented, the insurance fee that can reduce the accident loss costs can be determined. Further study is needed to estimate the benefit of the accident loss cost reduction seen from the cost-based approach method.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.48-55
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• 2011

Objectives: The purpose of this study was to examine the impact of Diagnosis-Related Group (DRG)-based payment on the length of stay and the number of outpatient visits after discharge in for patients who had undergone caesarean section. Methods: This study used the health insurance data of the patients in health care facilities that were paid by the Fee-For-Service (FFS) in 2001-2004, but they participated in the DRG payment system in 2005-2007. In order to examine the net effects of DRG payment, the Difference-In-Differences (DID) method was adopted to observe the difference in health care utilization before and after the participation in the DRG payment system. The dependent variables of the regression model were the length of stay and number of outpatient visits after discharge, and the explanatory variables included the characteristics of the patients and the health care facilities. Results: The length of stay in DRG-paid health care facilities was greater than that in the FFS-paid ones. Yet, DRG payment has no statistically significant effect on the number of outpatient visits after discharge. Conclusions: The results of this study that DRG payment was not effective in reducing the length of stay can be related to the nature of voluntary participation in the DRG system. Only those health care facilities that are already efficient in terms of the length of stay or that can benefit from the DRG payment may decide to participate in the program.

• Health Policy and Management
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• v.5 no.2
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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.

• Journal of Korean society of Dental Hygiene
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• v.12 no.5
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• pp.999-1006
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• 2012

Objectives : The purpose of this study was to understand and compare the knowledge of the adolescents and adults among the residents of Seoul metropolitan city about water fluoridation program. Methods : A total of 613 adolescents and adults between the age of 15 and 31-49 was surveyed by the questionnaire. Among them, the source of drinking water, the source of cooking water, awareness of caries prevention effect of water fluoridation program, awareness of cost benefit of health insurance of water fluoridation program, approval of water fluoridation program, awareness of health safety of water fluoridation program were surveyed. Results : 85.5% of adolescents and 88.9% of adults were surveyed to use public water supply for drinking water, and 95.3% of adolescents and 96.8% of adults were surveyed to use public water supply for cooking water. But only 14.0% of adolescents, comparing to the 42.1% of adults, were surveyed to be aware of the caries prevention effect of water fluoridation, and only 6.0% of adolescents, comparing to the 24.6% of adults, were surveyed to be aware of the caries prevention effect of water fluoridation to reduce to health insurance expenditure. About 82.6% of adolescents, comparing to the 92.1% of adults, were surveyed to vote for the fluoridation program, and only 6.8% of adolescents, comparing to the 28.6% of adults, were surveyed to be aware of health safety of water fluoridation program. Conclusions : Extensive oral health education program to the adolescents are necessary about using water fluoridation to prevent the dental caries.

• The Korean Journal of Applied Statistics
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• v.31 no.2
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• pp.303-313
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• 2018

This study considers time series models to forecast drug expenditures in national health insurance. We adopt autoregressive error model (ARE) and transfer function model (TFM) with segmented level and trends (before and after 2012) in order to reflect drug price reduction in 2012. The ARE has only a segmented deterministic term to increase the forecasting performance, while the TFM explains a causality mechanism of drug expenditure with closely related exogenous variables. The mechanism is developed by cross-correlations of drug expenditures and exogenous variables. In both models, the level change appears significant and the number of drug users and ratio of elderly patients variables are significant in the TFM. The ARE tends to produce relatively low forecasts that have been influenced by a drug price reduction; however, the TFM does relatively high forecasts that have appropriately reflected the effects of exogenous variables. The ARIMA model without the exogenous variables produce the highest forecasts.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.