• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.9-15
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• 2005

Objectives : To analyze medical expenses by cancer site and survival time among cancer patients in their last year of life. Method : The study subjects were 45,394 people that had died of cancers in 2002, were registered by the Korea Central Cancer Registry and received National Health Insurance benefit in the last year (360 days) of life. Personal identification data, general characteristics, dates of death and cancer incidence, and site of cancer were collected from the National Statistical Office and the Korea Central Cancer Registry, and merged with the data of the individual medical expenses of the Health Insurance Review Agency. Results : Average monthly cost curves were U-shaped with high costs near the time of diagnosis and death, and lower costs in between. Medical expenses in the last year of life were around 30.3, 16.7, 13.0, and 12.1 million won among leukemia, lymphoma, ovarian cancer, and breast cancer patients, respectively. Digestive organ cancers including stomach, esophagus, liver, pancreas, and colorectal cancers had relatively low medical expenses. Medical expenses in the last year of life were inverse U-shaped with high expenses near one year of survival. Average monthly cost in the 12 months before death among the patients who had survived $10{\sim}15$ years were more than two-fold greater than the cost before diagnosis among those who had survived for less than one year. Conclusions : Leukemia was the most expensive cancer. It is possible that once diagnosed as cancer, medical expenses do not return to the level before diagnosis. Further research will be needed to understand the magnitude and change of the medical expenses among cancer patients with long term follow up data.

• Journal of Environmental Health Sciences
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• v.35 no.1
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• pp.1-10
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• 2009

This study assessed the relationships between levels of $PM_{10}$ and hospitalization rates for asthma among children from 2003 to 2005 at four major cities in Korea. In addition, we estimated the reduced number of asthma hospitalization associated with an ambient $PM_{10}$ improvement to the acceptable levels as recommended by the World Health Organization (WHO). The Generalized Additive Model (GAM) was used to estimate the relative risks (RR) of asthma hospitalization associated with changes in $PM_{10}$ The RRs of children's asthma hospitalization for every $10{\mu}g/m^3$ increment in $PM_{10}$ were 1.009(95% CI = 1.004-1.014) in Seoul, 1.013(95% CI = 1.006-1.021) in Incheon, 1.009(95% CI = 1.002-1.016) in Busan, and 1.021(95% CI = 1.005-1.037) in Ulsan. We assessed $PM_{10}$ related health benefits from implementing the WHO's guidelines (24-hour average $50{\mu}g/m^3$) using the U.S. Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program. The estimated benefits were 439(95% CI = 216-666) reduced asthma hospitalization in Seoul, 720(95% CI = 304-1,151) in Incheon, 260(95% CI = 66-459) in Busan, and 126(95% CI = 30-228) in Ulsan. It was concluded that improving $PM_{10}$ condition to the WHO guideline would make a significant contribution to the reduction in asthma hospitalization among children. Therefore, public health measures are still needed to improve air quality in Korea.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 1997.11a
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• pp.44-48
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• 1997

The Swedish Fire Research Board was established in 1979 to initiate and fund relevant fire research efforts. The Board is responsible for a long term research programme revised every third year, and the Board is one of two major Swedish sponsors of all fire research. Beside the Board we also have the Swedish National Rescue Services, funded by the government. BRANDFORSK gives very high priority for the industry and the insurance company and the need they express for fire research. Research that the Rescue Services Board are funding is mainly focusing the need for the fire department. The Swedish Fire Research Board, BRANDFORSK, is the joint agency of the Swedish government, the insurance industry and the business sector, for the initiation, funding and supervision of different kinds of fire research. Work is directed by a Programme Board and is performed in the form of projects at universities, research institutes, state authorities and private firms. The Secretariat of BRANDFORSK shares the premises of the Swedish Fire Protection Association, SFPA, and the SFPA is the principal and the party which enters into agreement with the State. The programme for the period 1997-1999 has been drawn up on the basis of both damage development and the trends in society which can be noted, and the evident fire problems of the interested parties and their need for fire research. The inputs in the programme have been broken down seven problem areas. In every problem area different project areas are set out, and these primarily specify the aim of the work. Our seven problem-areas are; Costs and benefits of fire protection measure. The role and behaviour of people and organizations Fire In buildings Fire in underground facilities Rescue operations fire in industries Fire and the environment. In comparison with previous fire research programmes, cost/benefit studies have been accorded higher priority, and this is also reflected in other problem areas. Grater Emphasis

• Journal of dental hygiene science
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• v.19 no.3
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• pp.190-197
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• 2019

Background: The Internet has advantages in terms of accessibility and amount of information, and the search for health information over the Internet is increasing exponentially. The purpose of this study is to analyze the information generated about some dental treatment on the internet by year. Methods: Naver Knowledge (JisikIn in Korean) which is an interactive search service was selected as the first search site in Korea. Scaling, wisdom tooth extraction, and endodontic treatment that can be paid by Korean health insurance were selected. Finally, 4,729 questions about scaling, 23,963 wisdom teeth extraction questions and 17,733 endodontic treatment questions were extracted. The question contents, the information about the questioner and the answerer, and an error of answers were investigated. Frequency analysis was used and chi-square test was used if necessary. Results: The most frequently asked questions were discomfort and dissatisfaction after the treatment. The need for treatment was the second in questions of the wisdom tooth extraction and endodontic treatment, but the health insurance benefit was the second in dental scaling. Most of the questioners didn't disclose personal information. The public answered the most in 2013~2014, but the highest percentage of the respondents was experts in 2017. Responses were mostly personal experience, but showed a tendency to decrease with years, and professional knowledge showed an increasing tendency. The error of the answer has also gradually decreased. Conclusion: Questions about dental care over the Internet are increasing exponentially, experts are responding increasingly, and errors in answers are decreasing. Nevertheless, it is necessary to pay attention to the related expert group to prevent misinformation.

• The Journal of the Convergence on Culture Technology
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• v.9 no.4
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• pp.393-399
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• 2023

Upper limb amputees wear an upper limb prosthesis for both aesthetic purposes and functional necessity, and in particular, in the case of amputee with both hands, it is essential to wear a myoelectric prosthetic hand capable of gripping action. The prosthetic hand operated by the EMG signal of the remaining muscles is a public insurance benefit item of the Industrial Accident Compensation Insurance, and test method standards are needed to be developed for the safety of the user and the effectiveness of the product performance. In this study, we developed systems for measuring the gripping force of myoelectric hand prosthesis by a load cell and for durability test of the prosthesis over repeated use with a proximity sensor, and propose a test method standard. Since the international test method standard has not yet been established, it is expected that Korea will be able to play a leading role in this standardization field in the future.

• Health Policy and Management
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• v.33 no.4
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• pp.457-478
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• 2023

Background: This study aims to contribute to the adjustment of the appropriate doctor manpower by analyzing the distribution, supply and demand, and estimation of the doctor manpower. Methods: This study utilized the medical personnel data of the Ministry of Health and Welfare, population trend data of the National Statistical Office, and health insurance benefit performance data of the National Health Insurance Service. Based on 2021, we compared the number of doctors in actual supply and the number of doctors in demand according to the amount of medical use by gender and age for 250 regions. Logistic regression analysis and scenario analysis were performed to estimate the future medical workforce by considering the demand for doctors according to the future demographic structure, the size of the quota in medical schools, and the retirement rate. Results: There were 186 regions in which the supply of doctors was below average, and the average ratio of the number of doctors in supply to demand in the region was 62.1%. Conclusion: In order to increase the number of active doctors nationwide to at least 80%, 7,756 people must be allocated. The number of doctors in demand is estimated to decrease after increasing to 1.492 times in 2059. The future projected number of doctors is expected to increase to 1.349 times in 2050 and then decrease taking into account the doctor quota and the retirement rate.

• Korea journal of population studies
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• v.14 no.1
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• pp.26-34
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• 1991

Migration studies that assume that decision making is done on an individual basis is overlooking the importance of the family factor. Considering that must people belong to families, it is more appropriate to view migration decision from the perspective of the family. This study analyzes the household migration decision whereby the alternatives are to stay, 10 undertake family migration or to undertake single migration of a member. In developing a conceptual model of household migration decision, it is assumed that the household's objective is to maximize household income which is a function of individual members' earnings. The benefits and costs of household migration and individual migration are identified and the household chooses the migration strategy that maximizes expected household income. When household members have conflicting earning prospects in the potential destination, the household considers single migration of the member with the best earning potentials. However, lone migration by a household member involves cost of family separation which is both monetary and psychic, and this study shows that lone migration is undertaken only when its net gains to the family are greater than the separation cost of the family. The major benefit of choosing single migration is the retention of home base in the place of origin which can serve as an insurance against the uncertainty of obtaining a job in the destination, the benefit that is unavailable in family migration. The conceptual analysis shows how a household's migration decision would depend on its members' economic roles and prospects in the destination. Besides the economic variables, social and life cycle variables of the family translate into separation costs and benefits of migration. This study indicates that one - earner family in low economic status but with good earning prospects and high separation costs is more likely to choose family migration over single migration.

• Health Policy and Management
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• v.32 no.1
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• pp.3-13
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• 2022

Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.155-190
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• 2015

The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

• Journal of Preventive Medicine and Public Health
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• v.28 no.3 s.51
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• pp.640-650
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• 1995

After the introduction of National Medical Insurance in 1989, the medical demand has rapidly increased. The impact of increased medical demand was followed by an increase in the number of claims in need of review. We studied a new, fair method for reducing the number of claims reviewed. We analysed 90,583 outpatient claims submitted between September and October; claims were made for services given August of 1994. We finally suggested a screening system for claims review using a statistical method of discriminant analysis of the medical costs. The results were as follows. 1. In the cut-off group, age, days of medication, number of hospital or clinic visits, and total charge were significantly high. The cut-off rates according to the hospital-type and existence of accompanied disease were significantly different 2. According to ICD, the cut-off rate was highest in peripheral enthesopathies and allied syndromes(20.76%), lowest in acute sinusitis(0.93%). The mean charges were significantly different according to ICD and existence of cut-off. 3. We build discriminant functions by ICD with such discriminant variables as patient age, sex, existence of accompanied disease, number of hospital or clinic visits, and 9 detailed hospital or clinic charges included in claim. 4. We applied the discriminant function for screening those claims that were expected to be cut-off. The sensitivities comprised from 40% to 70%, and specificities from 70% to 95% by ICD. Acute rhinitis had highest sensitivity(100.00%) and other local infections of skin and subcutaneous tissue had highest specificity(98.45%). The expected number of cut-off was 17,762(19.61%). The total sensitivity was 49.62%, the total specificity was 82.57% and the error rate was 19.66%. We lacked economic analysis such as cost-benefit analysis. But, if the new method of screening claims using discriminant analysis were applied, the number of claims in need of review will reduce considerably.