• 한국임상약학회지
• /
• 제22권1호
• /
• pp.73-80
• /
• 2012

This study was to determine the inappropriate drug use in pediatric outpatients who received 2 or more prescriptions on the same day. Retrospective drug utilization reviews (DURs) were implemented to samples obtained from national health insurance claims data during December 2008 to February 2009, using 5 DUR criteria (duplication, drug-drug interaction, drug-disease interaction, drug-age contraindication, incorrect dosage) established in the Drug Information Framework (DIF)-$Korea^{TM}$, DUR program. Among 38,451 claims analyzed in the study, 74.7% had more than one conflicts in the 5 DUR modules. Among 16,472 patients analyzed, 49.6% had conflicts with duplication criteria composing of ingredient duplication (23.3%) and therapeutic class duplication (39.6%). Incorrect dosages were found in 73.6% of patients and under-dosage conflicts accounted for 59.9%, which was higher than over-dosage conflicts (38.3%). In this study, inappropriate drug prescriptions such as under-dose, pediatric contraindication and therapeutic duplication were prevalent in pediatric outpatient settings, suggesting much more awareness to the society, to prevent drug related problems in a vulnerable pediatric group.

• 항공우주정책ㆍ법학회지
• /
• 제6권
• /
• pp.137-147
• /
• 1994

Clearly there are many legal arguments and criticisms surrounding the proposals for change in the Warsaw Convention and the need for a radical review. The question remains is unlimited liability the answer or should there be some other form of supplemental compensation and if so, what limits should be applicable. It does seem that the adopted limits of the Convention are seen by many as the first line of defence, which, dependent on political and cultural differences, the legal interpretation of contractual wording and the legal system globally have resulted in enormous differences in compensation paid whether or not the Convention limits were imposed. An example of this is in the United States, which highlights the significance of the problem in that domestic travellers without Convention Limits can, through the American legal system, obtain compensation in the multi-million dollar area for a death claim, whereas a passenger t1ying internationally would in the first instance be subject to Convention Limits. expensive legal action through litigation. To date, we can advise that insurers have not charged additional premium for unlimited liability coverage. Insurance rates as we have stated are hardening considerably. To date, average rate increases have been plus 56% for aircraft hull and plus 45% for liabilities. Insurers last year suffered global losses of around US $ 1.1 Billion against a premium income of US $ 800,000. The target premium income for 1993 is believed to be in the region of US $1.4 Billion.

• 보건교육건강증진학회지
• /
• 제31권4호
• /
• pp.51-62
• /
• 2014

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

• 한국임상약학회지
• /
• 제25권3호
• /
• pp.159-165
• /
• 2015

Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권4호
• /
• pp.1591-1597
• /
• 2015

Background: Korea has experienced rapid economic development in a very short period of time. A mixture of traditional and modern risk factors coexists and the rapid change in non-genetic factors interacts with genetic constituents. With consideration of these unique aspects of Korean society, a large-scale genomic cohort study-the Health Examinees (HEXA) Study-has been conducted to investigate epidemiologic characteristics, genomic features, and gene-environment interactions of major chronic diseases including cancer in the Korean population. Materials and Methods: Following a standardized study protocol, the subjects were prospectively recruited from 38 health examination centers and training hospitals throughout the country. An interview-based questionnaire survey was conducted to collect information on socio-demographic characteristics, medical history, medication usage, family history, lifestyle factors, diet, physical activity, and reproductive factors for women. Various biological specimens (i.e., plasma, serum, buffy coat, blood cells, genomic DNA, and urine) were collected for biorepository according to the standardized protocol. Skilled medical staff also performed physical examinations. Results: Between 2004 and 2013, a total of 167,169 subjects aged 40-69 years were recruited for the HEXA study. Participants are being followed up utilizing active and passive methods. The first wave of active follow-up began in 2012 and it will be continued until 2015. The principal purpose of passive follow-up is based on data linkages with the National Death Certificate, the National Cancer Registry, and the National Health Insurance Claim data. Conclusions: The HEXA study will render an opportunity to investigate biomarkers of early health index and the chronological changes associated with chronic diseases.

• 무역상무연구
• /
• 제18권
• /
• pp.137-157
• /
• 2002

The clauses of bill of lading(B/L) consist of the terms of contract for the carriage of goods by sea because of clauses of B/L by the mutual agreement of contracting parties. There are some exempted cause of deviation clause in B/L for specific reasons. Then deviation clauses are influenced by Rules of international carriage of goods by sea, because the international rules become the governing law of contract for the carriage of goods by sea. The problem of deviation clauses in B/L is stipulated as follows. "It shall be prerequisite to the Merchant' claim for damages on account of deviation that the merchant's insurance shall first have been cancelled on account of alleged deviation. No deviation shall oust the right to limit liability or damages, and the Carrier shall always be entitled to the full benefit of all privileges, rights and immunities contained in this Bill of Lading and incorporated tariffs." This stipulation should be adjusted according to the confirmed cases, otherwise it will be invalid according to the Hague Rules and Hamburg rules. The sphere of a reasonable deviation in the deviation clause should be interpreted in the connection with the designed voyage and the commercial object of contract for the carriage of goods by sea and the deviation become valid unless the policy, the general object of international rules or the true intention of contracting parties has violated.

• 한국건축시공학회:학술대회논문집
• /
• 한국건축시공학회 2019년도 춘계 학술논문 발표대회
• /
• pp.45-46
• /
• 2019

Accident rate in domestic construction industry has been increased rapidly in every year. In particular, the rate of death has been shown very high compared with other industries. It means that safety activities performed by government is not effective in reducing the rate of accident. To solve these problems, the risk factors should be predicted in advance, controlled, monitored and managed from start of project to end of project. However, most studies have been conducted by using frequency of occurrence of accident and only listed the importance of risk. Therefore, the objective of this study is to provide basic material to develop risk quantifying model for human accidents on construction site in South Korea. In the future, it is expected to be used as a reference of study on developing safety mangement checklist in construction industry and model for forecasting accident.

• 한국건축시공학회:학술대회논문집
• /
• 한국건축시공학회 2017년도 추계 학술논문 발표대회
• /
• pp.195-196
• /
• 2017

The number of human accidents in the construction industry is increasing every year, and it constitute the highest percentage among industry. This means that activities performed to prevent safety accidents in the country are not efficient to reduce the rate of accidents in the construction industry. In order to solve this issue, research has been conducted from various perspectives. But, research regarding to quantification model of human accidents is insufficient. the objective of this study is to conduct a basic study on quantification model development of human accidents. To achieve the objective, first, Cause of accident is defined the through literature review. Second, a basic statistic analysis is conducted to determine the characteristics of the accident causes. Third, the analysis is conducted after dividing into four categories : accumulate rate, season, total construction cost, and location. In the future, this study can be used as a reference for developing the safety management checklist for safety management in construction site and development of prediction models of human accident.

• 한국한의학연구원논문집
• /
• 제18권2호
• /
• pp.65-89
• /
• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

• Journal of Korean Neurosurgical Society
• /
• 제63권1호
• /
• pp.108-118
• /
• 2020

Objective : This study aimed to determine the incidence and analyze trends of the herniated lumbar disc (HLD) based on a national database in the Republic of Korea (ROK) from January 2008 to December 2016. Methods : This study was a retrospective analysis of data obtained from the national health-claim database provided by the National Health Insurance Service for 2008-2016 using the International Classification of Diseases. The crude incidence and age-standardized incidence of HLD were calculated, and additional analysis was conducted according to age and sex. Changes in trends in treatment methods and some treatments were analyzed using the Korean Classification of Diseases procedure codes. Results : The number of patients diagnosed with HLD was 472245 in 2008 and increased to 537577 in 2012; however, it decreased to 478697 in 2016. The pattern of crude incidence and the standardized incidence were also similar. Overall, the incidence of HLD increased annually for the 30s, 40s, 50s, and 70s until 2012 and then decreased. However, the incidence of HLD for the 80s continued to increase. The crude incidence of HLD in female patients exceeded that of male patients in their middle age (30s or 40s) and was 1.5-1.6 times higher than in male patients in their 60s. The total number of open discectomy (OD) increased from 71598 in 2008 to 93942 in 2012 and then decreased to 85846 in 2016. The rate of younger patients (the 20s, 30s, and 40s) who underwent OD was decreased, and the rate of younger patients who underwent percutaneous endoscopic lumbar discectomy was increased. However, the rate of older patients (the 70s and 80s) who underwent OD was continuously increased. Conclusion : This nationwide data on HLD from 2008 to 2016 in the ROK demonstrated that the crude incidence and the standardized incidence increased until 2012 and then decreased. The annual crude incidence was different according to age and sex. These findings may be considered when deciding future health policy, especially in countries with a similar national health insurance system (or with plans to adopt).