Kang, Ji-Man;Lee, Jinhong;Park, Yoon Soo;Park, Yoonseon;Kwak, Yee Gyung;Song, Je Eun;Choi, Young Ju
Pediatric Infection and Vaccine
/
v.26
no.3
/
pp.170-178
/
2019
Purpose: Annual influenza vaccination is the best strategy to prevent healthcare-associated influenza transmission. Influenza vaccination rates among healthcare workers (HCWs) vary by country, region, and year. We investigated the influenza vaccination rates for HCWs during the 2017-2018 influenza season in South Korea, where a non-mandatory vaccination campaign was conducted. Methods: We retrospectively investigated factors affecting the influenza vaccination rate among HCWs during the 2017-2018 influenza season in three tertiary hospitals in Goyang City, where the non-mandatory influenza vaccination program is conducted. Results: Consequently, 6,994 of 7,180 HCWs (97%) were included, and the overall vaccination rate was 85%. Nurses had the highest rate with 92%, followed by health technicians (88%), physicians (84%), and non-medical HCWs (79%, P<0.001). Vaccination rates differed, depending on the frequency of contact with patients in the non-medical HCWs (frequent contact vs. less-frequent contact; 90% vs. 73%, P<0.001). Conclusions: The influenza vaccination rate among HCWs during the 2017-2018 influenza season in Korea was 85%, which is among the highest rates compared with previously reported non-mandatory vaccination rates in other countries. The vaccination rate may vary depending on the HCW's occupational characteristics, including the extent of contact with the patient. Therefore, a multifaceted strategy is needed to increase the vaccination rate of HCWs.
The development of the aviation industry has exponentially increased the volume of passengers and cargo and gradually expanded the damage scope of all kinds of accidents in the process of transportation. As a result, the need for aviation insurance has accordingly grown bigger and bigger every day. That is why most nations have a law to force mandatory insurance on the aviation industry. However, the Montreal Convention of 1999, which Korea also signed and today has the most extensive effect in the international civil aviation community, offers no clear interpretations about the coverage of aviation insurance along with the Air Transport Business Promotion Act of Korea. The advanced nations of air transport business such as EU, the U. S. A. and Canada prescribe the coverage of aviation insurance and have a law that makes it mandatory for all the passengers and third parties to cover air carrier's liability. EU requires them to include cargo and baggage in scope of coverage, and the U. S. A. and Canada recommend insuring by having a shipper receive a written notice containing information about whether the concerned cargo is insured or not. Making the scope of coverage of aviation insurance clear by law serves several purposes including diversifying risks for air transport companies, providing the victims with enough protection, observing the international accountability required in the air transport industry, and promoting the productive and sustainable growth of the aviation industry. Thus problems with Korea's aviation insurance should be resolved by clearly stating the coverage of aviation insurance that the Korean air carriers and operators need to insure according to the current state of Korea's air transport by consulting the legislations of the advanced nations in air transports. and enacting a law to comprehensively govern Korea's aviation insurance.
Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.
Objectives : The aim of this study is to identify factors determining the purchase of private health insurance under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. It includes cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer. Data were gathered from the hospital Order Communication System (OCS), medical records, and face-to-face interviews, using a structured questionnaire. Clinical, socio-demographic and private health insurance related factors were also gathered. Results : Overall, 43.9% of patients had purchased one or more private health insurance schemes related to cancer, with an average monthly premium of \65,311 and an average benefit amount of \19million. Females, younger aged, high income earners, national health insurers and metropolitan citizens were more likely to purchase private health insurance than their counterparts. Conclusions : About half of Korean people have supple-mentary private health insurance and their benefits are sufficient to cover the out-of-pocket fees required for cancer treatment, but inequality remains in the purchase of private health insurance. Further studies are needed to investigate the impacts of private health insurance on NHI, and the relationship between cancer patients' burden and benefits.
Just as safety is the most important thing in aviation, safety is the most important in the operation of unmanned aircraft (RPA), and safety operation is the most important in the legal responsibility of the operator of the unmanned aircraft. In this thesis, the legal responsibility of the operator of the unmanned aircraft, focusing on the responsibility of the operator of the unmanned aircraft, was discussed in depth with the issue of insurance, which compensates for damages in the event of an accident First of all, the legal responsibility of the operator of the unmanned aircraft was reviewed for the most basic : definition, scope and qualification of the operator of the unmanned aircraft, and the liability of the operator of the Convention On International Civil Aviation, the ICAO Annex, the RPAS Manual, the Rome Convention, other major international treaties and Domestic law such as the Aviation Safety Act. The ICAO requires that unmanned aircraft be operated in such a manner as to minimize hazards to persons, property or other aircraft as a major principle of the operation of unmanned aircraft, which is ultimately equivalent to manned aircraft Considering that most accidents involving unmanned aircrafts fall to the ground, causing damage to third parties' lives or property, this thesis focused on the responsibility of operators under the international treaty, and the responsibility of third parties for air transport by Domestic Commercial Act, as well as the liability for compensation. In relation to the Rome Convention, the Rome Convention 1952 detailed the responsibilities of the operator. Although it has yet to come into effect regarding liability, some EU countries are following the limit of responsibility under the Rome Convention 2009. Korea has yet to sign any Rome Convention, but Commercial Act Part VI Carriage by Air is modeled on the Rome Convention 1978 in terms of compensation. This thesis also looked at security-related responsibilities and the responsibility for privacy infringement. which are most problematic due to the legal responsibilities of operating unmanned aircraft. Concerning insurance, this thesis looked at the trends of mandatory aviation insurance coverage around the world and the corresponding regulatory status of major countries to see the applicability of unmanned aircraft. It also looked at the current clauses of the Domestic Aviation Business Act that make insurance mandatory, and the ultra-light flight equipment insurance policy and problems. In sum, the operator of an unmanned aircraft will be legally responsible for operating the unmanned aircraft safely so that it does not pose a risk to people, property or other aircraft, and there will be adequate compensation in the event of an accident, and legal systems such as insurance systems should be prepared to do so.
Background: This study aims to develop a "Predictive Model for the Possibility of Collection Delinquent Health Insurance Contributions" for the National Health Insurance Service to enhance administrative efficiency in protecting and collecting contributions from livelihood-type defaulters. Additionally, it aims to establish customized collection management strategies based on individuals' ability to pay health insurance contributions. Methods: Firstly, to develop the "Predictive Model for the Possibility of Collection Delinquent Health Insurance Contributions," a series of processes including (1) analysis of defaulter characteristics, (2) model estimation and performance evaluation, and (3) model derivation will be conducted. Secondly, using the predictions from the model, individuals will be categorized into four types based on their payment ability and livelihood status, and collection strategies will be provided for each type. Results: Firstly, the regression equation of the prediction model is as follows: phat = exp (0.4729 + 0.0392 × gender + 0.00894 × age + 0.000563 × total income - 0.2849 × low-income type enrollee - 0.2271 × delinquency frequency + 0.9714 × delinquency action + 0.0851 × reduction) / [1 + exp (0.4729 + 0.0392 × gender + 0.00894 × age + 0.000563 × total income - 0.2849 × low-income type enrollee - 0.2271 × delinquency frequency + 0.9714 × delinquency action + 0.0851 × reduction)]. The prediction performance is an accuracy of 86.0%, sensitivity of 87.0%, and specificity of 84.8%. Secondly, individuals were categorized into four types based on livelihood status and payment ability. Particularly, the "support needed group," which comprises those with low payment ability and low-income type enrollee, suggests enhancing contribution relief and support policies. On the other hand, the "high-risk group," which comprises those without livelihood type and low payment ability, suggests implementing stricter default handling to improve collection rates. Conclusion: Upon examining the regression equation of the prediction model, it is evident that individuals with lower income levels and a history of past defaults have a lower probability of payment. This implies that defaults occur among those without the ability to bear the burden of health insurance contributions, leading to long-term defaults. Social insurance operates on the principles of mandatory participation and burden based on the ability to pay. Therefore, it is necessary to develop policies that consider individuals' ability to pay, such as transitioning livelihood-type defaulters to medical assistance or reducing insurance contribution burdens.
The aim of this study is to develop strategies activating long-term care visiting nursing. The research design was a descriptive survey study, and the data were collected from the visiting nursing center managers, customers, and long-term care insurance staffs. The major results were as follows. To activate the long-term care visiting nursing, first, the basic nursing care for ensuring sustainable health management has to be included. Second, the visiting nursing must be designated as mandatory use in standard guideline for using long-term care services. Third, the insurance pricing of visiting nursing must be based on the cost of visiting nursing. And, last, using a visiting nursing must be possible without a doctor's order sheet, when it is required for the assessment of patient's health status.
Purpose - The primary objective of this study is to investigate the impact of employee characteristics on employees' preference towards corporate pension products. This study can provide a guidance for maximization of benefits for employees and their affiliated corporation. Employee characteristics include average length of labour, wage system of annual salary, age, types of interest rates and size of corporation. Existing research generally concentrate on vitalizations of corporate pension product raising an imperfection, improvements, tax benefit analysis and legal consideration. Thus, this study intensively analyses the effect of employee attributes on firms' decision for corporate pension products, such as DB(defined benefit) and DC(defined contribution) type. Research design, data, and methodology - The data were collected using self-administrated questionnaire survey on corporate pension products from CEOs or HR directors 250 foreign-invested companies', purchasing pension plans in practice with domestic financial trustees (insurance companies, banks and security companies). Hypotheses testing was conducted using Logistic Regression analysis with SPSS/PC+ 21.0. Results - The findings of the study are as follows. Employees with the long length of labour are more likely to have DB plan; more likely to prefer DC plan with the dividend distribution product regarding the types of interest rate. SMEs(less than 100 employees) are more likely to select DC plan whereas high fluctuation in wage with annual salary has no impacts. In addition, the ages has no significant effect on the preference. Conclusions - This study has examined with the empirical testing that employees' variable attributes and qualities are one of the vital factors for corporation pension plan selection. Currently, majority employees are highly likely to join DB plan and Defined interest types. Corporation with less than 10 employees prefer IRP scheme while most of corporation are intended to join DC plan. In a very near future, corporation more than 300 employees will be required to purchase mandatory plan under national regulation. For maximization of employees' contentment to corporation pension insurance and for complementing the flaws of existing plans, the future studies shall also research in a perspective of employee benefit.
Since the age of Lord Mansfield, who laid the foundation of the modern English insurance contract law in the second part of the 18th century, English insurance law has developed a unique rule of warranty. Lord Mansfield adopted very different approach and afforded such a strict legal character to insurance warranty, because the promise, given by the insured, played an important role for the insurer to assess the scope of the risk insured at that time. It is still important that the insured keep his promises strictly to the insurer under the insurance contract, but legal environments have changed dramatically since the times of Lord Mansfield. English Law Commission proposed some proposals for reforming the warranty regime to reflect the changes of legal environment in CP 2007. This article is, therefore, designed to examine the proposals and consider their legal and practical implications. The proposals of Law Commission is summarized as following. First, in CP 2007, Law Commission made two principal proposals for reform of the law on warranty. The first is that the insurer should not be entitled to rely on a breach of warranty unless the insured has been provided with a witten statement of what they have undertaken under warranty. The second is that the insurer should not be entitled to reject a claim on the ground that the insured has breached a warranty unless there was a causal connection between the breach and the loss. Secondly, for consumer insurance, the rule requiring a causal connection would be mandatory, whereas for business insurance, it would be possible for the parties to agree on the effect a breach of warranty should have, provided they use clear language to express their intentions. Thirdly, where the insured contracted on the insurer's written standard terms of business, some statutory controls would be afforded to the contract to ensure that the cover was not substantially different from what the insured reasonably expected. Finally, Law Commission propose that a breach of warranty give the insurer the right to terminate the contract, rather than automatically discharging it from liability, but (unless otherwise agreed) only if the breach has sufficiently serious consequences to justify termination under the general law of contract. Having evaluated the proposals of the Law Commission and considered their legal and practical implications, it is quite clear that the proposed rule interfere with freedom of contract and create legal uncertainty. But change can not made without any victims, so Law Commission's attempt to change severe and injust aspects of the warranty regime would be very welcomed and respected.
Cheong, Won;Yim, Jun;Oh, Dae-Kyu;Im, Jeong-Soo;Ko, Kwang Pil;Kim, Yun Mi
Journal of agricultural medicine and community health
/
v.38
no.2
/
pp.108-115
/
2013
Objective: This study aimed to examine the effects of chronic disease management program based on clinics for blood pressure control or glycemic control in patients with hypertension or type 2 diabetes mellitus in Incheon. Methods: An observational follow up study was done on 11,501 patients registrated at clinics from January 1st to December 31st, 2010 in Incheon. Experience of education and mandatory laboratory tests were assessed with the registration data and income status was identified by National Health Insurance data. The odds ratio and 95% confidence intervals were derived from logistic regression models. Results: The experience of education has a positive effect for blood pressure control in the non-control group with hypertension at the time of registration (Odds ratio 1.357, confidence intervals: 1.112~1.655). The experience of mandatory laboratory tests has a positive effect for blood pressure control in the control group with hypertension at the time of registration (Odds ratio 1.738, confidence intervals: 1.387~2.178). But the effects of the experience of education and mandatory laboratory test in patients with type 2 diabetes mellitus were not identified. Conclusions: This study revealed the relationship between the experience of education or mandatory laboratory testing and blood pressure control in patients with hypertension.
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