• Journal of the Korean Professional Engineers Association
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• v.38 no.1
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• pp.88-90
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• 2005

National medical bill is amounting 31 trillion, equivalent to about 8% of GDP. And Japanese poeple are beginning to doubt the western medical system that depends upon drugs and operations. They are seeking another method of treatment. It is well known the forest has many healthy and recreation benefit. Now I would like to talk about the benefits of forest therapy.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.3-16
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• 1985

Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

• Korean Medical Education Review
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• v.22 no.2
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• pp.93-98
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• 2020

This paper examined the principles of experiential learning theory (ELT) relevant to learning from experience and introduces examples which were applied to medical education from a theoretical perspective. The experiential learning theory encompasses the theories of Dewey, Kolb, and Schon, whose key ideas highlight the continuity of experience, interaction of experience, and reflection. According to ELT, growth is education, and education is a reconstruction of experience. Experiential learning is a way of thinking about the educational process by constructing meaningful learning through reflection-in-action. This paper examines the learning principles of ELT and presents practical examples of the application of ELT and its implications for medical education. An in-depth understanding and application of ELT could benefit the field of medical education.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.171-209
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• 2022

There were also many medical-related rulings in 2021, among which the rulings reviewed in this paper are as follows. The first relates to a case in which the medical record, which is the primary judgment data regarding the presence or absence of medical negligence, has been modified. The court judged whether there was negligence on the basis of the first written medical record without considering the contents of the medical record that was later modified. Next, the ruling on the case of asking for liability for damages for prescription of anti-obesity drugs recognized negligence related to prescription, but denied liability for property damage by denying a causal relationship, and recognized only alimony for violation of the duty of explanation. The a full-bench ruling on the scope of subrogation of the National Health Insurance Corporation, which subrogates the claims for compensation for medical expenses against the perpetrator of the patient, changed the existing precedent that had taken the 'deduction method after offsetting negligence' and judged it as 'the method of offsetting negligence after deduction'. In addition, in the ruling on whether or not there was negligence, the court was not bound by the medical record appraisal result. Lastly, in relation to the National Health Insurance Service's disposition of reimbursement for medical care benefit costs, we reviewed the ruling that discretion should be exercised even when a non-medical person makes a refund to a medical institution opened by a non-medical person. And we also reviewed the ruling that the scope of reimbursement for medical institutions jointly using facilities and manpower specifically should be determined.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.2
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• pp.92-99
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• 2016

Purpose: The use of flumazenil administration in the emergency department is still controversial because of concerns about adverse effects. The present study was conducted to re-evaluate the risk-benefit ratio associated with flumazenil administration to patients suspected of having acute hypnotics and sedatives poisoning in the emergency department. Methods: A retrospective chart review study was conducted for patients whose final diagnoses were "poisoning" and "benzodiazepine" or "sedatives-hypnotics" from Mar. 2006 to Feb. 2015. The basal characteristics of the patients, including past medical history, ingredients and dose of ingested drug and co-ingested drugs were investigated. For patients administered flumazenil, responsiveness and time from admission to flumazenil administration were investigated with supplement. All collected data were analyzed in aspect terms of risk/benefit. Results: A total of 678 patients were included in our study. Benzodiazepine was the most common sedative/hypnotic drug prescribed, and the frequency of prescription continuously increased. The proportion of TCA as co-ingestion decreased from 13.1% to 3.9% in patients with acute sedative/hypnotic poisoning. Flumazenil was administered to 55 patients (8.1%), of which 29 patients (52.7%) were applied to contraindications. Fifty-three patients (96.4%) showed positive responsiveness, including partial responsiveness after flumazenil administration. No severe adverse events were identified. Conclusion: Based on the current trends in prescription patterns for sedative/hypnotic drugs, increased use of non-TCA antidepressants, and responsiveness to administration of flumazenil, benefit seemed weighted more in this study, although the observed benefits were based on limited results. Further prospective multicenter studies will be needed to optimize benefit-risk ratio.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.183-196
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• 2016

Objectives: There is no systematic review on economic evaluations of telemedicine in Japan, despite over 1000 trials implemented. Our systematic review aims to examine whether Japan's telemedicine is cost-saving or cost-effective, examine the methodological rigorousness of the economic evaluations, and discuss future studies needed to improve telemedicine's financial sustainability. Methods: We searched five databases, including two Japanese databases, to find peer-reviewed articles published between January 1, 2000 and December 31, 2014 in English and Japanese that performed economic evaluations of Japan's telemedicine programs. The methodological rigorousness of the economic analyses was assessed with a well-established checklist. We calculated the benefit-to-cost ratio (BCR) when a reviewed study reported related data but did not report the BCR. All cost values were adjusted to 2014 US dollars. Results: Among the 17 articles identified, six studies reported on settings connecting physicians for specialist consultations, and eleven studies on settings connecting healthcare providers and patients at home. There are three cost-benefit analyses and three cost-minimization analyses. The remaining studies measured the benefit of telemedicine only, using medical expenditure saved or users' willingness-to-pay. There was substantial diversity in the methodological rigorousness. Studies on teledermatology and teleradiology indicated a favorable level of economic efficiency. Studies on telehomecare gave mixed results. One cost-benefit analysis on telehomecare indicated a low economic efficiency, partly due to public subsidy rules, e.g., a too short budget period. Conclusions: Overall, telemedicine programs in Japan were indicated to have a favorable level of economic efficiency. However, the scarcity of the economic literature indicates the need for further rigorous economic evaluation studies.

• Safety and Health at Work
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• v.4 no.3
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• pp.166-176
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• 2013

Background: Effective policy implementation is essential for a healthy workplace. The Ryan-Kossek 2008 model for work-life policy adoption suggests that supervisors as gatekeepers between employer and employee need to know how to support and communicate benefit regulations. This article describes a workplace intervention on a national employee benefit, Family and Medical Leave Act (FMLA), and evaluates the effectiveness of the intervention on supervisor knowledge, awareness, and experience with FMLA. Methods: The intervention consisted of computer-based training (CBT) and a survey measuring awareness and experience with FMLA. The training was administered to 793 county government supervisors in the state of Oregon, USA. Results: More than 35% of supervisors reported no previous training on FMLA and the training pre-test revealed a lack of knowledge regarding benefit coverage and employer responsibilities. The CBT achieved: (1) a significant learning effect and large effect size of d = 2.0, (2) a positive reaction to the training and its design, and (3) evidence of increased knowledge and awareness regarding FMLA. Conclusion: CBT is an effective strategy to increase supervisors' knowledge and awareness to support policy implementation. The lack of supervisor training and knowledge of an important but complex employee benefit exposes a serious impediment to effective policy implementation and may lead to negative outcomes for the organization and the employee, supporting the Ryan-Kossek model. The results further demonstrate that long-time employees need supplementary training on complex workplace policies such as FMLA.

• The Journal of the Korean life insurance medical association
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• v.26
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

• Proceedings of the PSK Conference
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• 2003.10a
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• pp.38-39
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• 2003

There have been remarkable medical advances, largely as the result of improved understanding of disease mechanisms and of advances in human genetics at the individual level. Subsequently, remarkable effective medicines continue to be discovered at an increasing rate. Development of these medicines become increasingly complex, accompanied by globalization and global standards, requiring ever higher standards of efficacy, safety and quality. (omitted)

• Journal of Environmental Health Sciences
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• v.35 no.4
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• pp.269-277
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• 2009

Objective : The objective of this study was to examine how experts and the public perceived various environmental and technological hazards based on psychometric paradigm. Methods : We conducted a survey that included 30 hazards and 10 risk attributes. Subjects of this study were 214 people with three groups; (1) experts (55 people), (2) graduates( 78 people), (3) under graduates (81 people). Factor analysis was used to confirm the common risk attribute from 8 risk attributes. Also, multiple regression analysis was used to identify factors influencing on perceived risk and benefit of hazards. Results : This study revealed that experts tend to be more tolerant than graduates and under graduate students for the 30 hazards. Using factor analysis, two main factors were identified: factor 1, commonly called "Dread Risk", and factors 2, commonly called, "Unknown Risk" in the literature. We identified that environmental hormone concentration and global warming ranked high in both dread risk and unknown risk. Multiple regression models were used to test the association of perceived social risk and perceived social benefit with two main factors. Dread risk had significant explanatory power on perceived social risk and benefit. We identified that the experts were less likely to perceived dread risk and know more information about the hazards. Conclusions : There were differences of risk perception between experts and lay people. Especially, experts' perception of risk was commonly lower than other people's perception.