• Health Policy and Management
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• v.33 no.4
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• pp.450-456
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• 2023

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.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.57-95
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• 1972

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.4
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• pp.312-316
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• 2014

Purpose: The aim of this study was to compare the fracture toughness of currently available resin cements for zirconia restorations and evaluate the effect of water storage on fracture toughness of those resin cements. Materials and methods: Single-edge notched specimens ($3mm{\times}6mm{\times}25mm$) were prepared from three currently available dual cure resin cements for zirconia restorations (Panavia F 2.0, Clearfil SA luting and Zirconite). Each resin cement was divided into four groups: immersed in distilled water at $37^{\circ}C$ for 1 (Control group), 30, 90, or 180 days (n=5). Specimens were loaded in three point bending at a cross-head speed of 0.1 mm/s. The maximum load at specimen failure was recorded and the fracture toughness ($K_{IC}$) was calculated. Data were analyzed using one-way ANOVA and multiple comparison $Scheff{\acute{e}}$ test (${\alpha}$=.05). Results: In control group, the mean $K_{IC}$ was $3.41{\pm}0.64MN{\cdot}m^{-1.5}$ for Panavia F, 2.0, $3.07{\pm}0.41MN{\cdot}m^{-1.5}$ for Zirconite, $2.58{\pm}0.30MN{\cdot}m^{-1.5}$ for Clearfil SA luting respectively, but statistical analysis revealed no significant difference between them. Although a gradual decrease of $K_{IC}$ in Panavia F 2.0 and gradual increases of KIC in Clearfil SA luting and Zirconite were observed with storage time, there were no significant differences between immersion time for each cement. Conclusion: The resin cements for zirconia restorations exhibit much higher $K_{IC}$ values than conventional resin cements. The fracture toughness of resin cement for zirconia restoration would not be affected by water storage.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.2
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• pp.82-89
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• 2014

Purpose: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. Materials and methods: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at $32^{\circ}C$. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan ${\delta}$) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (${\alpha}$=0.05). Results: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan ${\delta}$was maintained at some level and reached the zero at the starting point where G' began to increase. The tan ${\delta}$and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. Conclusion: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.4
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• pp.325-329
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• 2015

Purpose: The aim of this study was to compare the film thicknesses of several resin cements as a function of time after mixing and to examine the effect of working time on the film thicknesses. Materials and methods: The film thickness (${\mu}m$) of 4 resin cements (n=10), 1 composite resin (Panavia F 2.0), 3 self-adhesive resin (Clearfil SA luting, Zirconite, RelyX U200) cements was measured at 20-second intervals after mixing of the cements up to 200 seconds under a load of 50 N. Linear regression was fitted to verify the effect of working time on the film thickness of each cement. Data were compared to the working time recommended by manufacturers using Wilcoxon test ($\alpha$=.05). Results: All of the materials showed a positive linear correlation between the film thickness and working time. There was no statistically significant difference between the working time based on our results and the values recommended by the manufacturers even though there was a discrepancy between those two values. Conclusion: The film thickness of resin cements could increase with the increase of working time. Working time to meet the ISO standard of $50-{\mu}m$ maximum film thickness could be different from the manufacturer's recommended value.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.126-134
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• 2020

Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

• Journal of Korean Home Economics Education Association
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• v.20 no.4
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• pp.107-123
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• 2008

This research focused on the aging society and the silver industry in adolescents. This subjects were the 642 high school students living in Gwangju. Data were analyzed with Frequency, Percentage, Mean, Std, $x^2$, and t-test using SPSS/PC WIN 14.0 program. The major findings were as follows: 1. The attitude to the old was found quite positive in the questioning items concerning the psychological aspects and family relationship. In the questioning items concerning the physical aspect, on the other hand, was the attitude shown a little negative. Most respondents didn't have a clear understanding of the aging society. Also the perception toward the old showed significant difference according to meeting frequency with grand-parents. The knowledge of the aging society showed significant difference according to sex. 2. Although they recognized the need of the silver industry, they didn't wish to have a job related to the silver industry. Also they represented the idea that the medical care service is the most essential for the silver industry showed significant difference according to sex. The selection of job related to the silver industry showed significant difference according to meeting frequency with grand-parents. 3. Most of the respondents were aware of the need to education for understanding of the old. In the course of home economics, the education of the silver industry should be given vocation and comprehension about the old. The need to education for understanding of the old showed significant difference according to sex, experience of living and meeting frequency with grand-parents. The education of the silver industry showed significant difference according to sex, experience of living with grand-parents.

• Journal of Korean Society for Geospatial Information Science
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• v.24 no.1
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• pp.43-50
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• 2016

Urbanization in Korea has increased significantly and subsequently, various facilities have been concentrated in urban areas at high speed in accordance with a growing urban population. Accordingly, damages have occurred due to a variety of disasters. In particular, fire damage among the social disasters caused the most severe damage in urban areas along with traffic accidents. 44,432 cases of fire occurred in 2015 in Korea. Due to these accidents, 253 were killed and property damage of 4,50 billion won was generated. However, despite the efforts to reduce a variety of damage, fire danger still remains high. In this regard, this study collected fire data, generated from 2007 to 2014 through the Jinju Fire Department and the National Fire Data System(NFDS) and calculated fire risk by analyzing the clustering of fire cases and facilities in Jinju-si based on the current DB of facilities, offered by the Ministry of Government Administration and Home Affairs. As a result, the risk ratings of fire occurrence were classified as four stages under the standards of the US Society of Fire Protection Engineers(SEPE). Business facilities, entertainment facilities, and automobile facilities were classified as the highest A grade, detached houses, Apartment houses, education facilities, sales facilities, accommodation, set of facilities, medical facilities, industrial facilities, and life service facilities were classified as U grade, and other facilities were classified as EU grade. Finally, hazardous production facilities were classified as BEU grade, the lowest grade. In addition, in the case of setting the standard with loss of life, the highest risk facility was the hazardous production facilities, while in the case of setting the standard with property damage, a set of facilities and industrial facilities showed the highest risk. In this regard, this study is expected to be effectively utilized to establish the fire reduction measures against facilities, distributed in urban space by calculating risk grades regarding the generation frequency, casualties, and property damage, through the classification of fire, occurred in the city, according to the facilities.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).