• Title/Summary/Keyword: P & I Insurance

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The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement

  • Kim, San-Han;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.16-23
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    • 2022
  • Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

A Study on Seaman's Criminal Responsibility of Marine Accidents (해양사고에 따른 해원(海員)의 과실책임에 대한 형사실무적 고찰)

  • Song Yong-Seop;Suh Geo-Suk;Park Yong-Uk
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.11 no.2 s.23
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    • pp.41-49
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    • 2005
  • In general, the criminal responsibility of seaman should always be directly assumed by the seamen, according to the principle of self-incrimination. Therefore, the only possible countermeasures for the criminal responsibility of seamen may be to reduce the responsibility by using criminal procedures (ex. the warrant substance examination system, the review system of legality for confinement as much as possible. Another possibility is to reduce the penalty through the revision of the law. In detail, concerning the problem of fine, the maximum fine for oil spill accidents by criminal negligence is KRW 30,000,000 under the current Ocean Pollution Prevention Act, and when an oil spill occurs, the maximum fine tends to be levied regardless of the amount of the spilled oil; thus, it is judged that grading the fine according to the amount of spilled oil may be worth considering. Regarding P & I's payment of fine, contrary to general belief, it is only possible to make up the loss when P & I takes up the legal responsibility or acknowledges its payment. In order to solve the problem, it is possible to consider the option of introducing new collective insurance program or mutual aid system. Also, as seamen are not specialists in legal issues, the ship owners' association or the marine afficers' association need to develop some program through which they can receive systematic assistance from legal specialists including lawyers when they encounter any legal problems (ex. free legal aid programs for farmers and fishermen). Finally, it may be possible to establish enact new laws or revise the existing Act on Special cases Concerning the Settlement of Traffic Accidents to insert a new section on marine accidents.

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A Study for risk management on Documentary Collection(D/P, D/A) Payment (추심결제(D/P, D/A)방식에서의 위험관리에 관한 연구)

  • Kwak, Su-Young
    • International Commerce and Information Review
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    • v.10 no.2
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    • pp.283-304
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    • 2008
  • According to globalization and localization of world economics international trade payment method was also changed. A traditional payment was Letter of Credit basis, however it is being increased to various methods such as remittance, documentary collection(D/P, D/A) and open account. In order to acquire a secure export payment, exporters prefer to L/C basis which is guaranteed by a reliable bank. However, the L/C should bear a security so that importers would rather documentary collection than L/C. The reasons for the preference of collection payment rather than L/C are a low commission cost, the conversion of buyer's market from seller's market due to severe competition in the world market, transaction increase between main office and branches and a right to control the goods until executing the payment by exporters. Besides of them, collection payment can handle safer and faster than open account basis. However, the collection payment has a risk which it isn't guaranteed by bank for the payment so that I would suggest countermeasures to minimize the payment risk utilizing the collection basis as follows; using export credit insurance system, a large domestic credit report provider such as D&B for absolutely fresh and new information, a collection proxy service for overseas deferred credit and suggestion specifying to order B/L not straight one on consignee in order to transfer the right of ownership with endorsement without problem.

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Lower Atrial Fibrillation Risk With Sodium-Glucose Cotransporter 2 Inhibitors Than With Dipeptidyl Peptidase-4 Inhibitors in Individuals With Type 2 Diabetes: A Nationwide Cohort Study

  • Min Kim;Kyoung Hwa Ha;Junyoung Lee;Sangshin Park;Kyeong Seok Oh;Dae-Hwan Bae;Ju Hee Lee;Sang Min Kim;Woong Gil Choi;Kyung-Kuk Hwang;Dong-Woon Kim;Myeong-Chan Cho;Dae Jung Kim;Jang-Whan Bae
    • Korean Circulation Journal
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    • v.54 no.5
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    • pp.256-267
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    • 2024
  • Background and Objectives: Accumulating evidence shows that sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce adverse cardiovascular outcomes. However, whether SGLT2i, compared with other antidiabetic drugs, reduce the new development of atrial fibrillation (AF) is unclear. In this study, we compared SGLT2i with dipeptidyl peptidase-4 inhibitors (DPP-4is) in terms of reduction in the risk of AF in individuals with type 2 diabetes. Methods: We included 42,786 propensity score-matched pairs of SGLT2i and DPP-4i users without previous AF diagnosis using the Korean National Health Insurance Service database between May 1, 2016, and December 31, 2018. Results: During a median follow-up of 1.3 years, SGLT2i users had a lower incidence of AF than DPP-4i users (1.95 vs. 2.65 per 1,000 person-years; hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.97; p=0.028]). In individuals without heart failure, SGLT2i users was associated with a decreased risk of AF incidence (HR, 0.70; 95% CI, 0.52-0.94; p=0.019) compared to DPP-4i users. However, individuals with heart failure, SGLT2i users was not significantly associated with a change in risk (HR, 1.04; 95% CI, 0.44-2.44; p=0.936). Conclusions: In this nationwide cohort study of individuals with type 2 diabetes, treatment with SGLT2i was associated with a lower risk of AF compared with treatment with DPP-4i.

Minimally Invasive Transforaminal Lumbar Interbody Fusion Using a Single Interbody Cage and a Tubular Retraction System : Technical Tips, and Perioperative, Radiologic and Clinical Outcomes

  • Lee, Chang-Kyu;Park, Jeong-Yoon;Zhang, Ho-Yeol
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.219-224
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    • 2010
  • Objective : A minimally invasive transforaminal lumbar interbody fusion (MIS TLlF) has recently been introduced. However, MIS TLlF is a technically challenging procedure. The authors performed retrospective analysis about MIS TLlF using a single interbody cage. Methods : Twenty-eight consecutive patients were treated by MIS TLlF. Of these 28 patients, 20 patients were included in this retrospective study. Perioperative, clinical, and radiologic outcomes were assessed. Clinical outcomes were assessed using Oswestry Disability Index (ODI) and Visual Analogue Scores (VAS). Fusion rates and cross-sections of operated spinal canals were assessed by CT. Results : Twelve patients underwent MIS TLlF at one segment and 8 patients at two segments (L3/4: 4, L4/5: 17, L5/S1: 7). Operation time for a single segment was 131.7 min and for two segment was 201.4 min, and corresponding blood losses were 208.3 mL and 481.2 mL, respectively. ODI and VAS scores were significantly improved at 6 months postop (ODI from 30.32 to 15.54, VAS from 7.80 to 2.20, p = 0.001) Twenty-two segments (78.6%) achieved grade I fusion, 4 segments (14.3%) achieved grade II, 2 segments (7.1%) achieved grade III and 0 segments achieved grade IV at 12 months. Postoperatively at 12 months, spinal canal cross sectional areas at disc spaces significantly increased from 157.5 to $294.3\;mm^2$ (p = 0.012). Conclusion : MIS TLlF achieved good clinical outcomes and high fusion rates. Our findings show that MIS TLlF performed with a single Interbody cage and a tubular retractor system can be used as a standard MIS TLlF technique.

Influence of Payer Source on Treatment and Outcomes in Colorectal Cancer Patients in a University Hospital in Thailand

  • Sermsri, Nattapoom;Boonpipattanapong, Teeranut;Prechawittayakul, Paradee;Sangkhathat, Surasak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.9015-9019
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    • 2014
  • The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.

Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.3
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

A Study on the Oil Pollution Compensation System in Korea (우리나라 유류오염보상제도에 관한 고찰)

  • 서동오
    • Journal of the Korean Institute of Navigation
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    • v.17 no.4
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    • pp.73-87
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    • 1993
  • As a result of accepting the '71 FUND Convention and enforcing the Oil Pollution Compensation Act 1992, we observed some benefits and costa. This paper analyses those benefits and costs and suggests se-veral key policy recommendations for the estasblishment of an effective oil pollution compensation regime in Korea. This paper identifies the said benefits and costs as follows : First, by establishing the oil pollu-tion compensation system as same as the international level, most of small and medium size of oil pollution damage which are caused by coastal tankers will be compensated by FUND. Second, most of oil pollution damage which are not covered by '69 CLC will be compensated by FUND. Third, some parts of FUND Contribution Fee and CRISTAL Contribution Fee to be charged by major oil companies will be doubled. However the limit of international oil pollution compensation system and the loophole outside the Oil Pol-lution Compensation Act 1992 suggest followings : 1) Radical risk management and insurance manage-ment of ocean going tanker owners, 2) Establishment of oil pollution claim settlement system, 3) Enforce-ment of crew and ship management for coastal tanker and 4) Establishment of Korean P & I Club.

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Change of Knowledge Intensive Service Sectors' Employment in Two Highway Corridors on the U.S. East Coast (미국 동부 연안 I-95, I-85회랑지대의 지식 기반 서비스업 고용 변화에 대한 연구)

  • Song, Ye-Na;Anderson, William P.;Lakshmanan, T.R.
    • Journal of the Economic Geographical Society of Korea
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    • v.13 no.4
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    • pp.584-600
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    • 2010
  • Aiming to reveal the employment evolution around interstate highway corridors, an extended shift-share analysis is conducted for metropolitan areas in two interstate highway corridors on the U.S. east coast: I-95 and I-85. Our focus is on knowledge service sectors, specifically finance, insurance, business services and health services for two time periods, 1977-1990 and 1990-2005. In the first period, the two corridors' metropolitan areas have outperformed their regions in terms of both output and labor productivity. But this picture turned negative in later period with some variation by industries. Also variation in performance over time was found even in metropolitan areas in the same corridor or in geographically adjacent areas.

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The status of care satisfactions of the disabled persons with community-based rehabilitation plan (장애인의 치료만족도에 따른 지역사회중심재활에 관한 연구)

  • Lee In-Hak;Park Rae-Joon;Kim Mi-Ran
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.13-32
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    • 1998
  • A questionaire was conducted to obtain ran satisfactions in information of the 325 disabled persons among the total 9,314 handicapped people in Taejon area, and was surveyed during the period of June 1 to August 31, 1997. The results are as follows: 1. Among the studied disabled persons, $54.5\%$ of male, and $45.5\%$ of female. 2. Before disabled in occupation, $32.0\%$ of out of work group were high, $6.5\%$ of farm, student group were low. Before disabled in occupation by gender, male group is $29.9\%$ of out of work group were high, $0.6\%$ of housework group were low. female group is$34.5\%$ of out of work group were high, $4.7\%$ of student group were low(P<0.001). 3. After disabled in occupation, $75.1\%$ of out of work group wert high, $10.8\%$ of in working group were low. After disabled in occupation by gender, male group is $87.6\%$ of out of work group were high, $1.7\%$ of housework group were low. female group is $60.1\%$ of out of work group were hgh, $10.8\%$ of in working group were low(P<0.001). 4. Medical security status, $64.9\%$ of medical aid group wore high, $35.1\%$ of medical insurance group were low. Medical security status by gender, male group is $71.2\%$ of medical aid group were high, $28.8\%$ of medical insurance group were Iew. female group is $57.4\%$ of medical aid group wan high, $42.6\%$ of medical insurance were low(P<0.01). 5. Disabled record status, $68.6\%$ of record group were high, $31.4\%$ of non group were low. Disabled record status by gender, male group is $78.5\%$ of record group were high, $21.5\%$ of non record group were low. female group is $56.6\%$ of record group were high, $43.4%$ of non record group were low(P<0.001). 6. Disabled duration status, $42.2\%$ of loss than 9 year group were high, $10.2\%\;of\;20-29,\;30-39$ year group were low. Disabled duration status by gender,'male group is $44.6\%$ of less than 9 year group were high, $6.2\%$ of 20-29 year group wert low. female group is $39.2\%$ of less than 9 year were high, $39.2\%$ of 30-39 year group were low (P<0.05). 7. Cause of disabled status, $26.5\%$ of other group, $23.7\%$ of congenital group were high. $9.2\%$ of unknown group, $6.8\%$ of industry accident, $2.5\%$ of drug poisoning group were low. Cause of disabled status by gender, male group is $27.7\%$ of other group, $23.7\%$ of congenital group were high, $2.3\%$ drug poisoning group were low. female group is $25.0\%$ of other group, $20.9\%$ of congenital group were high, $2.5\%$ of drug poisoning group were low (P<0.001). 8. Disabled type status, $19.4\%$ of double disabled group were high, $2.2\%$ of muscle paralysis group were low. Disabled type status by gender, male group is $22.0\%$ of double disabled group were high, $2.3\%$ of muscle paralysis group were low. female group is $23.3\%$ of rheumatism group were high, $0.7\%$ of amputation group were low(P<0.001). 9. Smoking status, $73.2\%$ of non smoking group were high, $26.8\%$ of smoking group were low. Smoking status by gender, male group is $59.9\%$ of double non smoking group were high, $40.1\%$ of Smoking group were low, female group is $89.2\%$ of non smoking group were high, $10.8\%$ of smoking group were low(P<0.001). 10. Drinking status, $80.0\%$ of non drinking group were high, $20.0\%$ of drinking group were low. Drinking status by gender, male group is $72.3\%$ of non drinking group were high, $27.7\%$ of drinking group were low. female group is $89.2\%$ of non drinking group were high, $10.8\%$ of drinking group were low(P<0.001). 11. Stress level status, $52.9\%$ of high stress group were high, $1.8\%$ of very severe stress group were low. Stress level status by gender, male group is $50.8\%$ of high stress group were high, $2.3\%$ of very severe stress group were low. female group is $55.4\%$of high stress group were high, $1.4\%$ of very severe stress group were low. 12. Heed status, $28.0\%$ of economic support were high, $4.6\%$ of speech therapy, brace group were low. Need status by Sender, male group is $2i2\%$ of economic support group were high, $4.5\%$ of bracegroup were low. female group is$27.7\%$ of economic support group were high, $3.4\%$ of speech therapy group were low. 13. Care satisfaction comparision, 3.09, 0.55 point of IBR, 4.01, 0.45 point of CHR(P<0.001). 14. The variables which had positive correlation with IBR were gender(r=0.1406, P<0.01), age(r=0.1872, p<0.001), economic level(r=0.1246, P<0.05), disabled record(r=0.1137, P<0.05), education level(r=-0.1122. p<0.05). 15. The variables which had positive : correlation with CBR were gender(r=0.1613, P<0.01), age(r=0.2255, P<0.001). list of family(r=0.12i3, P<0.01), disabled record(r=0.1273, P<0.05). education level(r=-0.1294, P<0.01).

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