• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.95-108
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• 1976

It is obvious that adequate nutrition is essential for growth and development of school children, and many elementary schools in this country have already practiced it. Therefore, it would seem apparent that the school feeding program would have a significant effect on the growth and development of school children. This paper presents a two-year experimental school-feeding program from 1973 to 1974, and attempts to evaluate its effects by before-and-after nutrition surveys conducted in two elementary schools, one experimental and the other as a control. The two schools are both located in the same county (Yongin-Kun, Kyunggi-Do), and the families of their students are presumed to share the same socio-economic level. To assess the effect of school-feeding, we measured height, weight, chest circumference and grasping power. Physical examination was done foresigns of nutritional deficiency. A stool examination for parasites and blood examinations for hemoglobin, hematocrit and serum protein were included. Analyses were done for 150 students selected randomly at the beginning of the program. These students attended the school throughout the program period. Results are as follows: 1. The amount of increase of height, weight, chest cirumference and grasping power were greater in the experimental school than in the control school, but the differences are not statistically significant. 2. Signs of vitamin deficiency decreased in both experimental and control schools during the two-year program period. 3. At the time of the 1974 post-survey, values of Hb. & Hct. revealed no significant differences between the two schools, but serum protein level was a little higher than that of general Korean rural children of the same age. 4. Infestation rate of parasites had increased in both schools during the two-year program period. 5. Each student of the two schools was classified into three major classes, according to the level of economic condition of his or her parents, namely higher, middle and lower. The results of each class of the experimental school was compared with that of the corresponding class of the control school, expecting the relative magnitude of change largest in the lower economic class of the experimental school. However, change was greatest in the middle class, still not being statistically significant. Finally, the authors concluded that the two-year period for such a program is not sufficiently long for its beneficial effects to be demonstrated and measured. As long as the growth and development of children are concerned, planning with a more distant perspective is required, as well as the development of new methods of evaluation.

• Journal of Climate Change Research
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• v.9 no.1
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• pp.13-29
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• 2018

This study presented evaluation procedure for selecting appropriate GCMs and downscaling method by focusing on the climate extreme indices suitable for climate change adaptation. The procedure includes six stages of processes as follows: 1) exclusion of unsuitable GCM through raw GCM analysis before bias correction; 2) calculation of the climate extreme indices and selection of downscaling method by evaluating reproducibility for the past and distortion rate for the future period; 3) selection of downscaling method based on evaluation of reproducibility of spatial correlation among weather stations; and 4) MME calculation using weight factors and evaluation of uncertainty range depending on number of GCMs. The presented procedure was applied to 60 weather stations where there are observed data for the past 30 year period on Korea Peninsula. First, 22 GCMs were selected through the evaluation of the spatio-temporal reproducibility of 29 GCMs. Between Simple Quantile Mapping (SQM) and Spatial Disaggregation Quantile Delta Mapping (SDQDM) methods, SQM was selected based on the reproducibility of 27 climate extreme indices for the past and reproducibility evaluation of spatial correlation in precipitation and temperature. Total precipitation (prcptot) and annual 1-day maximum precipitation (rx1day), which is respectively related to water supply and floods, were selected and MME-based future projections were estimated for near-future (2010-2039), the mid-future (2040-2069), and the far-future (2070-2099) based on the weight factors by GCM. The prcptot and rx1day increased as time goes farther from the near-future to the far-future and RCP 8.5 showed a higher rate of increase in both indices compared to RCP 4.5 scenario. It was also found that use of 20 GCM out of 22 explains 80% of the overall variation in all combinations of RCP scenarios and future periods. The result of this study is an example of an application in Korea Peninsula and APCC Integrated Modeling Solution (AIMS) can be utilized in various areas and fields if users want to apply the proposed procedure directly to a target area.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.469-476
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• 2024

Background/Aims: The reimbursement policy for cryptogenic stroke (CS) was expanded in November 2018 from recurrent strokes to the first stroke episode. No reports have demonstrated whether this policy change has affected trends in implantable loop recorder (ILR) utilization. Methods: We identified patients who received an ILR implant using the Korea Health Insurance Review and Assessment Service database between July 2016 and October 2021. Patients meeting all the following criteria were considered to have CS indication: 1) prior stroke history, 2) no previous history of atrial fibrillation or flutter (AF/AFL), and 3) no maintenance of oral anticoagulant for ≥4 weeks within a year before ILR implant. AF/AFL diagnosed within 3 years after ILR implant or before ILR removal was considered ILR-driven. Results: Among 3,056 patients, 1,001 (32.8%) had CS indications. The total ILR implant number gradually increased for both CS and non-CS indications and the number of CS indication significantly increased after implementing the expanded reimbursement policy. The detection rate for AF/AFL was 26.3% in CS patients over 3 years, which was significantly higher in patients implanted with an ILR within 2 months after stroke than those implanted later. Conclusions: The expanded coverage policy for CS had a significant impact on the number of ILR implantation for CS indication. The diagnostic yield of ILR for AF/AFL detection seems better when ILR is implanted within 2 months than later. Further investigation is needed to demonstrate other clinical benefits and the optimal ILR implantation timing.

• Journal of Service Research and Studies
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• v.13 no.1
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• pp.1-26
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• 2023

We analyze the effects and related factors of Smart Factory adoption. 110 and 325 samples were collected by median-size-industry matching method, respectively, of adopting and non-adopting companies. We use financial statement data (ROA, etc.) from the year before adoption to the fourth year after adoption. Abnormal operating performance and annual abnormal changes are obtained according to event study method, and analyzed by Wilcoxon signed-rank test and t-test. ROA and sales growth rate demonstrate short-term effects after adoption, but not long-term effects. As a result of regression analysis to examine if the three factors of labor intensity, R&D intensity, and prior financial performance have moderating effect, the moderating effect of R&D intensity and prior financial performance is confirmed. In addition, we perform regression analysis to confirm performance effects of early and late adoptions and whether prior financial performance and organization size have moderating effect. It is confirmed that the later the time of adoption, the greater the effect of adoption in the long term and the moderating effect of prior financial performance and organization size is confirmed.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.1-21
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• 1997

In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

• Journal of the Korean Home Economics Association
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• v.11 no.4
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• pp.414-423
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• 1973

Before the modern education was introduced in Korea men had the opportunity to be educated. Women's education was limited to a small number of girls belonging to ruling class. It was the men who got a job to earn the money for the family. The customary law prohibited women from being employed. They were to stay at home engaged in household affairs. This phenomenon has undergone a change when modern education was adopted which gave women the equal opportunity in education. The modernization of the country required a lot of educated and skilled labour. Since 1945 when Korea was liberated from the Japanese colonial administration the modernization programme has been worked out in every field such as industry, education, culture and politics, etc. The traditional grand family was transformed to nuclear family. The migration took place from country to town. With the adoption of compulsory education in the primary school the schoolgirls are increased in great number. The number of girls has been increased every year in Middle Schools, High schools and Universities. Even if boys still outnumber girls in all education institutions, the rate of increase of girl students are higher than that of boy students. Accordingly women are given more opportunity than ever for the employment vis-a-vis men. The number of employed women has been increasing greatly in recent years inproportion to the acceleration of industrialization. The type of their job is also various and colorful ranging from factory worker to doctor and lawyer. There are some problems to be solved with respect to the improvement of women's education. The improved women's education should be reviewed light of the fact that inequality still exists between men and women in occupation and wages, and that women is required of good education contributable to the better Korean society.

• Health Policy and Management
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• v.18 no.2
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• pp.1-18
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• 2008

As medical insurance had been implemented for Magnetic Resonance Imaging (MRI) from January 1, 2005, this study investigated whether there had been any change in the amount of the medical care utilization of patients who undertook MRI before and after the insurance coverage, and was to examine factors affecting the amount of medical care utilization of MRI. Data were collected from patients who undertook MRI before and after the insurance coverage for a year at a general hospital in Kyeanggi-do. $X^2$ and t-test were used for the analysis of their general characteristics, the number of MRI, and its medical costs before and after the insurance coverage, and hierarchical multiple regression analysis for the factors affecting the amount of the medical care utilization of MRI. The results of this study were as follows. First, the number of MRI after the insurance coverage was significantly decreased. Second, there was no significant difference in the total medical costs of MRI after the insurance coverage, but a significant difference was found in patient's share of medical costs. Third, six variables were found to be affecting the amount of the medical care utilization of MRI, and the variables showed to lead the number of MRI decrease after the insurance coverage. These six factors explained 21.4% of the total number of MRI. As MRI had been covered by insurance, the use of MRI and patient's share of the costs were deceased, but the total medical costs were not affected. Reasons for that could be found in that MRI insurance, different from the case of CT insurance coverage, was allowed not to cover some items and the kinds of diseases subjected to the insurance coverage were extremely limited, lowering insurance prescription rate. In addition to that, the average medical cost of MRI was not changed after the insurance coverage. Therefore, as future measures for the MRI insurance, coverage, it should be considered to allow insurance coverage to no coverage items and to expand the scope of benefit coverage, or to lower patient's share of the costs. Furthermore, researches should be done to explore how recipients will act and how suppliers will react if the coverage is expanded, including expanding the scope of coverage and reducing patient's share of the costs, as well as to conduct research on its economic analysis according to case mix.

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.523-534
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• 2010

Objectives: We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. Methods: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume (over 16 operations in a year) and low volume institutions, after performance reporting (December 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. Results: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p = 0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25 - 0.95) and 10% (${\beta}$=-0.102, p<0.01) and cost was not changed (${\beta}$=-0.01, p=0.27). The high volume institutions were more decreased than low volume in length of stay. Conclusions: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginally shifted from low volume institutions to high volume institutions.

• Journal of the Korean Society for information Management
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• v.38 no.3
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• pp.141-174
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• 2021

In this study, by examining the actual usage data of the university library website before and after COVID-19 outbreak, the usage behavior of users was analyzed, and the data before and after the virus outbreak was compared, so that university libraries can provide more efficient information services in a pandemic situation. We would like to suggest ways to improve it. In this study, the user traffic made on the website of University C was 'using Google Analytics', from January 2018 to December 2018 before the oneself of the COVID-19 virus and from January 2020 to 2020 after the outbreak of the virus. A comparative analysis was conducted until December. Web traffic variables were analyzed by classifying them into three characteristics: 'User information', 'Path', and 'Site behavior' based on metrics such as session, user, number of pageviews, number of pages per session time, and bounce rate. To summarize the study results, first, when compared with data from January 1 to January 20 before the oneself of COVID-19, users, new visitors, and sessions all increased compared to the previous year, and the number of sessions per user, number of pageviews, and number of pages per session, which showed an upward trend before the virus outbreak in 2020, increased significantly. Second, as social distancing was upgraded to the second stage, there was also a change in the use of university library websites. In 2020 and 2018, when the number os students was the lowest, the number of page views increased by 100,000 more in 2020 compared to 2018, and the number of pages per session also recorded10.46, which was about 2 more pages compared to 2018. The bounce rate also recorded 14.38 in 2018 and 2019, but decreased by 1 percentage point to 13.05 in 2020, which led to more active use of the website at a time when social distancing was raised.