• Health Policy and Management
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• v.4 no.1
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• pp.49-76
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• 1994

Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

• Journal of Preventive Medicine and Public Health
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• v.25 no.3 s.39
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• pp.312-329
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• 1992

The purpose of this study is to estimate cesarean section rate in Korea and analyze the socioeconomic variables and health resources which affect regional variation in the rate. Samples were drawn from the record of vaginal and cesarean section deliveries based upon insurance claim bills which have been submitted to the National Federation of Medical Insurance for the first three months, January through March, 1991. The results are obtained as follows : It was found that. cesarean section rate was increasing rapidly up to 23.1% in 1991. Cesarean section per 10 thousand insured people was 4.8 and the number of cesarean section per 10 thousand insured eligible($15{\sim}49$ years old) female was 7.6. The fee for normal delivery was 109,489 won and that for cesarean section was 390,024 won. The average days of hospitalization in normal delivery was 2.3 days, and those in cesarean section was 7.6 days. On the average cesarean section has a longer of stay as much as by 4.3 days and cost 3.6 times more than normal deliveries. Cesarean section rates vary among medical facilities 19.8% at clinics 37.6% in small-scale hospitals, and 29.1% in general hospitals. The regional variation of cesarean section rates was also fairly prominent. The South Cheju Gun has the highest rate of cesarean section, 56.2%. Meanwhile no cesarean section cases has been reported in Sunchang Gun during the period of this study. The variation is noted among provinces. The rate for Cheju province has been 3.4 times higher than that for Chunnam. The number of cesarean section per 10 thousand insured people vary greatly among regions, too. This study has found that there exists significant regional variations among various geographic units in terms of average length of stay, average cost, number of obsretricians and number of beds. Multiple regression analysis was done to identify factors explaining the regional variance of various cesarean section rates : In the urban areas, no significant explaining variables were noted except the number of beds for the dependent variable of cesarean section cases per 10 thousand insured eligible females. The smaller the number of bed, the more cases of cesarean section was noted for an urban area. The is mostly because the rate of cesarean section is higher in medium-size hospitals than in large general hospitals. In the rural areas, the factor of education has been found significant for all three deplendent variables. The higher the educational level, the rate of cesarean section is most likely to rise. An income variable measured by the amount of monthly insurance contribution has been identified a powerful predictor in explaining the valiance of cesarean section rates. The same has been noted for the number of obstetricians. Similar findings are observed for the country as a whole. The income level has veen found as the most powerful explaining factor in the regional variance of cesarean section rates. In general the rate is higher in the urban areas, and lower in the area with more small hospitals. As this is the initial attempt to identify the factors relevant to the regional difference in the rates of cesarean section, more elaborated study is urgently required.

• Journal of Preventive Medicine and Public Health
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• v.43 no.2
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• pp.174-184
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• 2010

Objectives: This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. Methods: We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. Results: Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. Conclusions: Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.

• Journal of Environmental Science International
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• v.1 no.2
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• pp.33-48
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• 1992

Since November 1990, the observations of methane (CH4) level have been carried out at Tae-ahn Peninsula (TAP) in Korea. Analysis on atmospheric data obtained in the period from November 1990 to August 1992 is carried out and the results are included in this study. We 임ole that CIL does not have a clear seasonal cycle with a minor maximum in August- september and with a minimum in June-July. The variations in monthly average level are much larger with 1765.01∼ 1857.21 pub (amplitude 92.20 ppb). The occurrence of a minimum in June-July is due to the inflow of the North Pacific air, an increase of OH radical and due to a decrease in CH4 emission from rice paddy. A maximum in August and September appears to result from an increase in organic materials in agriculture (rice paddy) and forests, inputs of local sources due to weak airflows, stagnation of the warm and moist air and from a decrease in OH radical.'rho present analysis indicates that according to CH4 data from Mongolia and from several sites in North Pacific TAP is influenced as much as 31 pub in average from the inputs of Chinese omission. When the atmospheric CH4 of TAP is compared with data observed at Korea National University of Education (KNU), the values of KNU are higher (127 ppb) than those of TAP. It is clear that air samples taken at KNU are influenced strongly by local sources in central Korea than those at TAP. According to analysis of trajectories and airflows, we find that there are 4 types in classification. Firstly, when an air flow is originated mainly in China values of CH4 gas are in medium ranges. Secondly, when an airflow is from both local (Korea) and China we find higher values. Thirdly, with an airflow from both local (Korea) and Japan origins medium values are recorded. Fourths)r, when an airflow of maritime origin arrives low values of atmospheric CH4 are observed at TAP.

• Ocean and Polar Research
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• v.23 no.4
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• pp.361-376
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• 2001

The characteristics of SST variability in the East Sea are analyzed using NOAA/AVHRR weekly SST data with about $0.18^{\circ}{\times}0.18^{\circ}$ resolution ($1981{\sim}2000$) and reconstructed historical monthly SST data with $2^{\circ}{\times}2^{\circ}$ resolution $(1950{\sim}1998)$. The distinct feature of wintertime SST is high variability in the western and eastern parts of $38^{\circ}{\sim}40^{\circ}$ latitudinal band, which are the northern boundary of warm current in the East Sea during winter. However, summertime SST exhibits variability with similar magnitude in the entire region of the East Sea. The analysis of remote correlation also shows that SST in the East Sea is closely correlated with that in the region of Kuroshio in winter, but in summer is related with that in the western and eastern regions of the same latitudes. From these results it is postulated that the SST variability in the East Sea may be related with the variations of East Korean Warm Current and Tsushima Warm Current in winter, but in summer probably with the variations of atmospheric components. In the analysis of ENSO related SST anomaly, a significant negative correlation between SST anomalies in the East Sea and SST anomalies in the tropical Pacific is found in the months of August-October (ASO). The SST in the ASO period shows more significant cooling in E1 $Ni\~{n}o$ events than warming in La $Ni\~{n}a$ events. Also, the regional analysis shows by the Student's t-test that the negative SST anomalies in the E1 $Ni\~{n}o$ events are more significant in the southwestern part of the East Sea.

• Journal of the Korean association of regional geographers
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• v.8 no.1
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• pp.40-64
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• 2002

The locational characteristics of ceramic industry in Miryang city, Kyongnam province, were clarified by means of examining the process of its formation, spatial variation, locations and their changes. The government policy on industry and the business fluctuation are important in the quantitative changes of the industry. The spatial variation of industry toward the outer part of area are the results of equilibrium between the decrease of firms in inner city and the increase of firms in outer part. The births and deaths of firms played important role in the processes of spatial variations. The industry location has lasted by the accumulation of location decision of 'potential entrepreneurs' who learned knowledges on the industry and had personal contacts with the business-related persons for long time. The main factors on the locational decision of firms are personal factor, raw materials, land, water and market. The locational problems have mainly related with plant expansion, land, marketing, labour and capital. They caused investment changes and caused relocations of firms. Such disadvantages as raw material exhaustion, shortage of land and congestion within the agglomeration area, development of road transportation and local government policy on industry location, induced recent decentralization of industry to outer part.

• The Korean Journal of Health Service Management
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• v.13 no.1
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• pp.15-30
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• 2019

Objectives: This study aimed to analyze people's accessibility to medical institutions providing national gastric cancer screening services in Gangwon-do using a geographic information system(GIS). Methods: To assess the spatial accessibility, network analysis was applied. Two types of network analysis-Service area analysis and origin-destination cost matrix(OD-cost matrix)-were applied to create network dataset. Results: The results of the analysis of the service area revealed that it took more than 60 minutes each to reach tertiary hospitals and general hospitals from 74.4% and 9.6% of Gangwon-do areas, respectively. Similarly, it took more than 60 minutes each to reach hospitals and clinics from 4.2% and 3.4% of Gangwon-do areas, respectively. The results of the OD-cost revealed that there were large regional variations in distance and time taken to reach the medical institutions. Conclusions: there were regional variations of spatial accessibility between Si and Gun in Gangwon-do.

• Proceedings of the Korea Contents Association Conference
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• 2006.11a
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• pp.403-407
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• 2006

This research aims to reduce severe damages to human beings and properties from floods that ravage Korea every year, by estimating right time to hydraulic structures based on the characteristics of variations in flood flows. To establish this permanent means for the flood mitigation, this research analyse design floods of various dams and hydraulic structures in connection with time of occurrence of the weather abnormalities in Korea. This research was derived the optimal regionalization of the precipitation data which can be classified by the climatologically and geographically homogeneous regions in Korea. Using the L-moment ratios and Kolmogorov-Smimov test, the underlying regional probability distribution was identified to be the GEV distribution among applied distributions. The regional and at-site analyses using L-moment for the design rainfall were tested by Monte Carlo simulation. Error tests were computed and compared with those resulting from at-site Monte Carlo simulation. Consequently, optimal design rainfalls following the regions and consecutive durations were derived by the regional frequency analysis.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.70-77
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• 2012

Objectives: Identify the characteristics related to the suicide rates in rural and urban areas of Korea and discover the factors that influence the suicide rate of the rural and urban areas. Methods: Using the data on causes of death from 2006 to 2008, the suicide rates were calculated and compared after age-standardization based on gender, age group and urbanicity. And, in order to understand the factors that influence suicide rate, total 10 local characteristics in four domains - public service, social integration, residential environment, and economic status - were selected for multiple regression analysis. Results: The suicide rates were higher in men than women, in rural areas than urban, and in older people than the younger. Generally, although there were variations according to age group and urbanicity, suicide rates were significantly related to residential environment and regional economic status but not related to regional welfare spending and social integration. In addition, the population over the age of 65 years, only regional economic status has significantly influence on their suicide rates. Conclusions: The influence of characteristics of regions on suicide rate is various by age-group, gender, and urbanicity. Therefore, in order to lower suicide rate and reduce the gap between regions, various approaches must be adopted by taking into account the socioeconomic characteristics of the regions.

• Journal of The Korean Society of Agricultural Engineers
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• v.51 no.4
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• pp.7-13
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• 2009

The paddy irrigation demand for Nakdong river basin in Korea due to the climate change have been analyzed using regional climate model outputs. High-resolution (27 ${\times}$ 27 km) climate data for SRES A2 scenario produced by the Meteorological Research Institute (METRI), South Korea, and the observed baseline climatology dataset (1971-2000) were used. The outputs from the ECHO-G GCM model were dynamically downscaled using the MM5 regional model by METRI. Maps showing the predicted spatial variations of changes in climate parameters and paddy irrigation requirements have been produced using the geographic information system. The results of this study showed that the average growing season temperature will increase steadily by 1.5 $^{\circ}C$ (2020s A2), 3.2 $^{\circ}C$ (2050s A2) and 5.2 $^{\circ}C$ (2080s A2) from the baseline (1971-2000) 19.8 $^{\circ}C$. The average growing season rainfall will change by -3.4 % (2020s A2), 0.0 % (2050s A2) and +16.5 % (2080s A2) from the baseline value 886 mm. Assuming paddy area and cropping pattern remain unchanged the average volumetric irrigation demands were predicted to increase by 5.3 % (2020s A2), 8.1 % (2050s A2) and 2.2 % (2080s A2) from the baseline value 1.159 ${\times}$ $10^6\; m^3$. These projections are different from the previous study by Chung (2009) which used a different GCM and downscaling method and projected decreasing irrigation demands. This indicates that one should be careful in interpreting the results of similar studies.