• Health Policy and Management
• /
• v.34 no.2
• /
• pp.163-177
• /
• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• Radiation Oncology Journal
• /
• v.21 no.3
• /
• pp.183-191
• /
• 2003

Purpose: To suggest the optimal radiation fields after a surgical resection based on a nationwide survey on the principles of radiotherapy for rectal cancer in the Korean Patterns on Care Study. Materials and method: A consensus committee, composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area, developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer after a surgical resection. The survey format included 19 questions on the principles of defining field margins, and was sent to the radiation oncologists in charge of gastrointestinal malignancies in all korean hospitals (48 hospitals). Thirty three ($69\%$) oncologists replied. On the basis of the replies and literature review, the committee developed guidelines for the optimal radiation fields nor rectal cancer Results: The following guidelines were developed: superior border between the lower tip on the L5 vertebral body and upper sacroiliac joint; inferior border $2\~3$ cm distal to the anastomosis in patient whose sphincter was saved, and $2\~3$ cm distal to the perineal scar In patients whose anal sphincter was sacrificed; anterior margin at the posterior lip of the symphysis pubis or $2\~3$ cm anterior to the vertebral body, to include the internal iliac lymph node and posterior margin $1.5\~2$ cm posterior to the anterior surface of the surface, to include the presacral space with enough margin. Comparison with the guidelines, the replies on the superior margin coincided in 23 cases ($70\%$), the inferior margin after sphincter saving surgery in 13 ($39\%$), the inferior margin after adbominoperineal resection in 32 ($97\%$), the lateral margin in 32 ($97\%$), the posterior margins in 32 ($97\%$) and the anterior margin in 16 ($45\%$). Conclusion: These recommendations should be tailored to each patient according to the clinical characteristics such as tumor location, pathological and operative findings, for the optimal treatment. The adequacy of these guidelines should be proved be following the Korean Patterns of Care Study.

• 대한공업교육학회지
• /
• v.39 no.2
• /
• pp.101-121
• /
• 2014

The study aims to develop the NCS based vocational curriculum model for the practical and creative human resources. For effectiveness of the study, the study consists of literature studies of both domestic and international, contents analysis, case study, expert(9samples) consultation and review, and in-depth-interview of the three advisory members. The validity of the developed model is analyzed through mean, standard deviation and contents validity ratio(CVR). The main results of the model development in our study are as follow. First, our NCS based vocational curriculum model for the practical and creative human resources is developed with the analyses of NCS development manuals, training standard utilization and training curriculum organization manuals, NCS learning module development manual and case studies, NCS research report, NCS based curriculum pilot development resources directed toward the high schools and vocational school as well as the domestic and international literature study on career training model like NCS. Second, based on the findings of our analysis in combination with the findings from the consultations with the expert and advisory committee, total 19 sub-factors of each step and domain are extracted. The sub-factors of domain in step 1 are the competency unit, definition of competency unit, competency unit element, performance criteria, range of variable, guide of assessment, key competency; in step 2, they are subject title, subject objectives, chapter title, chapter objectives, pedagogical methods, assessment methods and basic job competence; and in step 2, they are NCS based subject matrix table, NCS based subject profile, NCS based job training curriculum table, NCS based subjects organization flowchart, NCS based job training operation plan. Third, the final model including step 3 NCS based subject profile are developed in association with the linked organizational sub-factors of step 1 and step 2. Forth, the validity tests for the final model by the step and domain yield the mean 4.67, CVR value 1.00, indicating the superior validity. Also, the means of each sub-factors are all over 4.33 with the CVR value 1.00, indicating the high validity as well. The means of the associated organizations within the model are also over 4.33 with the CVR value of 1.00. Standard deviations are all .50 or lower which are small. Fifth, based on the validity test results and the in-depth-interview of the expert and advisory committee, the model is adjusted complemented to establish final model of the NCS based vocational curriculum for the practical and creative human resources.

• Journal of Food Hygiene and Safety
• /
• v.24 no.4
• /
• pp.352-356
• /
• 2009

The purpose of this study was to introduce the toxicological study review to evaluate the safety of PDMS on the 69th JECFA meeting. Polydimethylsiloxane is a polymer and its ADI was established at 23rd JECFA meeting in 1979. The ADI was maintained although the specification was expanded at its 26th, 29 th, 37 th meetings. Recently, it was reported that PDMS with low molecular weight and viscosity has high absorption rate and different toxicity, so it was submitted at 69th meeting. Toxicological studies of PDMS were submitted from the sponsor and additional information is collected from a document searching. The toxicological studies were reviewed in accordance with the 'Guidelines for the preparation of toxicological working papers for the Joint FAO/WHO Expert Committee on Food Additives'. In the available acute, sub-chronic and chronic toxicity studies on PDMS, dose-related increases in incidence and severity of ocular lesions(corneal crystal, inflammation of the corneal epithelium etc.) were consistently observed after oral dosing. It seems to be a local irritant effect, but the mechanism by which the ocular lesions arose is unclear, although the lack of absorption of PDMS indicates that it is unlikely to be a direct systemic effect. Consequently, the relevance of the ocular lesions for food use of PDMS could not be determined. The ADI of PDMS was re-established from 0-1.5 mg/kg bw/day to 0-0.8 mg/kg bw/day by applying additional safety factor 2 based on its ocular toxicity. The result of 0-0.8 mg/kg bw/day is a temporary ADI until further data are provided to 2010.

• Journal of Society of Preventive Korean Medicine
• /
• v.20 no.1
• /
• pp.55-64
• /
• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

• Journal of Acupuncture Research
• /
• v.27 no.4
• /
• pp.147-178
• /
• 2010

Objectives : This study was to propose the improved instruction for authors and research ethic regulations by the comparative analysis of those of the domestic journals, for the purpose of enhancing the citation rate of Journal of Korean Acupuncture and Moxibustion Society. Methods : Narrative review method was used for comparatively analyzing instruction for authors of 34 domestic journals, especially focused on how to write a reference. Thereafter, in order to elucidate the drawbacks of current instruction for authors and research ethic regulations of the acupuncture and moxibustion society, the well prepared instructions and research ethic regulations was selected from them, which were compared with the present instructions for authors and research ethic regulations of the acupuncture and moxibustion society. Results : As a result of the comparative analysis of instruction for authors in the 34 domestic journals, style for references was based largely on that of National Library of Medicine and vancouver at the same time. The number of reference was limited according to types of writings. for example, the original article and case report was frequently limited to 40 and 20 references respectively. Authors were mostly listed up to six. If there are more, the first three or six authors were listed with 'et al'. it was generally recommended that using abstracts as references should be avoided and References to papers accepted but not yet published should be designated as 'in press' or 'forthcoming', and that the names of journals should be set in italics and abbreviated according to the List of Journals Indexed for Medline (formerly Index Medicus) published by the National Library of Medicine or koreanmed or WHO-IST, etc. In addition, citation of electrical literature, English writing of reference and obligational citation of more than two articles in the journals were encouraged. In consequence of comparison between well prepared instructions and research ethic regulations of the selected journals and those of current instructions for authors and research ethic regulations of the acupuncture and moxibustion society, the followings were needed to be added or revised. 1. Requirements for case reports were not mentioned. 2. Reporting Guidelines for Specific Study Designs were not included. 3. Previous Orthography of herbal prescription should be revised. 4. Orthography of authors and guidelines for writing article constituents such as title, abstract, introduction, method, statistics, results, discussions were not presented. 5. How to write a reference was so simplified. 6. Definition of Research Ethical Misconduct was omitted and establishment, management and members of committee for research ehtics were not mentioned, 7. Information, reception and investigative procedures of Research Ethical Misconduct was not specified. Conclusions : For the development of Journal of Korean Acupuncture and Moxibustion Society, apporopriate revision of the instruction for author and research ethic regulations should be made based upon the above findings. English writing of reference were believed to be one of the alternatives enhancing citation rate.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.41 no.3
• /
• pp.83-93
• /
• 2013

This study has been performed to analyze and consider the problems after 30 years in terms of landscape design competition process in Korea, so that it can provide the basic data, which can improve the future landscape design competition. We have used Delphi Investigation to carry out a survey that targets professionals and identifies problems. The results are summarized as follows. Firstly, the results of the analysis of Landscape Design Competition for institution theory and case studies showed that there is an issue from four perspectives which are 'method of design competition', 'guidelines for design competition', 'winner selection process', and 'design changes after winning' Secondly, the process by professional Delphi performed expert analysis, and agree with expert opinion. As a result, we derived the problems of a landscape design competition system with the 12 items. Third, in the 'design competition style', two items, the 'design competition style' and 'problem of design public offering period' had become a problem. Fourth, the 'Guidelines for design competition', 'non-hierarchical excess of the amount of instructions', 'directive determined the guidelines', and the 'provision of confusion' three items had also become a problem. Fifth, 'sex expert committee review selection process winning work', 'Problems of participation', 'examination scoring system experts lack', and 'non-landscaping' had become a problem. Sixth, 'The design of the original order' as much as possible 'design changes after the winning work' Four 'order to Comments to reduce the creativity of the design of the climate', 'original extension', 'contractor feedback of excess without the promise of frequent personnel changes', design period of the person in charge is reflected in excess item has become a problem. I considered that a continuous research on the improvement of the problems of the landscape design competition system based on the results must be performed.

• Convergence Security Journal
• /
• v.14 no.6_1
• /
• pp.45-55
• /
• 2014

China has vast land, variety of people, religions and cultures. China has faced terrorism threat from the struggles of people, religions and resources. The 11thStanding Committee of the National People's Congress of China decided to strengthen the anti-terrorism action on October 29, 2011. This study compared, analyzed and estimated the counter-terrorism laws of the USA, Britain and Germany thinking about the China's anti-terrorism decision. The counter-terrorism laws of the USA, Britain and Germany are largely composed of previous prevention of terror and oppression of it later. They enacted the laws both for people and property. They also rearranged the power and role of governmental institutes on counter-terrorism. The contents of the counter-terrorism laws are specific, detailed and systematic. But the anti-terrorism law of China has restriction on the power and roles for previous prevention and oppression of terrorism, handling of people and property. This study reviewed the foreign countries' counter-terrorism laws and the way to connect the regulations on terrorism crimes of the revised Chinese criminal law and the anti-terrorism decision, when they enact the anti-terrorism laws in China in the future.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.4
• /
• pp.281-302
• /
• 2009

The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy. The etiology and antimicrobial susceptibility of major pneumonia pathogens can differ by country. Therefore, the ideal treatment guidelines for community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia for immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

• Korean Journal of Environment and Ecology
• /
• v.22 no.5
• /
• pp.536-543
• /
• 2008

This study was carried out to review the satisfaction with compensation for damage caused by the released Asiatic Black Bears into the whole area of Jirisan National Park and to offer basic data for reasonable conflict management with local community. A questionnaire survey was conducted from Jun. 2007 to Dec. 2007 on 93 subjects who got their compensations for the bear damage from 2004 until 2007. The results stayed at a middle level of satisfaction with the proper damage indemnity program with as mean $3.14{\pm}0.85$ points on the basis of 5 point scale. The satisfaction with compensation was found to have a significant correlation with the factors, such as income levels, whether to agree to restoration project, compensation money and compensation procedures. The compensation plan through the Animal Damage Compensation Consultation Committee was accepted positively(mean: $3.3{\pm}0.9$); however, to the compensation plan for the 80% compensation of actual amounts of bear damage, was acknowledged negatively(mean: $2.6{\pm}1.11$).