• Journal of health informatics and statistics
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• 제43권4호
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• pp.318-328
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• 2018

Objectives: People are living longer, but often with diseases or chronic conditions. As a consequence, interest in resolving insurance blind spots is growing. This study provides substandard risk-relevant statistics to help substandard risks who are likely to fall in insurance blind spots obtain insurance coverage, such as the reimbursement of medical costs, as well as to stimulate insurance product development. Methods: This study uses National Health Insurance Service (NHIS) cohort data to determine the relevant statistics. The incidence rates of severe diseases are derived and compared against standard risks to establish a set of relative risk factors. These incidence rates of standard and substandard risks are then compared. Results: Currently, an individual's cancer history is used in the underwriting process for simplified issue insurance. However, underwriting focusing on hospitalization and procedures related to serious illnesses could lower premiums for substandard risks. Moreover, the statistical results could be used to expand the coverage of health insurance products. Conclusions: This study's relative risk factors can be used to derive simplified issue premium rates for substandard risks. They can also be used to implement discount and loading schemes for medical reimbursement insurance and help insurance companies implement proactive risk management.

• 한국학교보건학회지
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• 제20권1호
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• pp.77-90
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• 2007

Purpose : This study identified the patterns of smoking of students attending middle schools and high schools, and analyzed its related health risk behaviors. Methods: The data was based on the survey of 1,517 middle students and 911 high students residing in Kyung-Gi district. Results: The current smoking rates of male and female middle students are 5.3%, and 3.1% respectively. The rates of experiences in smoking are 21.4% and 16.0%(male/female). The current smoking rates of male and female high students are 17.9% and 8.5%, whereas the rates of experiences in smoking are 34.2% and 23.3% respectively. On the other hands, 14.1% of middle students and 12.0% of high students were exposed to smoking for at least 2 hours per day. The majority of middle and high school smokers started smoking when they were in middle or high school. And the most popular places to smoke were children's playgrounds, public open area., parks, and so on. Whether having a smoker as a friend or not and students' own perception towards smoking influenced the decisions to smoke for middle and high students. Both middle and high students, regardless of their gender, who have higher rates of drinking experiences and the hours of computer usage were found to have higher rates of smoking experiences. Meanwhile, the sleeping hours is in reverse proportion to the rate of smoking experiences. There was statistically significant difference in smoking experiences related to the degree of obesity only in the female high students: underweight and overweight students showed higher rates of smoking experiences than those falling in the normal weight range. Conclusion: For the effective prevention of adolescence smoking, it is necessary to adopt a comprehensive approach, which classifies the target population according to their age and sex and cover all health risk behaviors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1707-1710
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• 2014

Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.

• 재무관리논총
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• 제3권1호
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• pp.179-211
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• 1996

This study examines whether trading mechanisms or market microstructures of markets have an effect on the integration issue of the international equity market. If the international equity market is integrated, identical stocks listed on different international stock exchanges should have the same rates of return, the same characteristics of stock price behavior and similar distributions of return. If different market microstructures, or trading mechanisms cause differences in characteristics of stock price behavior, those can lead to different rates of return because of different liquidity risk for the same stocks between markets. This study proposes international asset pricing with liquidity risk related to trading mechanisms. Systematic risk by itself cannot predict the sign of expected rate of return difference for the same stocks between international markets. Liquidity risk factors related to market microstructure provide explanations for the sign of rate of return differences between markets, However, liquidity risk factors related to market microstructure do not have a significant effect on the rate of return differences and sensitivity of return differences between markets, Trading mechanisms or market microstructures might not have a significant effect on the interpretation of the international equity market integration studies, if trading volume or other factors are controlled.

• 한국의료질향상학회지
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• 제10권2호
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• pp.216-231
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• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

• 한국지하수토양환경학회지:지하수토양환경
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• 제16권2호
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• pp.12-29
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• 2011

Risk-based screening levels (RBSLs) of some pollutants for residential adults were derived with risk assessment tools developed by United States Environmental Protection Agency (USEPA), American Society for Testing and Materials (ASTM), and Korea Ministry of Environment (KMOE) and compared each other. To make the comparison simple, ingestion of soil, dermal contact with soil, outdoor inhalation of vapors, indoor inhalation of vapors, and inhalation of soil particulates were chosen as exposure pathways. The results showed that the derived RBSLs varied for every exposure pathway. For direct exposure pathways (i.e., ingestion of soil and dermal contact with soil), the derived RBSLs varied mainly due to the different default values for exposure factors and toxicity data. When identical default values for the parameters were used, the same RBSLs could be derived regardless of the assessment tools used. For inhalation of vapors and inhalation of soil particulates, however, different analysis methods for cross-media transfer rates were used and different assumptions were established for each tool, identical RBSLs could not be obtained even if the same default values for exposure factors were used. Especially for inhalation of soil particulates pathway, screening level derived using KMOE approach (most conservative) was approximately 5000~10000 times lower than the screening level derived using ASTM approach (least conservative). Our results suggest that, when deriving RBSL using a specific tool, it is a prerequisite to technically review the analysis methods for cross-media transfer rates as well as to understand how the assessment tool derives the default values for exposure factors.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.89.1-89.8
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• 2018

Objective: Highly effective chemotherapy for patients with low-risk gestational trophoblastic neoplasia (GTN) is associated with almost a 100% cure rate. However, 20%-30% of patients treated with chemotherapy need to change their regimens due to severe adverse events (SAEs) or drug resistance. We examined the treatment outcomes of second-line chemotherapy for patients with low-risk GTN. Methods: Between 1980 and 2015, 281 patients with low-risk GTN were treated. Of these 281 patients, 178 patients were primarily treated with 5-day intramuscular methotrexate (MTX; n=114) or 5-day drip infusion etoposide (ETP; n=64). We examined the remission rates, the drug change rates, and the outcomes of second-line chemotherapy. Results: The primary remission rates and drug resistant rates of 5-day ETP were significantly higher (p<0.001) and significantly lower (p=0.002) than those of 5-day MTX, respectively. Forty-seven patients (26.4%) required a change in their chemotherapy regimen due to the SAEs (n=16) and drug resistance (n=31), respectively. Of these 47 patients failed the first-line regimen, 39 patients (39/47, 82.9%) were re-treated with single-agent chemotherapy, and 35 patients (35/39, 89.7%) achieved remission. Four patients failed second-line, single-agent chemotherapy and eight patients (17.0%) who failed first-line regimens were treated with combined or multi-agent chemotherapy and achieved remission. Conclusions: Patients with low-risk GTN were usually treated with single-agent chemotherapy, while 20%-30% patients had to change their chemotherapy regimen due to SAEs or drug resistance. The second-line regimens of single-agent chemotherapy were effective; however, there were several patients who needed multiple agents and combined chemotherapy to achieve remission.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5951-5956
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• 2015

Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.

• 기본간호학회지
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• 제21권3호
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• pp.264-274
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• 2014

Purpose: This study was done to determine inpatient fall rates in an acute hospital setting and to explore risk factors and characteristics across clinical departments. Methods: The medical records and standardized fall reports of 416 patients admitted between January 1 and December 31, 2012 were reviewed. Descriptive statistics and statistical tests were used, including: t-test, ${\chi}^2$-test, ANOVA. Results: The total fall rate per 1,000 inpatient days was 0.49. Fall rate, fall risk factors and characteristics such as age, type of fallers and mean MFS (Morse Fall Scale) differed significantly among clinical departments. Conclusions: The analysis results show that the fall rates, fall risk factors and characteristics of acute hospital inpatient falls varied significantly across clinical departments. The findings of this study suggest that hospitals should consider differences in fall related characteristics across clinical departments when implementation fall prevention strategies and interventions.

• 대한설비공학회:학술대회논문집
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• 대한설비공학회 2006년도 하계학술발표대회 논문집
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• pp.460-467
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• 2006

Some large accidents in tunnels in recent years, such as Mont Blanc, Gotthard and Tauern tunnels, have lead to an increasing attention for tunnel safety and necessity of tool for quantitative risk assesment of road tunnel. And the purpose of this study is to develop the quantitative risk assesment tool for the application of road tunnel. The objectives of this paper are as follows : (1) analyze of traffic accident rates in tunnel, (2) make out scenario for fire accidents, (3) develop the evacuation model and FED calculation model, (4) Present the results from quantitative risk assesment for the model tunnel according with the fire heat release rates and distances of cross passage.