• The Journal of the Korean life insurance medical association
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• v.28 no.1_2
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• pp.31-35
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• 2009

Background : Many of internists have been working for insurance industry. Insurance medicine is use of medical knowledge for insurance industry. There is social role of insurance medicine in terms of soundness of insurance administration. Recently social role of internists also have been being watched. Although theme of insurance medicine is medical risk selection, insurance claims administration also needs medical experts'opinion. There are not any corroborative study of medical consulting for insurance claims. Among insurance industry, someone called this medical review of insurance claims as 'medical claims review'. Aim : To investigate usefulness of medical review of insurance claims. Design : Questionnaire survey with claim staffs in one of insurance claim adjustment company in Korea. Methods : 265 claim staffs were divided into 4 groups and conducted survey using a questionnaire of 20 questions. Utility score, job satisfaction score, and difficult factors of claims administration were measured. Results : Utility score and job satisfaction score are highest in medical claims review group. The most difficult in claim administration to claim staffs was demonstrated to medical knowledge. Conclusion : Medical review of insurance claims is proved to be worthy. Document-based consulting method, namely medical claims review, is more useful than telephone-based simple query among claim staffs...Subjects of the medical claims review are medical record and it's principle is independent medical examination with evidence-based approach, it also has role of protecting fraud of insurance claims. Two main question types of medical claims review are verification and advice.

• Communications for Statistical Applications and Methods
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• v.24 no.3
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• pp.211-226
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• 2017

The chain-ladder method, for which run-off data is employed is popularly used in the rate-adjustment and loss-reserving practices of non-life-insurance and health-insurance companies. The method is applicable when the underlying assumption of a consistent development pattern is in regards to a cumulative loss payment after the occurrence of an insurance event. In this study, a modified chain-ladder algorithm is proposed for when the assumption is considered to be only partially appropriate for the given run-off data. The concept of a structural-change point in the run-off data and its reflection in the estimation of unpaid loss amounts are discussed with numerical illustrations. Experience data from private health insurance coverage in Korea were analyzed based on the suggested method. The performance in estimation of loss reserve was also compared with traditional approaches. We present evidence in this paper that shows that a reflection of a structural-change point in the chain-ladder method can improve the risk management of the relevant insurance products. The suggested method is expected to be utilized easily in actuarial practice as the algorithm is straightforward.

• Journal of Electrical Engineering and Technology
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• v.12 no.6
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• pp.2166-2176
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• 2017

Electricity price prediction plays a crucial part in making the schedule and managing the risk to the competitive electricity market participants. However, it is a difficult and challenging task owing to the characteristics of the nonlinearity, non-stationarity and uncertainty of the price series. This study proposes a hybrid improved strategy which incorporates data preprocessor components and a forecasting engine component to enhance the forecasting accuracy of the electricity price. In the developed forecasting procedure, the Seasonal Adjustment (SA) method and the Ensemble Empirical Mode Decomposition (EEMD) technique are synthesized as the data preprocessing component; the Coupled Simulated Annealing (CSA) optimization method and the Least Square Support Vector Regression (LSSVR) algorithm construct the prediction engine. The proposed hybrid approach is verified with electricity price data sampled from the power market of New South Wales in Australia. The simulation outcome manifests that the proposed hybrid approach obtains the observable improvement in the forecasting accuracy compared with other approaches, which suggests that the proposed combinational approach occupies preferable predication ability and enough precision.

• Asia-Pacific Journal of Business
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• v.14 no.1
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• pp.351-364
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• 2023

Purpose - This study examines the effects of Dubai oil price and the volatility on the asymmetry of domestic gasoline price adjustment. Additionally, the study investigates the effects of "Altteul" gas-station and tax-cut policies on asymmetry. Design/methodology/approach - Firstly, the study calculates proxies for asymmetry and volatility of each window(every 3-month) by error-correction model and GARCH(1, 1) using daily domestic gas price and Dubai oil price from 2008/04/15 to 2022/12/31. Secondly, the study investigates the effects of the increasing rate of Dubai oil price, volatility, "Altteul" gas-station and tax-cut policies on asymmetry. The autoregressive distributed lag regression model is employed for estimations. Findings - The study finds that changes in the increasing rate of Dubai oil price and both types of volatility of Dubai oil price increase asymmetry. While "Altteul" gas-station and tax-cut policies decrease asymmetry. Additionally, the study fails to find that asymmetry in the Korean gasoline market in the estimation with total observations. Research implications or Originality - An increase in Dubai oil price volatility means an increase in cost uncertainty for gas-station owners. Since cost uncertainty is a kind of financial risk, the increase in volatility reinforces the asymmetry. The study provides supporting evidence for the idea.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.218-228
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• 2000

Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

• Journal of Periodontal and Implant Science
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• v.48 no.4
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• pp.251-260
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• 2018

Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.

• Nutrition Research and Practice
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• v.7 no.5
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• pp.409-417
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• 2013

This study was performed to determine the effects of dietary calcium (Ca) intake, milk and dairy product intake, and serum vitamin D level on bone mineral density. The survey data from the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES) for adults (3,819 males, 5,625 females) aged > 20 years were examined; osteoporosis was defined according to the standards for Asian populations (T-score < -2.5). The risk for osteoporosis significantly decreased as Ca intake increased; this effect persisted (quartile 4 vs. quartile 1 of Ca intake: odds ratio [OR] 0.66; 95% confidence interval [CI]: 0.50-0.87) even after adjustment for gender, age, and other factors (body mass index, serum vitamin D, menstruation, female hormone intake, menopausal status, and the number of days per week of muscular strength exercise). Additionally, the risk for osteoporosis significantly decreased as the Ca/P ratio increased (quartile 4 vs. quartile 1: OR 0.76; 95% CI: 0.58-0.98). The degree of risk was 0.96 (0.66-1.38) in those who consumed < 1 portion of milk or dairy products daily, and 0.71 (0.53-0.96) in those who consumed > 1 portion per day, compared with those who had zero intake. The risk for osteoporosis significantly decreased as the serum 25(OH) vitamin D level increased. From these results, we advocate an increase in Ca, milk, and dairy product intake, and that serum 25(OH) vitamin D levels be maintained within the normal range, for the maintenance of bone health and the prevention of osteoporosis in adults.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2771-2775
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• 2015

Background: Associations between ABO blood groups and risk of several malignancies have been reported, although there are limited data regarding hepatocellular carcinoma (HCC). The aim of this study was to investigate any possible association between the ABO genotype, especially blood group A, and HCC risk in Koreans. Materials and Methods: We conducted a case-control study of 1,538 patients with newly diagnosed HCC at Chonnam National University Hwasun Hospital and 1,305 randomly selected members of the general population. The ABO genotype was determined by multicolor real-time polymerase chain reaction (PCR) using displacing probes. Adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated using logistic regression models with adjustment for gender, age, smoking, alcohol drinking, and hepatitis B and C status. Results: The risk of HCC in genotype AA was significantly higher than in OO (aOR=1.773, 95% CI=1.161-2.705). The risk in blood group A was also higher than in blood group O (aOR=1.448, 95% CI=1.005 1.897). No significant difference was found for the AA, BO, BB, and AB genotypes, or blood group B and AB. Conclusions: Blood group A and genotype AA showed the highest risks of HCC in a Korean population. No significant difference was found for the AO, BO, BB, and AB genotypes, or blood group B and AB.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7443-7447
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• 2014

Aim: Little is known about the genetic associations with Basal cell carcinoma (BCC) risk in non-Caucasian populations, in which BCC is rare, as in Korea. We here conducted a pilot genome-wide association study (GWAS) in 12 patients and 48 standard controls. Method: A total of 263,511 SNPs were analyzed with the Illumina HumanOmni1 Quad v1.0 DNA Analysis BeadChip for cases and Korean HapMap 570K for controls. Results: SNP-based analyses, based on the allele genetic model with adjustment for sex and age showed suggestive associations with BCC risk for 6 SNPs with a P-value (P < 0.0005). However, these associations were not statistically significant after Bonferroni correction: rs1040503, rs2216491, rs13407683, rs4751072, rs9891263, and rs1368474. In addition, results from gene-based analyses showed suggestive associations with BCC risk for 33 candidate genes with a P-value (P <0.0005). Consistent with previous GWAS and replication studies in Caucasian populations, PADI6, RHOU and SLC45A2 were identified as having null associations with BCC (P > 0.05), likely due to the smaller sample size. Conclusions: Although this was a small-scale negative study, to our knowledge, we have conducted the first GWAS for BCC risk in an Asian population. Further large studies in non-Caucasian populations are required to achieve statistical significance and confirm these findings.

• Journal of Nutrition and Health
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• v.33 no.8
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• pp.873-881
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• 2000

Recent research reported health risks associate with high carbohydrates diets. Objectives of this study were to evaluate in a cross-sectional study if high carbohydrate diet is associated with coronary heart disease(CHD) risk factors: examined blood concnetration of triglyceride(TG), total cholesterol, high density lipoprotein cholesterol(HDL-C), plasma glucose, systolic blood pressure(BP), body mas index(BMI), wasit-hip ratio(WHR) and waist-stature ratio(WSR). Using the most recent US National Health and Nutrition Examination Survey(IIINHANES III) data, the nationally representative US population (3772 men, 4095 women of 25-64 years of age) was divided into low vs. high carbohydrate diet groups(below 40% vs. above 60% energy intake from cab carbohydrates) and compared by the CHD risk factors. Triglyceride was higher(p<0.001) in the high carbohydrate group, whereas high density-lipoprotein cholesterol(HDL-C)was lower(p<0.01) in the high carbohydrate diet group. In plasma glucose, there was no significant differences between high carbohydrate diet and low carbohydrate diet. In adiposity(BMI, WHR and WSR), it also showed no significant differences, After adjustment for age, ethnicity, alcohol and smoking in upper 60%-carbohydrate diet, Odds Ratio of TG and HDL-C were 1.42 and 1.23 in men and 1.22 and 1.17 in women. 50-60% carbohydrate diet was associated with decreased risk of CHD. Dietary guidelines for Koreans recommend 60-70% of total energy from carbohydrate, as Koreans traditionally consumed high carbohydrate diets. In a cross-sectional population of adults, diets containing 55-60% energy from carbohydrate were suggested as a dietary guideline of carbohydrate intake for Koreans. (Korean J Nutrition 33(8) : 873-881, 2000)