In this paper, the 1.24 million elderly patient medical data (HIRA-APS-2014-0053) provided by the Health Insurance Review and Assessment Service and weather data are analyzed with generalized estimating equation (GEE) model and long short term memory (LSTM) based recurrent neural network (RNN) model to predict the number of disease occurrence. To this end, we estimate the patient's residence as the area of the served medical institution, and the local weather data and medical data were merged. The status of disease occurrence is divided into three categories(occurrence of disease of interest, occurrence of other disease, no occurrence) during a week. The probabilities of categories are estimated by the GEE model and the RNN model. The number of cases of categories are predicted by adding the probabilities of categories. The comparison result shows that predictions of RNN model are more accurate than that of GEE model.
Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.
Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.
Journal of the Korean Society for Library and Information Science
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v.45
no.1
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pp.311-332
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2011
The purpose of this study was to establish core elements required for the implementation of multicultural library services, to analyze the features of each element, and to develop a model of effective multicultural library services. This model was aimed to improve multicultural services and programs currently managed on a short-term basis by public libraries in Korea and help those libraries develop more systematic and long-term multicultural services. To proceed with this study, the literature review, a case study and a survey(the exploratory factor analysis, T-test and ANOVA analysis) were conducted. In this study, it is found that more effective operation of multicultural services in public libraries requires cooperation and integration with not only other libraries and related social and educational institutions in a community, but also international network. Based on this idea, the model of operating multicultural services in public libraries in Korea was proposed in this study.
Objectives : This study examined the factors influencing variation by local areas of antibiotics prescription rate in upper respiratory infections (URI) according to the public reporting. Methods : We used the National Health Insurance Claims Data which the clinics claimed for URI (Korean Standard Classification of Disease, J00 ~ J06) in ambulatory care. The period of analysis was from the first quarter (from January to March) of 2005 to the first quarter of 2007. The number of samples was total 242 local areas that included all clinics (N = 7,942), which prescribed antibiotics for URI in ambulatory care. Results : None of the demographic and socioeconomic characteristic indicators was statistically significant. Among the provider factors, An increase in number of doctors and the average annual antibiotics prescription rate (from 2003 to 2004) for URI by local area were significantly related to an increase of antibiotics prescription rate according to the public reporting. And an increase in number of pediatric clinics, the proportion of clinics less than 5 years since has opened and the average annual fluctuation of antibiotics prescription rate (from 2003 to 2005) were significantly related to a decrease in antibiotics prescription rate by local area according to the disclosure of information. Conclusions : According to the public reporting, the antibiotics prescription rate in clinics had decreased sharply. However, the reduction of antibiotic prescription rate varied in different local areas. The factors influencing variation by local areas in antibiotics prescription rate can be used for establishing effective strategies to reduce variation by region in antibiotics prescription rate.
Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.
Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.
Journal of the Korean Society of Environmental Restoration Technology
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v.20
no.5
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pp.43-58
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2017
This study aims to provide basic understanding for evaluating the quantitative and qualitative progress of national protected areas, through the theoretical review of Aichi Biodiversity Target 11 in order to comply with recommendations of international community and to conserve biodiversity. As a result of the study, Aichi Biodiversity Target 11 sets out the specific contents that the Parties should achieve for protected areas by identifying them as temporal and spatial goals. The temporal goal, the time schedule for achieving the goal, is 2020, and the spatial goal is divided into quantitative expansion goals and qualitative improvement goals. The quantitative expansion goals present the target coverage of protected areas separately terrestrial and marine. The qualitative improvement goals include the target areas for conservation and five conservation considerations. The conservation targets focus on the important areas with regard to biodiversity and ecosystem services. The five conservation considerations mean effective management, equitable management, ecological representativeness, connectivity, and integration into the landscape and seascape for protected areas. Finally, it suggests that two tracks of protected areas and other effective area-based conservation measures(OECMs) should be used as conservation measures to build an integrated system. The results of this study can be applied to quantitative and qualitative evaluation methods for protected areas and it can contribute to achieve quantitative expansion goals and qualitative improvement goals for them.
Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.
Journal of the Korea institute for structural maintenance and inspection
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v.18
no.4
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pp.107-117
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2014
This study tests homogeneity and performs multiple comparison analysis among treatment levels of each factor group through t-test by materials and analysis of variance by structural type and service period. For that descriptive statistical analysis is performed for static and dynamic response characteristics and their ratios of calculated versus measured values based on a good many safety assessment reports for bridges. Homogeneity and post hoc test based on descriptive statistical analysis provide the measures for homogeneity identification among comparison groups in addition to the statistical reference values such as central tendency, variation and shape. This study is expected to be valuable for structural integrity assessment and design by comparing the measured and calculated values with the reference values for the homogeneous group identified, which can help the engineers review the adequacy of the values and put the group database to practical use.
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