• Title/Summary/Keyword: Social Insurance

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Using Machine Learning Techniques to Predict Health-Related Quality of Life Factors in Patients with Hypertension (머신러닝 기법을 활용한 고혈압 환자의 건강 관련 삶의 질 요인 예측)

  • Jae-Hyeok Jeong;Sung-Hyoun Cho
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.11-24
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    • 2024
  • Purpose : This study aims to identify the factors influencing health-related quality of life through machine learning of the general characteristics of patients with hypertension and to provide a basis for related research on patients, such as intervention strategies and management guidelines in the field of physical therapy for health promotion. Methods : Annual data from the second Korean Health Panel (Version 2.0) from 2019 to 2020, conducted jointly by the Korea Health and Social Research Institute and the National Health Insurance Service, were analyzed (Korea Health Panel, 2024). The data used in this study was collected from January to July 2020, and the data was collected using computer-assisted face-to-face interviews. Of the 13,530 household members surveyed, 1,368 were selected as the final study participants after removing missing values from 3,448 individuals diagnosed with hypertension by a doctor. Results : The results showed that walking (P2) was the most significant factor affecting health-related quality of life in random forest, followed by perceived stress (HS1), body mass index (BMIc), total household income (TOTc), subjective health status (SRHc), marital status (Marr), and education level (Edu). Conclusion :To prevent and manage chronic diseases such as hypertension, as well as to provide customized interventions for patients in advanced stages of the disease, research should be conducted in the field of physical therapy to identify influencing factors using machine learning. Based on the findings of this study, we believe that there is a need for additional content that can be utilized in the field of physical therapy to improve the health-related quality of life of patients with hypertension, such as diagnostic assessment and intervention management guidelines for hypertension, and education on perceived stress and subjective health status.

Globalization and Independency of Populist Nations' Welfare Policies: Focusing on the Influences of Multinational Pharmaceutical Companies on the Korean Government's Policy on the Pharmaceutical Industry (세계화와 국민국가의 복지정책 자율성: 다국적 제약자본이 우리나라 제약정책 결정에 미친 영향을 중심으로)

  • Lee, Su-Yun;Kim, Young-Mi
    • Korean Journal of Social Welfare
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    • v.57 no.3
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    • pp.5-30
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    • 2005
  • Globalization has conflicting effects on pharmaceutical policies. A change into a 'populist competitive nation' due to globalization strengthens policies to reduce drug manufacturing costs while the WTO's TRIPS Agreement that is affected by multinational pharmaceutical companies increases drug manufacturing costs by bolstering the patent rights on new drugs. Currently, the independency of populist nations' policies to reduce drug manufacturing cost is being compromised because multinational organizations(such as the European Union) which represents the interests of the multinational pharmaceutical companies put restrictions on the pharmaceutical policies of populist nations for purposes of promoting the industrial goals of the multinational companies. Korea is no exception. Up until the late 1990s, the main feature of the pharmaceutical policies in Korea was keeping the drug price at the cost level based on a growth-driven ideology, and this was Korea's unique policy tools as a developing nation. However, the increase in the power of multinational pharmaceutical companies currently infringes on the independency of Korea's pharmaceutical policies. Expensive imported drugs were originally covered by the national health insurance plan, but starting from 1999 such drugs began to be covered by the plan. After separation of medical and pharmaceutical services, the use of expensive drugs was increased, and the Korean government planned to introduce the reference price policy in order to contain the cost of the national health insurance plan. However, due to pressures from the U.S. government as well as multinational pharmaceutical companies, implementation of the policy has been postponed. In addition, due to a pressure from the U.S. government, a working group was created which would affect the health care policy of the Korean government. Discussions so far on globalization was about whether the change into populist competitive nations due to globalization resulted in the reduction of welfare spending. However, this study shows not only the reduction of health care cost through policies to reduce drug manufacturing costs but increase in welfare spending by raising the strengths of multinational pharmaceutical companies that are for-profit providers of welfare service. While focusing on the contradictory effects of globalization on pharmaceutical policies of a nation, this study looked at how these conflicting effects end up promoting the interests of multinational pharmaceutical companies by examining the Korean case.

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Entry Types and Locational Determinants of North Korean Workers in Cross-border Regions between North Korea and China (중국 대북 접경지역의 북한 노동력 진입 유형과 요인)

  • Lee, Sung-Cheol;Lee, Yong-Hee;Kim, Boo-Heon
    • Journal of the Economic Geographical Society of Korea
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    • v.22 no.4
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    • pp.438-457
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    • 2019
  • The main purpose of this paper is to identify the entry types and locational determinants of North Korean workers in cross-border regions between North Korea and China. More specifically, the paper has attempted to divide the entry type of them in the regions into two; 1) entry via transactions between Chinese traders with North Korea and North Korea trade companies, and 2) entry via transactions between Korean-Chinese middlemen and North Korean trade companies. Also, it has analyzed main factors of their locational determinants in the spatial contexts of the regions. There have been changes in two perspectives in terms of the entry paths and types of them in accordance with the transformation of characteristics of United Nations sanction against North Korea from 'call-upon' to 'decide' after UN Security Council Resolution 2094 in 2013. Firstly, main agents who have dealing with North Korean trade companies which have right to dispatch North Korean workers have been changed from Chinese traders into Korean-Chinese brokers who are specialized in the introduction of North Korean workers with one-stop service from visa administrative to labor managements. Secondly, there has been a transfer of North Korean workers in the regions from formal to informal workers who has been admitted into China with a short stay or a tourist visa, and then remained illegally to be employed in China. Therefore, as demands on service which is able to guarantee the security of North Korean informal workers and their managements have increased, Korean-Chinese brokers have been stimulated in the regions after the operation of real international sanctions against overseas North Korean workers. In addition, the main factors of their locational determinants in cross-border regions between North Korea and China are could be analyzed in three perspectives; 1) an increase in real wages in accordance with the reform of the Chinese social insurance system after 2011, 2) the structural vulnerability of labor markets in the regions, 3) the utilization of stable and manageable workers.

A Study on Image of the Nurse (간호사 이미지에 관한 연구)

  • Kim, Hyung-Ja;Kim, Hyeon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.97-110
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    • 2001
  • An image exists in the thought of every subjective person and it exercises its influence over everything, having a great power in the real world. An positive image of the nurse has an influence on her faith, value and confidence, therefore increasing her job satisfaction, helping to upgrade her level of profession of nursing through qualitative nursing service as a result, considering the necessity of such an image when it comes to improvement of the profession, the confirmation of the image is indispensable to its evaluation of a speciality in nursing. This study is intended to help that improvement of the nursing profession in the present so that the total effort in every field of nursing is made and to offer basic material for developing a strategy to improve the image of nurses. This study is designed to investigate such an image descriptively. The subjects include 105 nurses, 60 doctors, 68 office workers, 88 medical engineers, 127 patients and there protectors with a total of 448 adapted with accidental sampling, who work at Y and W general hospital in Chonju. The measuring instrument consists of 40 question, with the researcher amended and made from on of Inja Song(1993), Donsoon Lee(1995), Ilsim yang(1998), and its Cronbach's alpha coefficient is .95. Data were collected from March 1 2000 to March 20, 2000 using self-reported questionnairs, analyzed with SPSS WIN 7.5 after encoding. The results are as follows: 1. Most of the subjects thinks the nursing as a hard, stressful, always busy job(more than 75%), and consider nurses as good-looking, supportive and responsible to co-workers to above average degree($50.0{\sim}74.9%$), especially it shows the idea that nursing is independently academic job and has come to fasten itself upon the public. But it shows below the everage($25.0%{\sim}49.9%$) in regard to self development as a specialist, affection for there job, an association activity, service to the community, high intelligence level and direct given patient nursing service. It also rated low as a recommendable job, independently nursing accomplishment, social position. 2. The nurses, patients and there protectors expressed more positive opinions than doctors, medical engineers, office workers about the image of the nurse(F=18.80, p=.00). This fact indicates that the former group evaluated the image similarly contrary to lowness of the latter. 3. In the study on what influenced upon the image, it defines to 79.8% by direct contact in the hospital or acquaintance with nurses, and 16.3% by mass media. 67.3% answered that they saw the image in a new light through hospitalization, which suggests an important source for the image management originates from caring for the quality of nursing service. Considering the evaluation of the image above, we need strategies to lead a unique professional knowledge and technological development, insurance of professional self-determination, high social position, participation in group activities, dedication to lifetime job, in order that nursing comes to expand as a professional occupation. Also, as for generating more positive images, we must take the quality of nursing service into account and offer and monitor correct information about the expanded role and function of the nurse continuously so that mass media reflect a more accurate image of nurses in general.

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Socioeconomic Impact of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN): the ACTION Study Protocol

  • Kimman, Merel;Jan, Stephen;Kingston, David;Monaghan, Helen;Sokha, Eav;Thabrany, Hasbullah;Bounxouei, Bounthaphany;Bhoo-Pathy, Nirmala;Khin, Myo;Cristal-Luna, Gloria;Khuhaprema, Thiravud;Hung, Nguyen Chan;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.421-425
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    • 2012
  • Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.

Ten Year Trend of Cancer Incidence in Seoul, Korea: 1993-2002 (서울시 암 발생률의 10년간 추이: 1993-2002)

  • Shin, Myung-Hee;Oh, Hyun-Kyung;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.2
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    • pp.92-99
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    • 2008
  • Objectives : Effective cancer prevention and control measures can only be done when dependable data on the cancer incidence is available. The Seoul Cancer Registry (SCR) was founded to provide valid, comparable and representative cancer incidence data for Koreans. We aimed to compare the cancer incidence in the first (1993-1997) and second term (1998-2002) of the SCR, and we analyzed the annual incidence trend during that 10 years. Methods : The SCR detects potential cancer cases through the Korean Central Cancer Registry (KCCR) data, the health insurance claims, the individual hospital's discharge records and the death certificates. About 87% of the SCR data is registered through the KCCR. The rest of the data is registered by SCR registrars who visit about $70{\sim}80$ mid-sized hospitals in Seoul to review and abstract the medical records of the potential cancer patients. Results: The total number of new cancer cases was higher in $1998{\sim}2002$ than in $1993{\sim}1997$ by 20.6% for men and 18.4% for women, respectively. The age-standardized rate (ASR) of total cancer per 100,000 increased 1% (from 295.4 to 298.3) for men and 5.1% (from 181.5 to 190.7) for women, between the two periods. The commonest cancer sites during 1998-2002 for men were stomach, liver, bronchus/lung, colorectum, bladder and prostate, and the commonest cancer sites for women were breast, stomach, colorectum, cervix uteri, thyroid and bronchus/lung. Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased. Conclusions : The cancer incidence is increasing in Seoul, Korea, especially for the colorectum and prostate for men, and for the breast, colorectum, bronchus/lung and thyroid for women.

Improvement of Activities of Daily Living Training to Promote Social Participation at a Pilot Project of Rehabilitation Medical Institutions (재활의료기관 시범사업에서의 사회복귀 촉진을 위한 일상생활훈련 개선방안)

  • Song, Young-Jin;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.35-45
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    • 2018
  • Objective : Questionnaires completed by occupational therapists and patients in institutions conducting a "Pilot Project of Rehabilitation Medical Institutions" were used to determine whether occupational therapy was able to establish appropriate patient support systems for return to home and community. Methods : The questionnaire was completed by 293 occupational therapists from 13 institutions conducting pilot projects and 296 patients from 8 institutions who were able to respond. Results : Although the Pilot Project of Rehabilitation Medical Institutions is being implemented to enable early return of patients to activities of daily living, the most important therapeutic goal is not efficiently applied. In addition, since the health insurance systems utilized in medical institutions are applied as in the pilot project, there is no basis for evaluation and mediation of practical daily activities and vocational rehabilitation for actual return to the community. Conclusion : Through a detailed review of the pilot project, it will be necessary to improve the quality of life through the early return of patients to social activity, and to make practical improvements to reduce unnecessary societal expenditures.

Hospice Medicine and Nursing Ethics (호스피스의료와 간호윤리)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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Actuarial analysis of a reverse mortgage applying a modified Lee-Carter model based on the projection of the skewness of the mortality (왜도 예측을 이용한 Lee-Carter 모형의 주택연금 리스크 분석)

  • Lee, Hangsuck;Park, Sangdae;Baek, Hyeyoun
    • The Korean Journal of Applied Statistics
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    • v.31 no.1
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    • pp.77-96
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    • 2018
  • A reverse mortgage provides a pension until the death for the insured or last survivor. Long-term risk management is important to estimate the contractual period of a reverse mortgage. It is also necessary to study prediction methods of mortality rates that appropriately reflect the improvement trend of the mortality rate since the extension of the life expectancy, which is the main cause of aging, can have a serious impact on the pension financial soundness. In this study, the Lee-Carter (LC) model reflects the improvement in mortality rates; in addition, multiple life model are also applied to a reverse mortgage. The mortality prediction method by the traditional LC model has shown a dramatic improvement in the mortality rate; therefore, this study suggests mortality projection based on the projection of the skewness for the mortality that has been applied to appropriately reflect the improvement trend of the mortality rate. This paper calculates monthly payments using future mortality rates based on the projection of the skewness of the mortality. As a result, the mortality rates based on this method less reflect the mortality improvement effect than the mortality rates based on a traditional LC model and a larger pension amount is calculated. In conclusion, this method is useful to forecast future mortality trend results in a significant reduction of longevity risk. It can also be used as a risk management method to pay appropriate monthly payments and prevent insufficient payment due to overpayment by the issuing institution and the guarantee institution of the reverse mortgage.

Korean Public Relations Trend and Social Acceptance in 1960s (1960년대 한국의 PR 상황 및 사회적 수용에 대한 연구)

  • Chae, Myung-Jin;Seon, Hye-Jin
    • Korean journal of communication and information
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    • v.35
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    • pp.292-328
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    • 2006
  • This study examined Korean Public Relations trend and social acceptance in 1960s. It centers on the acceptance conditions of PR concept, corporate PR and governmental PR. It analyzed PR recognition and practical activities of the general corporations, financial institutions and public corporations in dealing with corporate PR. It also analyzed Korean governmental PR through examining the structure of governmental PR system, PR activities in rural communities and the police. In those days, PR concept had been misused to no small degree and not been accepted correctly that the necessity to let people know PR in its proper meaning was raised. Laying emphasis upon the technical side, corporate PR activities had centered on publicity. Especially, at that time, the banks, the insurance companies and the public corporations had perceived the importance of PR and implemented a set of PR activities. It can be said that a special feature in government PR in 1960s lies in the expansion of the public information system and reinforcement of PR policies. Also, PR in rural communities had been doing to give information relating to agriculture technique and to improve the living conditions of the farm area. The importance of PR in police had been on the side of promoting relations with people and improving treatment of the people by policeman.

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