• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• International Commerce and Information Review
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• v.15 no.4
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• pp.287-311
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• 2013

The arbitration parties may disagree with the arbitrator's award about whether they are eligible for the dispute case. While lots of disputes cases relating to subrogation are arising, it is not easy to find subrogation arbitration system to handle them clearly. The main issue is an availability of subrogation arbitration in case of the dispute which the insurer requests the arbitration against the carrier according to the arbitration clause of Bill of Lading. The direct parties of arbitration clause of the B/L are the carrier and the holder of the B/L. Could the insurer get the position of the arbitration party in stead of the holder of the B/L after compensation if there was an accident of insurance on the way of carriage? Even though there are a few arbitral awards of subrogation, the reason of the eligibility of subrogation arbitration is not enough. This paper scrutinized precedent research papers, arbitration awards, judicial precedents, and the Automobile Subrogation Arbitration System. Vague dispute resolution system which burden corporations with so many costs must be not good for business. In the view of economic efficiency, blank of contract, reciprocality, and Coase Theorem, it is recommended that subrogation arbitration system for the international trade would be better focus on the hypothesis of "Firm Offer Character of Arbitration Clause."

• Korean Journal of Agricultural Science
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• v.29 no.1
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• pp.66-83
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• 2002

The economic feasibility analysis including benefit-cost ratio and internal rate of return of a land consolidation and on-farm development project was mainly depended upon the direct benefits and costs arising during project life. Therefore the projects were neglected in allocating the government's financial funds and loans on account of the low economic rate of return of the project. Accordingly the extended benefit-cost analysis method should be introduced and adapted to cover not only the benefit s such as non-market values of environmental and food security fun ct ions of the project but also market values of the project outputs. The main purposes of this study are (1) to prepare a guide line for economic feasibility analysis based on the IBRD and ADB guidelines, (2) to estimate the benefits from productivity increase, labor saving, savings of O&M cost of farm mechanization and project facilities, savings of farmer's burden for their public health, increasing environmental and public functional value of paddy fields, improving food security condition and formation of peaceful and uncontroversial rural society by implementing the land consolidation and on-farm development, (3) to introduce the newly adapted analytical method as the extended benefit cost analysis which could make possible to be included the values of non-market goods such as the food security and the environmental public function of paddy fields. To carry out this study, the existing publications on the guidelines for economic agricultural projects were reviewed and consultation was made with a For the post evaluation study of the land consolidation and on-farm development project, field survey in Jigok and other comparative area were made to get available information. According to the project completion report, Jigok land consolidation and on-farm development project has 55ha of benefit area out of 69ha of gross area. The project was started in November 11th, 2000 and completed october 30th, 2001. The total project costs were amounted to 2,548 million won and the annual project benefits were estimated at 335million won evaluated by domestic market prices. The ERR(Economic Rate of Return) and SRR(Social Rate of Return) of the project based on the shadow pricing system were estimated at 4.4% and 16% respectively. On the other hand, the ERR and SRR based on the domestic market value system were amounted to 6.37% and 14.62%. In conclusion, Korean land consolidation and on-farm development projects have not carried out from the view point of economic rate of return under shadow pricing system but from the view point of domestic pricing system. For the future feasibility studies on land consolidation projects have to be carried out including the non-market values as environmental and food security function of the projects.

• Journal of Korea Port Economic Association
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• v.32 no.2
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• pp.39-57
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• 2016

Many countries are developing transportation technologies aimed at reducing environmental pollution and the environmental burden. For example, environmentally friendly transportation routes and methods are being used to improve inland waterways in Europe. Against this backdrop, a case study was conducted on special cargo (weight cargo, earth and sand, etc.) on Korea's Gyeong-In Ara Waterway, an inland waterway connecting the Han River and the West Sea, serving a distribution function. The results of the analysis showed that coastal shipping could be promoted using the waterway, including a positive synergy among environmental, economic, and social aspects. That is, by shifting from overland transportation to marine transportation, it is possible to reduce environmental pollution, ease traffic congestion, decrease traffic accidents, and shorten the licensing period for the weight cargo demand of the northern area of the Han River. In this respect, the Gyeong-in Ara Waterway could become an environmentally friendly transportation route, promoting coastal shipping in Korea. However, for this to occur, support systems such as subsidies for marine transportation and using the inland waterway are required, as happens in the EU. Furthermore, existing policies to promote coastal shipping should be improved and applied more broadly.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.51-57
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• 2018

Objectives Low back disability, along with low back pain, places a significant social burden in terms of work loss and medical expenses. Motion-Style-Acupuncture-Treatment using Traction (T-MSAT) is employed as one of the conservative treatments to such conditions. In the present study, effectiveness of Korean Medical treatments, including T-MSAT, was investigated in inpatients with low back disability and low back pain. Methods Among the patients who were admitted between January 2018 to June 2018 with disabled low back function, ones that were treated with T-MSAT were identified. Pain and function were compared at the point of admission and discharge, using Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI), respectively. Results Over the hospitalization period of 34.55 days, pain intensity significantly decreased from NRS score of 6.14 to 3.26 and low back function also significantly improved from ODI score of 50.93 to 33.73 upon receiving Korean Medical treatments including T-MSAT. Conclusions Korean Medical treatments including T-MSAT were found to be effective in inpatients with low back disability with a statistical significance. To evaluate the sole effectiveness of T-MSAT, rigorous clinical trials are necessitated in future.

• Quality Improvement in Health Care
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• v.26 no.1
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• pp.23-34
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• 2020

Purpose: This qualitative study was conducted to examine the current status and problems concerning the collection of present on admission (POA) indicators and determine how to use these indicators for evaluating the quality of care and degree of patient safety. Methods: A total of 11 health information managers were divided into two groups according to the size of their hospitals. Two focus group discussions (FGDs) were conducted, one for each group, which followed a pre-developed semi-structured guideline. The verbatim transcriptions of the FGDs were analyzed. Results: The majority of participants were concerned about entering POA flags honestly because they did not know how future POA indicators would be used. In particular, for some participants, POA N was a burden that could imply a signal of mismanagement within the medical institution. In addition, the lack of awareness and indifference of physicians regarding POA indicators were some of the difficulties for POA flag entry. Although medical institutions are making efforts to improve the accuracy of POA flagging, many participants mentioned the need to develop real case-oriented POA entry guidelines to improve the accuracy of POA flagging. Conclusion: To increase the validity of POA indicators, it is necessary to increase the level of awareness of POA indicators in physicians and other medical professionals. Furthermore, efforts related to POA indicators by individual medical institutions need to be reflected in the process evaluation.

• Journal of Science and Technology Studies
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• v.15 no.2
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• pp.229-262
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• 2015

Toxic tort cases have increased dramatically since the 1970s, as large technological systems, such as nuclear power plants and chemical factories, or mass-produced, high-tech products, had exposed citizens and consumers to dangerous substances. It was, however, difficult to establish causal connection between exposure and the alleged harms in many of the environmental, pollution, and product liability cases under the framework of tort law conception of causation and responsibility. Science and law was called upon to resolve such 'late modern' legal cases where true causes are hard to find, where no single explanatory factor is sufficient for explaining diseases like cancer. This article examines how plaintiffs in the Korean tobacco litigation mobilized such late modern tools in science and law, such as epidemiology and the allocation of the burden of proof, in the context of the global circulation of science and law. It further shows how a set of the scientific theories and legal arguments developed in order to cope with late modern risk played a central role in establishing a causation between smoking and cancer in 2011. This article suggests that STS scholars can fruitfully examine the interaction between science and law as a way to understand and engage with social and legal issues engendered by late modern risk.

• The Journal of the Korea Contents Association
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• v.21 no.9
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• pp.806-816
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• 2021

This study aims to describe the reporting patterns of articles on the Emergency Grant for all citizens(EGAC) and compare the reporting attitudes by newspaper companies. The main results are as follows: First, conservative newspapers reported more than four times as much coverage of EGAC as liberal newspapers. Newspaper articles reported during the week of the National Assembly Election Day accounted for about a quarter of the total, and 79.1% of the articles were reported in the political realm of newspapers, and only 2.8% in the social realm. Second, a conservative newspaper reported a critical attitude toward EGAC at 52.6% and favorable articles at 5.3%. On the other hand, in a liberal newspaper, critical articles were 17.1% and favorable articles were 37.1%. The inefficiency of selectivism was reported as the basis for the argument in favor, and concerns about the burden of deterioration in the financial soundness of the opponents were reported the most. Politicians are the most cited sources of information in articles. Finally, in prior to policymaking, the proportion of the media in favor of and against the news was similar, and the proportion of articles with a neutral attitude accounted for more than half. And in the specific method discussion stage, the articles in favor of the article exceeded the proportion of articles on the opposite side.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.603-613
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• 2018

Background/Aims Functional dyspepsia (FD) is one of the most common gastrointestinal disorders, and FD imposes social and economic burden worldwide. The aim of this study is to identify the prevalence and risk factors of FD in health check-up population in tertiary centers in Korea. Methods A nationwide multicenter prospective study was performed at 9 tertiary healthcare centers in Korea between September 2016 and June 2017. A total of 2525 subjects were investigated based on endoscopic findings and questionnaires with the Rome III criteria, and Helicobacter pylori serology (IgG). Results A total of 1714 subjects without organic disease were enrolled. The mean (${\pm}SD$) age was 51.5 (${\pm}12.7$) years, and 917 patients (53.5%) were female. The proportion of H. pylori seropositivity was 51.0% (874/1714). The prevalence of FD was 10.3% (176/1714), and the subtypes of postprandial distress syndrome alone, epigastric pain syndrome alone, and postprandial distress syndromeepigastric pain syndrome overlap were 4.8%, 3.0%, and 2.5%, respectively. Multivariate analysis showed that female gender (OR, 1.58; 95% CI, 1.14-2.21) and education below college level (OR, 1.45; 95% CI, 1.01-2.07) were related to FD. Multivariate analysis based on age 60 showed female gender as a significant (OR, 2.90; 95% CI, 1.06-7.94) factor in the group ${\geq}60$ years. Conclusions The prevalence of FD was 10.3% in the health check-up population in Korea. Female sex and education below college level were risk factors for FD. Female sex is a risk factor for FD in old age, underscoring the need for close attention in this age group.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.370-379
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• 2018

This study was conducted 1) to investigate the effects of treatment and other factors on the quality of life of thyroid cancer surgical patients and 2) to provide fundamental data for development of an intervention and symptom management program to improve the quality of life of those patients. A total of 76 patients who were diagnosed with thyroid cancer and underwent thyroidectomy from July 2013 to December 2014 participated in this study. To investigate the factors affecting quality of life, a t-test and ANOVA analyses were conducted, after which multiple regression analysis was performed. The results were statistically significant between preoperative and one month after surgery of sex, cancer history, fatigue, and quality of life until 3 months after surgery of stage, cancer history, anxiety, and pain. Multiple regression analysis showed that the most influential factors affecting the quality of life were depression and fatigue at one month prior to and after surgery and anxiety at three months after surgery, while no factors were found to be influential at six months after surgery. Overall, the results of this study suggested that it is imperative to manage depression and fatigue one month prior to and after surgery to reduce the physical and psychological pain experienced by thyroid cancer patients. Moreover, three months after the surgery, anxiety should be closely monitored and controlled to improve the quality of life of the patients. This approach is expected to reduce the burden on the health care system and social costs, which will positively affect public health.