• Journal of Korean society of Dental Hygiene
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• v.6 no.3
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• pp.243-261
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• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.11-19
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• 2014

Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

• Journal of Korean Society on Water Environment
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• v.27 no.2
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• pp.200-209
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• 2011

The purpose of the study is to optimally manage sewage treatment plant with analysis of phosphorus contribution and improvement of water quality contributing rate in the effect of inflowing point of effluent and Pal-Dang lake after reducing T-P discharge from large scale public sewage treatment plant at upstream of Pal-Dang lake. Also, this study, for enforcement of T-P in effluent, plans optimal management of effluent T-P through examining propriety of environmental, technological, and economical aspect such as water quality standard of domestic and foreign T-P and related policy. In regarding optimal management of T-P discharged from public sewage treatment plant located in upstream of Pal-Dang lake, the study drew following conclusions. With the optimal management of public sewage treatment plant, it showed that a pollution level became higher in the order of Sumgang E in South-Han river, C in Dalcheon, B1 B2, A in North-Han river, and J in Kyungancheon, and it is required reduction of T-P first. The highest value in analysis of benefit-costs from sewage treatment plant in the selected research area was Kyungan B, and the others are with the order of Jojong A, Bokha A, Kyungan A, and Yanghwa A. With result of this study, all 14 areas are required more enforced phosphorus treatment. The study resulted that the most top priority areas were Hangang F, Sumgang B, and Gyungan A, top priority areas were Bokha A, Dalcheon B, and Cheongmi A, priority areas were Hangang E, Heukcheon A, Gyungan B, and Jojong A, and potential areas were Sumgang A, Yanghwa A, Dalcheon A, and Hangang D. It seems to be appropriate to apply 0.2 mg/L of T-P treatment for water supply source reservation, 0.5 mg/L for the other areas by locally, and 0.2~0.5 mg/L for biological nitrogen phosphorus treatment method and 0.5~1 mg/L for Conventional Activated Sludge by technologically. Also, it may be appropriate to apply 0.2 mg/L for the most top priority area(I), 0.3 mg/L for the top priority area(II), 0.4 mg/L for priority area(III), and 0.5 mg/L for potential area(IV) by the separation of priority area.

• The korean journal of orthodontics
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• v.23 no.1 s.40
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• pp.17-35
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• 1993

We tried to evaluate frequencies and severities of malocclusion of various socioeconomic areas according to growth and development. To obtain objective validity, we used Handicapping Labiolingual Deviation (HLD) suggested by Draker, Treatment Priority Index (TPI) by Grainger, Handicapped Malocclusion Assessing Record (HMAR) by American Dental Association and American Association of Orthodontist. Seoul and Kwangju were selected as an urban group, Ahnyang as an middle socioeconomic group and Hwasun near the Kwangju area as an rural group. 140 (male 63, female 73) of 5th grade in 'E' elementary school students in Seoul, 202 (male 101, female 101) of 'S' elementary school students in Kwangju, 207(male 105, female 102) of 'H' elementary school students in Hwasun, and 100(male 49, female 51) of 'M' elementary school students of in Ahnyang of all the same grade were analyzed and we obtained the results as follows; 1. TPI, HLD, and HMAR showed high coincidence and reproducibility between different observer. (p<0.01) 2. In comparison of TPI, HLD, and HMAR according to clinical decision, there was statistically difference between each other. (p<0.01) 3. As the severity of malocclusion increases there was high correlation between TPI and HLD, and between HLD and HMAR (p<0.05) 4. With respect to differences between areas in TPI and HLD, there was statistically difference between Ahnyang and other areas. 5. In Seoul as an urban group there was a high incidence of periodic checkup and history of orthodontic treatment than other area. 6. Mode of feeding and posture during sleeping did not affect the severity of malocclusion. As a conclusion, TPI, HLD and HMAR are so reproducible and coincident that they can be used as a guide on evaluating the frequency and severity of malocclusion and determining the priority of orthodontic treatment to determine the need and supply of orthodontic treatment. Furthermore these indices can provide objectively valid data for establishing public health problem solution.

• Journal of Korean Society of Water and Wastewater
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• v.29 no.4
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• pp.503-510
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• 2015

The objective of this study is to analyze the investment adequacy of the projects implemented according to the master plan on sewerage rehabilitation at Seoul. The planned and actually implemented ratio of invested money on sewage treatment plants (STPs) to sewers were compared in two temporal periods. Though the planned ratio of investment on STPs to sewers was 50:50 (in 2009-2020), the actual implemented ratio in 2009-2013 was 34:66. Until 2020, the greater investment ratio on STPs to sewers should be made considering the necessity of coping with stricter legal compliance on advanced treatment, stormwater treatment and so on. The priority of the planned and partially implemented projects among four STPs and at each STP was evaluated. Considering only the performance indicator of reduced load of BOD, T-N, T-P per the capacity of each STP facility, the performance among four STPs was shown as Jung-Rang>Tan-Cheon>Seo-Nam>Nan-Ji. The reverse order of the performance results in the past may be considered for future investment priority, but the efficiency of operation implemented at each STP, deteriorated status of each STP, investment in the past and so forth should also be considered. As for the priority of projects conducted within each STP, projects related to legal compliance (such as advanced tertiary treatment, stormwater treatment, etc.) have highest priority. Odor-related project and inhabitant-friendly facility related projects (such as building park on STPs, etc.) has lower priority than water quality related projects but interactivity with end-users of sewerage should also be important.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.69-90
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• 2021

Purpose : This study explores unmet medical services within a region for patients admitted to a single medical institution in one region and was to analyze the importance and satisfaction of hospital selection attributes. Through this, we tried to solve the unmet medical needs of patients and provide useful basic data in terms of hospital management in the region. Methods : It were collected to a total of 250 questionnaires for patients admitted to the regional integrative medical hospital. However, 232 samples were used for the final analysis, excluding 18 copies not reported in good faith. For the analysis, first, demographic frequency analysis of inpatients and inpatients was performed, and second, characteristics of patients, including frequent disease receiving treatment, were analyzed. Next, descriptive statistics analysis was conducted on unmet medical service intentions. In terms of hospital selection attribute, the items of continuity maintenance (I quadrant), priority visibility (II quadrant), low priority (III quadrant), and excessive effort (IV quadrant) were derived using the IPA (importance-performance analysis) matrix technique. Results : The derived results were classified by item and area. In the priority administration area, it was the reputation and recognition of medical institutions and the service area of medical institutions. In the case of items, there were 6 items including the importance of surgery and medical expenses, and diet at hospitalization. 1) Conclusion : Thus a result of this study, resources are efficiently allocated to priority correction areas with high importance but low satisfaction and circulatory medical treatment is performed in the departments required by patients who use medical care and, various methods, such as preparing a policy to support medical expenses, should be sought.

• Health Policy and Management
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• v.16 no.1
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• pp.73-94
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• 2006

This study was carried out to show how the Analytic Hierarchy Process technique could be used in setting the priority among selected diseases to increase the range of health insurance benefit. Thirty experts, including doctors (group1), experts for preventive medicine or public health(group2), and representatives of the insured(group 3), participated in the study panel that is conducted for priority setting. They were asked to evaluate the priorities among 6 selected criteria and then 42 selected diseases. The results were as follows; First, representatives of the insured think that the magnitude of out-of-pocket payment should have high priority while doctors think that effectiveness of treatment should have high priority. Second, all experts think that catastrophic diseases such as malignant neoplasm, major heart disease, and cerebral vascular disease should have high priority in health insurance coverage even though there is little difference among groups. These results can be useful to establish a systematic strategy for expanding health insurance benefit package.

• Journal of Korean society of Dental Hygiene
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• v.4 no.2
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• pp.237-253
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• 2004

This study was to find a patient's motive for receiving implant treatment by age and gender using a self-reporting questionnaire survey with adults(men & women) in Woolsan. The result was as follows: 1. As a result of questionnaire survey with 155 patients in total(86 men, 69 women), 24 of 86 men(27.9%) valued the natural mastication feature of dental implant most, that is as similar as natural teeth, while 18 of 69 women(26.1%) had the most priority over the longer life of implant than common dental prostheses. By age, those in their 20s and 30s had a preference to implant treatment because it does not need to pulling out teeth for prostheses, while those in their 40s and over had a priority to the natural mastication feature of implant that is similar as much as natural teeth. By dental treatment, all of respondents said that the natural mastication feature is the most important in getting dental implant. It was founded that whether one can taste food as it is or not is less important, regardless of age or gender. 2. The greatest obstacle to implant surgery was expensive medical fees, 88 of 155 respondents(56.8%), with a fear of surgery itself being the least obstacle. 3. 90.2% of the total respondents said that they will want to receive dental implant treatment if their economy allow.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.20-26
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• 2016

Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.160-162
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• 2005

Dead oscars (Astronotus ocellatus) were presented for necropsy in January, 2005. Oscars, which had been reared densely, were dead in large quantities. At necropsy, they were severely infected by Dactylogyrus spp. We requested for the oscar samples which had been raised in the same water tank. Two of them were sacrificed and necropsied. At the microscopic examination, we verified dactylogyrosis of oscars. The other oscars were treated by praziquantel. Treatment was started with a dosage of 2.5 mg/L. From a second day, we treated 5.0 mg/L every two days during 4 days. At sixth day, No Dactylogyrus flukes were found but only larvae were existed. After 2 weeks without additional medication, both Dactylogyrus flukes and larvae were eliminated.