• Title/Summary/Keyword: claims analysis

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The Effects of Aronia Extract on Body Weight and Body Fat: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial (체지방에 대한 아로니아 추출물의 효과: 무작위배정, 이중눈가림, 위약-대조 임상연구)

  • Ha, Ki Chan;Park, Yu Kyung;Baek, Hyang Im;Kim, Hye Mi;Kim, Young Mi;Jeong, Da Young;Shin, Sang Wook;Bae, Jung Shik;An, Ji Hye;Jeon, Yeon Jeong;Park, Ji Eun;Kwon, Young Dal
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.1
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    • pp.105-113
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    • 2020
  • Objectives Excess weight and obesity are a crucial public health problem worldwide and are considered as the main cause of many chronic diseases. The present study evaluated the effects of Aronia melanocarpa extract (AMEX) supplementation on body compositions in overweight or obese people. Methods This randomized, double-blind, placebo-controlled clinical trial was carried out on 66 healthy overweight or obese peoples. The eligible subjects were divided into AMEX and placebo supplement treatment for 12 weeks. Anthropometrics, body composition (dual-energy X-ray absorptiometry), and blood analysis were performed preand post intervention. Results We observed significant reductions in the body weight and body mass index in both groups; however, the decrease was higher in the AMEX group. Body fat mass and percent body fat showed a tendency to decreases after AMEX supplementation. No clinically significant changes were observed for any safety parameter. Conclusions In conclusion, the data of this trial indicate that AMEX were not effective in reducing body compositions, but as a safe supplement, it may help weight loss in overweight or obese people.

Using Workers' Compensation Claims Data to Describe Nonfatal Injuries among Workers in Alaska

  • Lucas, Devin L.;Lee, Jennifer R.;Moller, Kyle M.;O'Connor, Mary B.;Syron, Laura N.;Watson, Joanna R.
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.165-172
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    • 2020
  • Background: To gain a better understanding of nonfatal injuries in Alaska, underutilized data sources such as workers' compensation claims must be analyzed. The purpose of the current study was to utilize workers' compensation claims data to estimate the risk of nonfatal, work-related injuries among occupations in Alaska, characterize injury patterns, and prioritize future research. Methods: A dataset with information on all submitted claims during 2014-2015 was provided for analysis. Claims were manually reviewed and coded. For inclusion in this study, claims had to represent incidents that resulted in a nonfatal acute traumatic injury, occurred in Alaska during 2014-2015, and were approved for compensation. Results: Construction workers had the highest number of injuries (2,220), but a rate lower than the overall rate (34 per 1,000 construction workers, compared to 40 per 1,000 workers overall). Fire fighters had the highest rate of injuries on the job, with 162 injuries per 1,000 workers, followed by law enforcement officers with 121 injuries per 1,000 workers. The most common types of injuries across all occupations were sprains/strains/tears, contusions, and lacerations. Conclusion: The successful use of Alaska workers' compensation data demonstrates that the information provided in the claims dataset is meaningful for epidemiologic research. The predominance of sprains, strains, and tears among all occupations in Alaska indicates that ergonomic interventions to prevent overexertion are needed. These findings will be used to promote and guide future injury prevention research and interventions.

Analysis of Outpatient Claim Trends and Utilization According to Health Coverage for Chuna Manual Therapy (추나 요법 건강보험 급여화에 따른 외래 청구 현황 및 의료이용 분석)

  • JaeYong Dong;JinHan Ju;SangHeon Yoon
    • Korea Journal of Hospital Management
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    • v.28 no.3
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    • pp.47-57
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    • 2023
  • Purpose: Health expenditure and utilization of Korean medicine are increasing every year. Since Chuna Manual Therapy was covered by National Health Insurance in 2019, it is predicted that the usage of Chuna Manual Therapy would be also increasing. However, there are few studies about Chuna Manual Therapy using Korean National Health Insurance claims database. Therefore, we will investigate the utilization trend of outpatient's Chuna Manual Therapy using Korean National Health Insurance database and suggest political implications. Methodology: The Korean National Health Insurance claims database was used to identify outpatient's Chuna Manual Therapy usage spanning 4 years from 2019-2023 and the number of Chuna Manual Therapy claims were approximately 18.61 million. Findings: The number of Chuna Manual Therapy claims and patients, health expenditure of Chuna Manual Therapy have been increasing spanning 4 years among over 65 aged. In the case of female patients, the number of Chuna Manual Therapy claims was more than male patients and health spending related to Chuna Manual Therapy was also higher than male patients. Most patients visited Korean medicine clinics due to musculoskeletal diseases, and most claims were from rural regions. Practical Implication: Since Chuna Manual Therapy was covered by National Health Insurance in 2019, Utilization of Chuna Manual Therapy has been increased overall. In particular, Chuna Manual Therapy is mostly implemented in the elderly, Korean medicine clinics, and local areas, thus policy managers will need to consider this.

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Impact of Risk Adjustment with Insurance Claims Data on Cesarean Delivery Rates of Healthcare Organizations in Korea (건강보험 청구명세서 자료를 이용한 제왕절개 분만율 위험도 보정의 효과)

  • Lee, Sang-Il;Seo, Kyung;Do, Young-Mi;Lee, Kwang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.2
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    • pp.132-140
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    • 2005
  • Objectives: To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. Methods: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. Results: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final risk-adjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test ($x^2$=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow $x^2$. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. Conclusion: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.

Herbal medicine prescription analyses of bronchiectasis patients with claim data during 5 years (2013~2017) (최근 5개년 (2013~2017)간 기관지확장증(J47) 환자에게 처방한 급여한약제제 현황 분석 - 건강보험청구자료 중심으로)

  • Kang, Sohyeon;Kim, Jinhee;Jang, Soobin;Lee, Mee-Young;Lee, Ju Ah;Park, Sunju
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.3
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    • pp.1-12
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    • 2019
  • Objectives : Korean national health insurance data is a useful real-world data representing whole medical bills submitted to Health Insurance Review Agency. This study aims to understand recent benefit trend of insurance herbal preparations for treating bronchiectasis(disease code J47) utilizing insurance data. Methods : We reviewed national health insurance claims data from 2013 to 2017 which have main diagnosis or sub diagnosis code of J47 and with the record of prescribing insurance herbal medication. Frequency analysis was performed to analyze the most frequently prescribed prescription. Results & Conclusions : Both the number of claims statement(770 to 1,746cases) and patients(266 to 484) of insurance herbal preparations increased considerably from 2013 to 2017. Top 10 preparations based on the number of claims statement were 'Samso-eum', 'Yeonkyopaedok-san', 'Socheongryong-tang', 'Bojungikgi-tang', 'Hyangsapyungwi-san', 'Yijin-tang', 'Saengmaek-san', 'Jaeumganghwa-tang', 'Ojeok-san' and 'Gungha-tang'. Top 10 preparations based on the number of patients were 'Samso-eum', 'Socheongryong-Tang', 'Saengmaek-san', 'Yeonkyopaedok-san', 'Haengso-tang', 'Hyangsapyungwi-san', Yijin-tang', 'Jaeumganghwa-tang', 'Bojungikgi-tang' and 'Hyeonggaeyeongyo-tang' in respectiv order. Claims of top 10 frequent preparations occupied more than 60% of total claims. We hope this finding to be utilized as basic data for future research of evidence-based bronchiectasis treatment utilizing Korean traditional medicine.

A Study on Nutrition Composition Labeling and Nutrition Claim Practices for the Processed Foods (시판 가공식품의 영양성분 및 영양강조 표시 실태에 대한 연구)

  • 오세인;장영애
    • Korean journal of food and cookery science
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    • v.20 no.1
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    • pp.100-111
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    • 2004
  • The purpose of this study was to investigate the status of current nutrition labeling on the packaging of the processed foods that provide consumers with a reliable and consistent source of information, which has been considered as a useful aid for food selection and a potent educational tool for nutrition in daily life. The 2,160 processed foods purchased at the supermarket on September, 2002, were divided by food category issued from the 2002 food codes and assessed in the terms of the nutrition composition labeling and nutrition claims. Nutrition composition labeling was found on 356 of the 2160 processed foods items. Milk and dairy products had 49.7% of nutrition composition labeling, which was the largest number among the food category. Tables were most frequently used as the type of nutrition composition labeling (79.8%). Nutrition composition including many different ways of expression, such as a table of nutrition composition, indication of nutrition composition, analysis table of nutrition composition and comparative table of nutrition composition, made frequent use of nutrition composition labeling titles (78.7%). The various unit of measures were use in the nutrition labeling of the processed foods, per l00g or 100$m\ell$ was the highest (44.6%) under the currently practiced nutrition labeling. The correct labeling standard with nutrient content and % RDA except energy, was used on 47.8% of labels, and those with only liability indication nutrient and liability indication nutrients plus discretion indication nutrients were 25.3 and 22.5% respectively. The processed foods with nutrition claims were 8.0% (172 items). Nutrition claims were divided in two ways: nutrient content claims and nutrient comparative claims. The most frequently used claims were contained in the former (44.4%) and more or plus in the latter case (16.3%). Ca was the most popular item as a nutrition claim nutrient (50.6%).

Strategy about Support System for Victims of Fire Cases through the Analysis of A Fire Cases (화재사례분석을 통한 화재피해자 지원체계 구축방안)

  • Cha, Jong-Ho
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.41 no.4
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    • pp.196-202
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    • 2018
  • There have been more than 40,000 cases of fires in Korea in the last three years. However, as 'Accidental Fire Liability Act' was judged to be non-conform to the Constitution in 2007, the damages by light mistakes should be compensated. Accordingly, disputes such as compensation claims, litigations and indemnification cases of the victims of fire increased. However, it is so difficult for victims of fire cases to take proper action. So, this study is to help victims of fire cases in the disputes and compensation claims of the victims, and to find actual and practical support system based on the analysis of compensation status. To help victims of fire cases, we need to survey about victims of fire cases with multiple victims. That survey is analyzed to find support plan for victims. Furthermore, to find support plan the current law is needed to be analyzed and reviewed to revision. It is also tried to identify problems in the operation of the Center for victims of Fire currently operated by fire stations and to find countermeasures. In addition, the status of subscription and problem of fire insurance for the compensation for the victims and the method to increase fire insurance subscription rate will be studied.

Challenging a Single-Factor Analysis of Case Drop in Korean

  • Chung, Eun Seon
    • Language and Information
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    • v.19 no.1
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    • pp.1-18
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    • 2015
  • Korean marks case for subjects and objects, but it is well known that case-markers can be dropped in certain contexts. Kwon and Zribi-Hertz (2008) establishes the phenomenon of Korean case drop on a single factor of f(ocus)-structure visibility and claims that both subject and object case drop can fall under a single linguistic generalization of information structure. However, the supporting data is not empirically substantiated and the tenability of the f-structure analysis is still under question. In this paper, an experiment was conducted to show that the specific claims of Kwon and Zribi-Hertz's analysis that places exclusive importance on information structure cannot be adequately supported by empirical evidence. In addition, the present study examines H. Lee's (2006a, 2006c) multi-factor analysis of object case drop and investigates whether this approach can subsume both subject and object case drop under a unified analysis. The present findings indicate that the multi-factor analysis that involves the interaction of independent factors (Focus, Animacy, and Definiteness) is also compatible with subject case drop, and that judgments on case drop are not categorical but form gradient statistical preferences.

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A Study on the Available Countermeasures through a Practical Analysis of China involving Trade Claims (중국 클레임 실태분석을 통한 대응방안에 관한 연구)

  • Kim, Kyung-Bae;Choi, Hyuk-Jun
    • Journal of Arbitration Studies
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    • v.17 no.1
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    • pp.137-155
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    • 2007
  • Since China joined the WTO, the trade between Korea and China has continued to grow by leaps and bounds, making both nations become mutually important trading partners to each other. The volume of trades with China showed a rapid upward trend with an average annual increase rate of 20% and the resultant dispute is also rising. Thus, this study was aimed to make some suggestions and come up with ways of responding claims by surveying Korean trading firms which have experience in making transactions with China to investigate the current status and the actual condition of their occurrence. As a result of this study, firstly, the main cause of such dispute was shown to be the failure to perform the agreement. Secondly, there were malty verbal agreements and due to a deterioration of trust in Chinese firms, the method of a letter of credit was adopted by many Korean firms. Thirdly, the payment and credit appeared to be most important in transactions with China. A credit inquiry is a must in future transactions with China. Fourthly, the indirect cause of the occurrence of trade claims was the difference in commercial practices and as for the way of settling disputes, the agreement through negotiations between the parties involved was the most. Fifthly, small and medium firms should make more of their credit and English proficiency than large ones do.

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Main Trends for Reforming the Law of Insurance Contract in England - Focused on the Insured's Post-Contract Duty of Good Faith in relation to Claims - (영국 보험계약법의 주요 개혁동향 - 보험금청구와 관련한 피보험자의 계약체결 후 선의의무를 중심으로 -)

  • Shin, Gun-Hoon
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.53
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    • pp.207-229
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    • 2012
  • In IP 7 and LCCP 201, Law Commission considers the insured's duty of good faith after the formation of the contract. This article intends to review and analyse the legal implications of proposals in IP 7 and LCCP 201. The results of analysis are following. First, Law Commission propose to end the remedy of avoidance under MIA 1906 section 17, because avoidance of past claims is unprincipled, impractical and unnecessarily harsh. Secondly, LC proposes that an insured who makes a fraudulent claim should forfeit the whole claim which the fraud relates, but that the fraud should not invalidate previous and legitimate claims. Thirdly, LC proposes to introduce a statutory right for the insurer to claim damages for the reasonable, foreseeable costs of investigate a fraudulent claim in specific circumstances and that damages would be limited to those cases where the insurer can show an actual, net loss. Finally, LC provisionally propose that an express fraud clause should be upheld in business insurance, whereas in consumer insurance, any term which purports to give the insurer greater rights in relation to fraudulent claims that those set out in statute would be of no effect.

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