• 제목/요약/키워드: claims analysis

검색결과 448건 처리시간 0.025초

건강 보험 청구 자료를 이용한 COPD 환자에서 치료제 처방 변화 분석: 흡입제를 중심으로 (Analysis of Treatment Pattern in COPD Patients Using Health Insurance Claims Data: Focusing on Inhaled Medications)

  • 임하나;박미혜
    • 한국임상약학회지
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    • 제32권3호
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    • pp.155-165
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    • 2022
  • Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

Covid-19 Occupational Risk Incidence and Working Sectors Involved During the Pandemic in Italy

  • Fabio Boccuni;Bruna M. Rondinone;Giuliana Buresti;Adelina Brusco;Andrea Bucciarelli;Silvia D'Amario;Benedetta Persechino;Sergio Iavicoli;Alessandro Marinaccio
    • Safety and Health at Work
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    • 제14권4호
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    • pp.398-405
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    • 2023
  • Background: Starting from March 2020 until December 2021, different phases of Covid-19 pandemic have been identified in Italy, with several containing/lifting measures progressively enforced by the National government. In the present study, we investigate the change in occupational risk during the subsequent pandemic phases and we propose an estimate of the incidence of the cases by economic sector, based on the analysis of insurance claims for compensation for Covid-19. Methods: Covid-19 epidemiological data available for the general population and injury claims of workers covered by the Italian public insurance system in 2020-2021 were analyzed. Monthly Incidence Rate of Covid-19 compensation claims per 100,000 workers (MIRw) was calculated by the economic sector and compared with the same indicator for general population in different pandemic periods. Results: The distribution of Covid-19 MIRw by sector significantly changed during the pandemic related to both the strength of different waves and the mitigation/lifting strategies enforced. The level of occupational fraction was very high at the beginning phase of the pandemic, decreasing to 5% at the end of 2021. Healthcare and related services were continuously hit but the incidence was significantly decreasing in 2021 in all sectors, except for postal and courier activities in transportation and storage enterprises. Conclusion: The analysis of compensation claim data allowed to identify time trends for infection risk in different working sectors. The claim rates were highest for human health and social work activities but the distribution of risk among sectors was clearly influenced by the different stages of the pandemic.

A Study on Error Analysis & Hedging Expressions of Medical Research Abstracts

  • 이은표
    • 영어어문교육
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    • 제13권1호
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    • pp.47-66
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    • 2007
  • Error analysis plays an important role because understanding the types of errors can give a better opportunity for both teachers and learners to recognize the nature of errors and ways of preventing them. This study looks into errors in the medical research abstracts written by 26 Koreans and also examines hedging expressions since hedging can be a necessary tactic in which the validity and objectivity of their claims is conveyed. The hedging expressions of these research abstracts are to be compared with those of Hyland (1996)'s study done on ENL academic writers of cell and molecular biology. The results of the study reveal that wrong word choice was the most commonly occurred errors, followed by prepositions, articles, adding and missing words. Many of these errors, except articles, seemed to derive from the native language interference. There were also run-on sentences, subject & verb agreement, tense, word order and minor errors. As for hedging, ESL medical writers seemed to use very limited hedging expressions and inappropriately strong modals. It is recommended to take variations of hedges using epistemic adverbials and adjectives to present their claims in a more valid and polite way. Limited verb choice was also noted. As for preventing or minimizing similar future errors, collocation practices in ESP focused on commonly used medical related words and expressions can be effective.

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판례분석을 통한 한의사의 설명의무에 관한 법학적 고찰 (Legal Study on the Explanatory Duty for Medical Practice in Korean Medicine by Judicial Precedent Analysis)

  • 이미선;김건형;양기영
    • Journal of Acupuncture Research
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    • 제29권4호
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    • pp.71-79
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    • 2012
  • Objectives : The purpose of this study is to set the explanatory duty on traditional Korean medical(TKM) treatment by analyzing the judicial precedents. Methods : The study was performed by analyzing nine cases of lawsuits related to Korean medicine doctor and explanatory duty among the medical dispute cases in Korea from 1968 through 2012. Results : Nine closed claims occurred regarding the violation of explanatory duties in the field of TKM practice. Two claims were decided by supreme court, three were decided by high court, and four were decided by district court. The causes of lawsuits were categorized as follows : bee venom pharmacopuncture, herb treatment, and an explanation for safety. Conclusions : To perform an explanatory duty has important legal implications for the protection of patients' rights and Korean Medicine doctors' autonomy on TKM treatment.

An Estimation of Loss Ratio Based on Empirical Bayes Credibility

  • Lee, Kang Sup;Lee, Hee Chun
    • Communications for Statistical Applications and Methods
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    • 제9권2호
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    • pp.381-388
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    • 2002
  • It has been pointed out that the classical credibility model used in Korea since the beginning of 1990's lacks in objectiveness. Recently, in order to improve objectiveness, the empirical Bayes credibility model utilizing general exposure units like the number of claims and premium has been employed, but that model itself is not quite applicable in the country like Korea whose annual and classified empirical data are not well accumulated and even varied severely. In this article, we propose a new and better model, Based on the new model, we estimate both credibility and loss ratio of each class for fire insurance plans by Korean insurance companies. As a conclusion, we empirically make sure analysis that the number of claims is a more reasonable exposure unit than premium.

작업여유시간의 가치 정량화 방법론 (Quantifying the Value of Floats)

  • 박영준;이동은
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2015년도 춘계 학술논문 발표대회
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    • pp.123-124
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    • 2015
  • The project participants make use of floats for their benefits. The owner may consume floats in an event of issuing change order(s) and may avoid the risk factors attributed by them; the contractor may reduce activities' costs by substituting the activity with alternative construction method and by leveling the resources, hence consuming floats. There are a lot of disputes and claims involved in the float ownership issue. The ownership of floats should be stipulated in the contract stage. To alleviate these disputes and claims, it is commendable to develop a computational method that quantifies the float value. This paper presents the method that computes the values of total floats which changes over the project life span. The system calculates CPM, compute the ratio of area of banana curve which is enclosed by earliest start curve and latest start-curve.

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Analysis of Marginal Count Failure Data by using Covariates

  • Karim, Md.Rezaul;Suzuki, Kazuyuki
    • International Journal of Reliability and Applications
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    • 제4권2호
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    • pp.79-95
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    • 2003
  • Manufacturers collect and analyze field reliability data to enhance the quality and reliability of their products and to improve customer satisfaction. To reduce the data collecting and maintenance costs, the amount of data maintained for evaluating product quality and reliability should be minimized. With this in mind, some industrial companies assemble warranty databases by gathering data from different sources for a particular time period. This “marginal count failure data” does not provide (i) the number of failures by when the product entered service, (ii) the number of failures by product age, or (iii) information about the effects of the operating season or environment. This article describes a method for estimating age-based claim rates from marginal count failure data. It uses covariates to identify variations in claims relative to variables such as manufacturing characteristics, time of manufacture, operating season or environment. A Poisson model is presented, and the method is illustrated using warranty claims data for two electrical products.

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Adjunct Roles and External Predication

  • Kim,Yong-Beom
    • 한국언어정보학회지:언어와정보
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    • 제2권1호
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    • pp.157-176
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    • 1998
  • This paper claims that beneficiary adjuncts are best analyzed as involving external predication in a version of grammatical framework called Head-driven Phrase Structure Grammar. This paper also claims that verbal catefories need to include the attribute INDEX among their semantic components in order to account for the external predication proposed in this paper. This paper distinguishes between recipient and beneficiary reles and assumes that the former is a semantic argument of a verb-type relation and that the latter is an adjunct which makes a semantic contribution as a modifier. This approach achives a unified analysis of modification phenomena of nominal and verbal categories and it can also accomodate Parson's(1990) idea that a verbal category denotes a set of events, not just an event.

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보험환자의 의료이용 추구경로 (Pathway of Medical Care Seeking of Insured Patients)

  • 한달선;김병익;이영조;권순호
    • 보건행정학회지
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    • 제2권1호
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    • pp.115-147
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    • 1992
  • The purposes of this paper are twofold : to identify what pathway insured patients are seeking medical care services through, and then, to provide the basis for the prediction and evaluation of the effects of a new policy intervention. To change the patient flow across different types of medical care facilities, this intervention has been enforced since July 1, 1989. It is mainly aimed at discouraging the use of the tertiary hospitals by imposing some restrictions on the patient's choice. The data for analysis were obtained from the claims to the insurance for govermment and school employees. The sample was drawn from the claims for about 1% of the enrollees using medical care facilities during 2 years since January 1, 1985. The sample included 91, 483 for 1985 and 81,914 for 1986, among them the number of patients to initiate the use of medical care service were 66,757 and 59,498 respectively. This paper analysed what types of and how many medical care facilities the patient with same disease had used.

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