• Health Policy and Management
• /
• v.29 no.4
• /
• pp.513-522
• /
• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.

• Journal of The Korean Association For Science Education
• /
• v.35 no.5
• /
• pp.919-929
• /
• 2015

This study aims to develop a modeling-based learning program about geologic structures and to reveal the relationship between the argumentation patterns and levels of students' mental models. Participants included 126 second grade high school students in four sessions of modeling-based learning regarding continental drift, oceanic ridges, transform faults, and characteristics of faults. A modeling-based learning program was implemented in two classes of the experimental group, and teacher-centered traditional classes were carried out for the other students in the comparison group. Science achievement scores and the distribution of students' mental models in experimental and comparison groups were quantitatively compared. The video-taped transcripts of five teams' argumentation were qualitatively analyzed based on the analytic framework developed in the study. The analytic framework for coding students' argumentation in the modeling-based learning was composed of five components of TAP and the corresponding components containing alternative concepts. The results suggest that the frequencies of causal two-dimensional model and cubic model were high in the experimental group, while the frequencies of simple two-dimensional model and simple cross sectional model were high in the comparison group. The higher the frequency of claims, an argumentation pattern was proven successful, and the level of mental model was higher. After the rebuttal was suggested, students observed the model again and claimed again according to new data. Therefore, the model could be confirmed as having a positive impact on students' argumentation process.

• Journal of Digital Convergence
• /
• v.14 no.6
• /
• pp.325-333
• /
• 2016

This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

• Journal of dental hygiene science
• /
• v.5 no.1
• /
• pp.7-12
• /
• 2005

This study was conducted to compare and analyze 877 cases of health insurance claims from the first half of 1999 requested to the dental centers of local health centers in rural areas and 510 identical cases from the first half of 2003. It was purposed to understand the trend of rural residents' visits to local health centers and to use the collected data as the basis needed for the vitalization of local dental cares to efficiently improve Korean citizens' dental hygiene. The results were shown as below: 1. The sexes of the visitors were fairly evenly distributed for each year. 2. Among the total of 39 types of diseases treated, 1999 had 31.9% of visits for 'Gingivitis and periodontal diseases' with 25.4% from ages between 10 and 19, for statistically attentive results. On the other hand, 2003 had 46.5% of visits for 'Oral examination' with 52.9% from ages between 0 and 9, for statistically attentive results. 3. For the distribution of age groups, majority in 1999 made visits for dental caries, gingivitis and periodontal disease, whereas majority in 2003 were for oral examination, dental caries, gingivitis and periodontal disease.

• Environmental and Resource Economics Review
• /
• v.14 no.3
• /
• pp.699-728
• /
• 2005

This article is basically an extension of Barten(1993), Brown et al. (1995), Holt and Bishop's(2002) price formation system. A new dynamic price formation system is attempted considering full rationality of the consumers' side. The underlying idea of the new dynamic price formation system is that consumers are rational and farsighted and thus consider past and future consumptions in addition to current consumption to accept the prices traders called. In an empirical application, the U.S. commercial fish demand data are particularly interesting to this analysis in which the species are over fished, including many of the most valuable species. Especially, the grouper-snapper complex are under management jurisdiction of the National Marine Fisheries Council. In the empirical section, it shows how to adapt the model to estimate the marginal values to consumers of commercial fisheries. Since it is conceived of regulations as inducing movements along the marginal value curves, it is of growing importance to regional and national policy makers who are confronted with competing claims on diminishing fish stocks by commercial fisheries interests. It performs well and shows the plausible signs and magnitudes of price flexibilities and interaction among species. It further contributes to the general methodology of applied economics.

• Journal of Preventive Medicine and Public Health
• /
• v.27 no.3 s.47
• /
• pp.609-626
• /
• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• School Mathematics
• /
• v.19 no.4
• /
• pp.751-774
• /
• 2017

Having mathematics for everyone in terms of students' mathematics achievement and attitudes toward mathematics is challenging in high school in South Korea. To gain such purpose, teachers are supposed to have a considerable amount of knowledge and develop mathematical and pedagogical reasoning and insight because equity can be fulfilled in mathematics classroom when any student share their ideas and have mathematical discussions. As a part of a large project aimed to develop and enact professional development for equity and examine its effects and, finally, to propose the direction of professional development to help students cognitively and affectively balanced grow in mathematics, the current study briefly introduces how such professional development was designed and implemented. This study reports its effect based on the statistical analysis of students' responses for the three different surveys, which are parts of the National Assessment of Educational Achievement study, TIMSS Advanced, and the survey about classroom interaction. The data collected in all students in school whose three mathematics teachers had participated in the professional development for two years. The findings consistently indicate the strong and impressive growths in students' attitudes toward mathematics, which are statistically significant. Furthermore, their attitudes toward mathematics are also related to interactions in a mathematics classroom. Based on such results, this study claims expansion of professional development for equity.

• Journal of Preventive Medicine and Public Health
• /
• v.34 no.4
• /
• pp.337-346
• /
• 2001

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

• Journal of Korea Trade
• /
• v.25 no.2
• /
• pp.152-177
• /
• 2021

Purpose - This study analyses the excepted requirement and burden of proof of the carrier due to unseaworthiness through comparison between the marine transport contract and marine insurance contract. Design/methodology - This study uses the legal analytical normative approach. The juridical approach involves reviewing and examining theories, concepts, legal doctrines and legislation that are related to the problems. In this study a literature analysis using academic literature and internet data is conducted. Findings - The burden of proof in case of seaworthiness should be based on presumed fault, not proved fault. The burden of proving unseaworthiness/seaworthiness should shift to the carrier, and should be exercised before seeking the protections of the law or carriage contract. In other words, the insurer cannot escape coverage for unfitness of a vessel which arises while the vessel is at sea, which the assured could not have prevented in the exercise of due diligence. The insurer bears the burden of proving unseaworthiness. The warranty of seaworthiness is implied in hull, but not protection and indemnity policies. The 2015 Act repeals ss. 33(3) and 34 of MIA 1906. Otherwise the provisions of the MIA 1906 remain in force, including the definition of a promissory warranty and the recognition of implied warranties. There is less clarity about the position when the source of the loss occurs before the breach of warranty but the actual loss is suffered after the breach. Nonetheless, by s.10(2) of the 2015 Act the insurer appears not to be liable for any loss occurring after the breach of warranty and before there has been a remedy. Originality/value - When unseaworthiness is identified after the sailing of the vessel, mere acceptance of the ship does not mean the party waives any claims for damages or the right to terminate the contract, provided that failure to comply with the contractual obligations is of critical importance. The burden of proof with regards to loss of damage to a cargo caused by unseaworthiness is regulated by the applicable law. For instance, under the common law, if the cargo claimant alleges that the loss or damage has been caused by unseaworthiness, then he has the burden of proof to establish the followings: (i) that the vessel was unseaworthy at the beginning of the voyage; and that, (ii) that the loss or damage has been caused by such unseaworthiness. In other words, if the warranty of seaworthiness at the inception of the voyage is breached, the breach voids the policy if the ship owner had prior knowledge of the unseaworthy condition. By contrast, knowingly permitting the vessel to break ground in an unseaworthy condition denies liability only for loss or damage proximately caused by the unseaworthiness. Such a breach does not, therefore, void the entire policy, but only serves to exonerate the insurer for loss or damage proximately caused by the unseaworthy condition.

• The Korean Journal of Archival Studies
• /
• no.68
• /
• pp.73-105
• /
• 2021

The aim of this study was to investigate the current state of operation of information disclosure system in Busan Metropolitan Police Agency and to suggest recommendations for improvement. To achieve this goal, this study quantitatively analyzed the data on information disclosure claims (2010~2020.6), appeal cases (2010~2020.6), the disclosure rate of original documents (2014~2019) and so on. Furthermore, it examined how and how much information is announced in advance through the agency's homepage and the information disclosure portal site. Results show that the agency has various problems regarding information disclosure including the high rate of transferring information to other institutions, the low disclosure rate of original documents, the high rate of information released publicly only after an administrative appeal, a small number of information announced in advance, and a not user-friendly website. To solve these problems, this study proposes providing accurate information about the scope of information the agency and other related institutions own, expanding the disclosure of original documents, discovering more information to announce in advance, and enhancing the usability of the website.