The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.25
no.3
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pp.78-87
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2012
Objective : The purpose of this study is to describe the characteristics of medical malpractice related to pediatric ophthalmology and to identify the causes and potential preventability of medical litigation in Korean medicine. Methods : A study was performed by analysing 8 cases of lawsuit in the year between 1968 and 2011, which were selected among the medical dispute cases involving pediatric ophthalmology. Results : The eight closed claims occurring in the field of pediatric ophthalmology were founded in the data for medical malpractice. One claim was supreme court decision, two claims were high court decisions and five claims were district court decisions. Conclusions : While malpractice claims occurring in the field of pediatric ophthalmology were uncommon, they resulted in a high rate and amount of indemnity payments. For reduction of medical disputes, improvement of clinical trials and clinical medical cares is emphasized, and informed consent is also important.
This study is designed to identify the differences in the types and importance of trade claims at the national level. For analysis data, abstracts of arbitration and court judgments published on the website of the United Nations Commission on International Trade Law are collected and used. The target countries are China and the United States, with 102 cases from China and 59 cases from the United States. By applying topic modeling techniques to the collection decisions of China and the United States, trade claims are categorized, and the importance of each type is identified using the network centrality index derived through semantic network analysis. The analysis results are as follows. First, the main types of trade claims were the same for both the United States and China: product nonconformity, delivery issues, and payments. However, in China, the order of product nonconformity > delivery issues > payments was important, and in the United States, payments > product nonconformity > delivery issues were found to be important. This study is significant in that it presents a strategic trade claim management plan using a quantitative methodology.
Journal of the Korean Society of Clothing and Textiles
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v.21
no.8
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pp.1307-1314
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1997
This study investigated the factors that influence consumers' distrust and consumers purchase intention for discounting, specifically discounting of clothes. Through literature, discounting rate, retailer type and brand reputation were identified as influencing factors and were tested. A 2$\times$2$\times$3 factorial design was used to test the effect of each factor on consumers' distrust and consumers' purchase intention for jean products. Retailer type was manipulated as high and low, brand reputation as well-known and less-known, and discount rates 10, 30 and 60%. An convenience sample of 165 female undergraduate students participated in the study. The data were analyzed using SPSS/PC+ The results showed that consumers did distrust discounting claims and consumers' distrust of the claims was greater for less-known brand. In addition, no significant effect of retailor type was found. Further effort is needed to generalize the result to different product categories.
Background: Coal mining is a hazardous industry. The purpose of the study is to identify the nature of occupational injuries and diseases among coal miners and to determine the factors that affect the rate of injury and duration of time loss from work. Methods: A retrospective cohort study was conducted using accepted workers' compensation claims data of 30,390 Australian coal miners between July 2003 and June 2017. Results: Musculoskeletal and fracture conditions accounted for approximately 60% of claims in all occupational groups. Cox regression analysis showed that older age and female gender were significant predictors of longer time off work. Injury types and occupations were associated with work time loss: mental health conditions, and machine operators and drivers had significantly longer durations of time off work. Conclusion: Future research can further address how these factors led to longer time off work so that coal industry regulators, employers, and healthcare providers can target interventions more effectively to these at-risk workers.
Kim, Logyoung;Sakong, Jin;Kim, Yoon;Kim, Sera;Kim, Sookyeong;Tchoe, Byongho;Jeong, Hyoungsun;Lee, Taerim
Health Policy and Management
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v.23
no.2
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pp.152-161
/
2013
Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.
Purpose - Pricing strategy is a very effective marketing activity and has a significant impact on consumer purchasing decisions. Numerous studies have investigated the effects of various pricing strategies. However, tensile price claims have received little attention in the literature. It is thus necessary to investigate how different forms of tensile price claims affect consumer response. This study uses the consumer self-confidence level as a moderator of consumer behavior. Research Research design, data, and methodology - This study investigates the effect of four different tensile price claims (i.e., maximum discount, minimum discount, average discount, and range discount advertisements) on consumers' perceived savings. A survey was conducted to collect data for testing hypotheses. Results - The results show that consumers with high levels of self-confidence perceive more savings for maximum discount advertisements than minimum discount advertisements, for range discount advertisements than average discount advertisements. On the other hand, consumers with low self-confidence feel more perceived savings for average discount advertisements than range discount advertisement. Conclusions - The results of this study provide a new insight into the effectiveness of tensile pricing based on consumer self-confidence levels, which may provide valuable theoretical and practical applications.
This study aims to explore group inquiry using science writing heuristic in elementary school science. We observed and examined what elementary students experienced in their science classes and moreover how they used their data to support their claims in the view point of scientific epistemology. The research question of this study is 'what is the result of coherence measurement for figuring out the relationship between argument and ground in group inquiry activity?'. To solve the study question, one fifth-grade class at an elementary school was selected. Four lessons in group inquiry using a worksheet of science writing heuristic were videotaped and transcribed. It was found that the hours of group inquiry when students can discuss meaningfully occupied approximately 37 to 45%. When measuring coherence in each lesson by developing a scale from one to five to estimate the coherence of the work sheet designed, the total average was 3.424. It implicated that students had their claims supported by some of their evidences. Although the figure was not enough to assist that they found strong bonds between their claims and data, they started to move forward to epistemological approach in their science lab works.
Objectives: The purpose of the study is to investigate the level of knowledge and screening review rates of dental health insurance claims in dental hygienists. This analysis will provide the educational information to the dental hygienists. Methods: A self-reported questionnaire was completed by dental hygienists in Jeonbuk from December 17, 2012 to January 24, 2013. The questionnaire was distributed by ordinary mail or direct visit. Except incomplete answers, 350 data were collected and analyzed. The study instrument was adapted from the structured questionnaire by Hong and Yoo. The questionnaire consisted of education experience of health insurance management, subjective and objective knowledge, insurance screening review, and need for health insurance education. Data were analyzed by SPSS 12.0 program. Cronbach alpha in the objective knowledge on health insurance rate criteria was 0.836 and this was a reliable figure. Results: The subjective knowledge level of dental insurance was higher in the senior dental hygienists. Subgingival curettage was the lowest percentage of correct answers in the objective knowledge. In recent six months, higher review control rate was shown in the higher claim for health insurance and insurance screening review. Conclusions: The majority of the respondents had lower level of knowledge of health insurance claims. The continuous education of dental health insurance will be necessary in the dental hygienists.
Hosny, Ossama A.;Elbarkouky, Mohamed M.G.;Elhakeem, Ahmed
Journal of Construction Engineering and Project Management
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v.5
no.1
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pp.11-19
/
2015
This paper presents optimized artificial neural networks (ANNs) claims prediction and decision awareness framework that guides owner organizations in their pre-bid construction project decisions to minimize claims. The framework is composed of two genetic optimization ANNs models: a Claims Impact Prediction Model (CIPM), and a Decision Awareness Model (DAM). The CIPM is composed of three separate ANNs that predict the cost and time impacts of the possible claims that may arise in a project. The models also predict the expected types of relationship between the owner and the contractor based on their behavioral and technical decisions during the bidding phase of the project. The framework is implemented using actual data from international projects in the Middle East and Egypt (projects owned by either public or private local organizations who hired international prime contractors to deliver the projects). Literature review, interviews with pertinent experts in the Middle East, and lessons learned from several international construction projects in Egypt determined the input decision variables of the CIPM. The ANNs training, which has been implemented in a spreadsheet environment, was optimized using genetic algorithm (GA). Different weights were assigned as variables to the different layers of each ANN and the total square error was used as the objective function to be minimized. Data was collected from thirty-two international construction projects in order to train and test the ANNs of the CIPM, which predicted cost overruns, schedule delays, and relationships between contracting parties. A genetic optimization backward analysis technique was then applied to develop the Decision Awareness Model (DAM). The DAM combined the three artificial neural networks of the CIPM to assist project owners in setting optimum values for their behavioral and technical decision variables. It implements an intelligent user-friendly input interface which helps project owners in visualizing the impact of their decisions on the project's total cost, original duration, and expected owner-contractor relationship. The framework presents a unique and transparent hybrid genetic algorithm-ANNs training and testing method. It has been implemented in a spreadsheet environment using MS Excel$^{(R)}$ and EVOLVERTM V.5.5. It provides projects' owners of a decision-support tool that raises their awareness regarding their pre-bid decisions for a construction project.
The Journal of the Korean life insurance medical association
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v.27
no.2
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pp.68-74
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2008
Medical verification of cancer diagnosis in insurance claims is a very important procedure in insurance administrations. Claims staffs are in need of medical experts' opinions about claim administration. This procedure is called medical claim review (MCR) and is composed of verification and advice. MCR verification evaluates the insured’s physical condition by medical records and compares it with product coverage. It is divided into assessment of living assurance benefit, verification of cancer, and assessment of the cause of death. Actually cancer verification of MCR is applicable to coding because the risk ratio in product development is usually coded data. There are some confusing neoplastic diseases in assessing the verification of cancer. This article reviews gastrointestinal stromal tumors (GIST) and mucosa-associated lymphoid tissue tumors (MALToma) of the stomach. The second most common group of stromal or mesenchymal neoplasms affecting the gastrointestinal tract is GIST. Nowadays there are many articles about the pathophysiology of GIST. However there are few confirmative theories except molecular cell biology of KIT mutation and some tyrosine kinase. Therefore, coding the GIST, which has previously been classified as an intermediate risk group according to NIH2001 criteria, for cancer verification of MCR is suitable for D37.1; neoplasm of uncertain or unknown behavior of digestive organs and the stomach. The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphomas. B-cell lymphomas of the MALT type, now called extranodal marginal zone B-cell lymphoma of MALT type in the REAL/WHO classification, are the most common primary gastric lymphomas worldwide. Its characteristics are as follows. First, it is different from traditional stomach cancers such as gastric adenocarcinoma. Second, the primary therapy of MALToma is the eradication of H. pylori by antibiotics and the remission rate is over 80%. Third, it has a different clinical course compared to traditional malignant lymphoma. Someone insisted that cancer verification is not possible for the above reasons. However, there have been findings on pathologic mechanism, and according to WHO classification, MALToma is classified into malignant B-cell lymphoma and it must be verified as malignancy in MCR.
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