• Title/Summary/Keyword: claims review

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A Study on the Cauchy Inequality (코시 부등식에 관한 연구)

  • 한인기
    • The Mathematical Education
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    • v.40 no.1
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    • pp.103-112
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    • 2001
  • In this article we study on various proofs and applications of the Cauchy inequality. Prof, Park H.S. claims that though “Mathematics for teachers” is not compulsory materials in school, it gives to mathematics teacher feeling of reassurance in the process of teaching mathematics. In our work, we review some materials concerned with Cauchy inequality, elaborate these, and develop materials for the mathematics teacher. We think that our materials are suitable to contents of “Mathematics for teachers”.

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A Study on the Seller's Liability under Article 42(1) of the CISG (CISG 제42조 (1)항의 매도인의 책임에 관한 소고)

  • Heo, Kwang Uk
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.60
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    • pp.47-77
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    • 2013
  • The way for seller to procure the goods for selling is to produce the goods at his own factory and to buy the manufactured goods from the other company. In order to produce the goods for selling the seller have to obtain the resource from the domestic company or overseas. In the middle of producing the goods to sell, seller may breach the right of a third party based on intellectual property rights. That is to say, seller may use the machine that has not itself been patented and use a process which has been patented by a third party. Seller may manufacture the goods which themselves are subject to the third party industrial property rights. Nowadays it is stressed the importance of intellectual property rights such as a patent, brand, and design. These factors consist of the core elements of the competitiveness of the goods. Many embedded software have been used in the various sector. So the disputes regarding to the intellectual property rights is gradually increasing in number. Article 42 of CISG defines the seller's delivery obligations and liabilities in respect to third party intellectual property rights and claims. It contains a special rule for this similar kind of defective in title, which tries to provide an proper solution to the complex problems caused by such rights and claims in international transactions. When seller will apply this clause to the business fields, there are several points to which seller should give attention. First, Intellectual property is general terms in intangible property rights, encompassing both copyright and industrial property. Which matter fall within the scope of intellectual property? The scope of intellectual property can be inferred from the relevant international conventions, which are based on broad international consensus. Second, Article 42 of CISG governs the relationship between the seller and the buyer, that is to say, questions of who has to bear the risk of third party intellectual property rights. The existence of such intellectual property rights, the remedies available and the question of acquiring goods free of an encumbrances in good faith are outside the scope of the CISG. The governing law regarding to the abovementioned matters is needed.

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Medical costs for patients with Facial paralysis : Based on Health Big Data (보건의료 빅데이터를 이용한 얼굴마비환자의 의료비용에 관한 연구)

  • Hong, Min-Jung;Umh, Tae-Woong;Kim, Sina;Kim, Nam-Kwen
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.98-110
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    • 2015
  • Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

A Study on Medical Expenses of Modern and Korean Medicine for Dementia Patients Under National Health Care (한국 치매 환자의 건강보험 의·한의 진료 비용에 관한 연구)

  • Lee, Jung Bae;Kang, Hyung Won;Kim, Jaeuk;Kim, Gahye;Kim, Nam-Kwen
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.1
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    • pp.31-38
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    • 2019
  • Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

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

  • Lim, Hana;Park, Mihai
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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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.

Effect of Argumentation Instruction on Medical Student Experiences with Problem-Based Learning (논증강화교육이 의학과 학생의 문제바탕학습 경험에 미치는 영향)

  • Ju, Hyunjung
    • Korean Medical Education Review
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    • v.19 no.2
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    • pp.101-108
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    • 2017
  • When participating in problem-based learning (PBL), it is important for medical students to generate claims and provide justifications for their claims in small group discussions. This study aimed to investigate the effect of argumentation instruction on medical student learning experiences with PBL. A total of one hundred first-year preclinical students from Inje University College of Medicine, who had attended argumentation instruction, participated in this study. All of the participants completed a 5-point Likert scale questionnaire regarding their learning experiences with PBL, before and after the argumentation instruction. The questionnaire comprised 22 items with eight subcategories: argumentation activity, reflection, integration of basic and clinical science, identification of lack of knowledge, logical thinking, self-directed study, communication, and attitude toward discussion. The collected data were analyzed through a paired-sample t-test. The results of this study found that the argumentation instruction promoted the preclinical students' experiences with argumentation activities, reflection, an integration of basic and clinical science, the identification of their lack of knowledge, logical thinking, and self-directed study, and it increased positive attitudes toward group discussion. The findings suggest argumentation instruction can enhance medical student group discussions and help students achieve the objectives of PBL, including acquisition of basic and clinical science knowledge and development of clinical reasoning and self-directed learning abilities, which can highlight the meaningful learning experiences students have with PBL.

Dectection of Insurance Fraud using Visualization Data Mining Tool (Visualization Data Mining Tool을 활용한 보험사기 적발)

  • Sung, Tae-Kyung
    • Information Systems Review
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    • v.5 no.1
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    • pp.49-60
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    • 2003
  • The purpose of this study is to empirically and practically verify the applicability of visualization data mining tool in detecting real-word insurance frauds that are now emerged as one of the most serious problems socially and economically. For the verification, Analyst's Notebook by i2, which has been known as the most effective visualization data mining tool, was adopted. With Analyst's Notebook, fraud-probable insurance transactions from a very large insurance claims are selected and then substantiation for insurance frauds are attempted. The results show that Analyst's Notebook not only detects insurance fraud transactions from a vast number of insurance claims, but is also able to pinpoint organized crime group by associating one fraud transaction to another fraud transaction. Therefore, it is safe to conclude that visualization data mining is very effective in detecting false transactions and crime behaviors including insurance fraud.

A Study on the Dispute Boards in International Medium and Long-term Transaction - Focus on the Construction Contract - (중장기 국제거래에서 분쟁해결위원회에 관한 고찰 - 건설계약을 중심으로 -)

  • Yu, Byoung Yook
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.57
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    • pp.79-108
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    • 2013
  • International transactions of plant and construction project need to time to time for completing the contract. During the performing the contract there may arise many claims and disputes it should be settled rapidly for processing schedule of works. However, arbitration and litigation for settlement of dispute are inappropriate in time and expense under the specifications of plant and construction project. Dispute boards are one of the successful resolution method of dispute prior to litigation or arbitration. If the dispute board was failed, of course, it may be allowed to continue into litigation or arbitration. As the creative methods of parties agreement, dispute boards may be expected to avoid claims and dispute in long and medium international contract. The purpose of this paper is to explore the specification and limitations of dispute boards that may clear disputes under long and medium contract of construction and procurement. It needs to be understand to determine whether is the useful methods for resolving dispute in the international project. This paper considers the specific natures of dispute board and its rules, procedures and problems including ICC and FIDIC for the contract of long and medium transaction.

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Survey on Labeling of Health Functional Foods in Internet Shopping Malls

  • PARK, Sang-Kyu;UHM, Tai-Hwan
    • Journal of Distribution Science
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    • v.17 no.6
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    • pp.57-63
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    • 2019
  • Purpose - This research is to review the state of standard labeling compliance and identify the factors that are conducive to compliance with the Labeling Standards of the Health Functional Foods Act in internet distribution. Research design, data, and methodology - We checked 9 labels including product name, expiration date, manufacturing date, raw material, ingredient, operative dose, nutritional information, daily intake, and functional effect which are based on Labeling Standards of the Act from 100 health functional foods in the internet shopping malls. These 9 structure & function claims were compared using a Chi-square test. Results - There was a statistically significant difference in the use of standard labeling between domestic product and imported products (p<.001). The related strength between these two variables showed a moderate effect size. Also, there was a statistically significant difference between accredited advertising/unaccredited advertising distinction and use of standard labeling (p<.001). The related strength between these two variables showed a moderate effect size. Conclusions - The Labeling Standards of the Act were not followed and found to be related to imports or unauthorized advertising in internet distribution. The information displayed according to the Labeling Standards was only about 2 on the average, so many labels have been posted unreadably without arrangement.

A Study on the Sphere of Application of the Provision for Interest under the CISG (국제물품매매계약(國際物品賣買契約)에 관한 UN협약상(協約上) 이자지급규정(利子支給規定)의 적용범위(適用範圍)에 관한 연구(硏究))

  • Bae, Jun-Il
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.13
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    • pp.235-253
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    • 2000
  • As to the sphere of application, Article 78 CISG undoubtedly applies to interest on the purchase price. Furthermore, the provision also applies to "any other sum that is in arrears". This language has been interpreted to encompass expenses that one party had on behalf of the other as well as reimbursements when the purchase price is reduced according to Article 50 CISG. However, it is questionable whether this language also extends to claims for damages. Legal scholars seem to agree that one has a right to interest on damage claims under Article 78 if the amount in question has been liquidated vis-a-vis the other party. Whether this right to interest also applies to unliquidated sums, is controversial, however. In this study, as a result of taking into account the puspose of Article 78, we could find the fact that regardless of whether the exact amount of damages has been specified yet, the breaching party still owes compensation to the other party from the time of the breach and, accordingly, the non-breaching party should be entitled to interest payments on the loss from that time. Consequently, Article 78 applies not only to liquidated but also to unliquidated damages.

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