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Problems and Solutions for Korean Medical Fee Contract System (건강보험 요양급여비용 계약의 문제점과 개선방안 연구)

  • Shin, Sung-Chul
    • Health Policy and Management
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    • v.19 no.1
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    • pp.1-30
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    • 2009
  • Korean medical fee contract system between the insurer and healthproviders was introduced in 2000. However, a continuous discord among contracting parties concerned and an irrational operation of an arbitration committee of Ministry for Health, Welfare and Family Affairs (MIHWAF) have made it difficult for them to reach to an agreement over last 8 years. The purpose of this study is to observe the current problems of contract system from the view of health insurance law and actual examples. Furthermore, I examined the of breakdown of negotiation by analyzing the eligibility of contracting parties, rationality of Resource Based Relative Value System (RBRVS) and contracting method and fairness of arbitration method in case of negotiation rupture. The results were as follows: First, since the introduction of medical fee contract system, there has been a problem in that both the president of National Health Insurance Corporation (NHIC) and health care provider association have not held strong negotiation power. Second, the frequent changes and notifications of Relative Value Units (RVUs) without any mutual consent between the insurer and provider association negatively have influenced the conversion factors and finally hindered the agreement of contract. Third, a current process that the conversion factors are mediated and determined at the arbitration committee of MIHWAF in the case of contract breakdown between contracting parties has some flaw in that the irrational composition of committee provoked the lack of fairness and objectivity of mediation. Fourth, we can not prospect a satisfactory outcome of arbitration committee because the mediation always has failed to proceed smoothly due to boycott of both committee members from insurer and providers over last 8 years. As a result, we have to make an every effort to resolve problems mentioned above and then dream of an advanced national health insurance system.

Study on Mechanistic Pattern Identification of Disease for NaeGyungPyen of DongEuiBoGam ("동의보감(東醫寶鑑)" 내경편(內景編)에 나타난 질병(疾病)의 병기론적(病機論的) 변증(辨證)화 연구 - 정신기혈(精神氣血)을 중심으로 -)

  • Kim, Yeong-Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.2
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    • pp.177-186
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    • 2010
  • This study is about researching DongEuiBoGam by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of essence, spirit, qi and blood in NaeGyungPyeb of DongEuiBoGam are these. In Essence, this explain mechanism of disease patterns those are seminal emission, dream emission, spermatorrhea, white ooze. These disease pattern's mechanisms are kidney yang deficiency, kidney yin deficiency, heart yang deficiency, heart yin deficiency, heart qi deficiency, spleen qi deficiency and so on. On viewpoints of viscera and bowels they are related with heart, kidney, spleen. And most of them are deficiency from deficiency-excess Pattern Identification. Classifying disease pattern of qi is about upward, downward movement and more concentrated deficiency than excess pattern. Fright palpitations can be classified heart deficiency with timidity, heart blood and qi deficiency, heart qi deficiency, heart blood deficiency, heart qi movement stagnation, water qi intimidating the heart, phlegm-fire harassing the heart, phlegm clouding the pericardium, and so on. Palpitations can be classified heart blood deficiency, heart yin deficiency, heart deficiency with timidity, heart spleen blood deficiency, spleen qi deficiency, phlegm-fire harassing the heart, intense heart fire, and so on. Forgetfulness can be classified heart spleen blood deficiency, heart spleen qi deficiency, kidney essence deficiency, heart qi deficiency, non-interaction between the heart and kidney, etc. for deficiency pattern, phlegm clouding the pericardium for excess pattern. In Blood just say inside bleeding pattern's category, there are nose bleeding, flopping syncope, qi counterflow, blood vomiting, hemoptysis, spitting of blood, bloody stool, hematuria, and so on. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.

Non-rational tendency in contemporary floral art & design : a focus on the exploration of the subconsciousness (현대 화예디자인에서의 비이성 경향에 관한 연구 : 무의식 탐구경향을 중심으로)

  • 강병길;이정민
    • Archives of design research
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    • v.15 no.1
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    • pp.15-26
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    • 2002
  • Contemporary visual art is characterized by a systematic study of the irrational. This trend was largely a reaction to the rationality of Modernism, which felt out of fair in the post-industrial society. This new trend against Modernism is represented by Deconstructivism. However, the appeal of irrationality has a deeper root. In this article, we examine the historical roots0 of this interest in the irrational. In doing so, we focus tour attention on the effect of Freud's theory of the subconscious on the growth of Surrealism in modern art. In particular, we explore how this same tendency is reflected in modern. floral art & design. By doing so, we are able to relate the developments in floral art & design with the developments in other areas of modern art. Finally, we show that it is possible for floral art & design to be in the vanguard of contemporary art because of its unique characteristics.

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Application of Gold Exploration Using Three-dimensional Resistivity Inversion in Sambo mine (3차원 전기비저항 역산 방법을 이용한 삼보 광산에서 금광 탐사)

  • Park Jong-Oh;Kim Hee-Joon;Song Moo-Young;You Young-June
    • The Journal of Engineering Geology
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    • v.15 no.1
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    • pp.19-27
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    • 2005
  • The Sambo mine is located in Hae-je Myeon, Moo-an Gun, Chollanamdo, which consists of host gneiss and rhyolite possessing quartzite veins with other compositions such as gold, silver, and sublimated sulfur. The ore grade estimated from the core was 0.05~10.9g/t or less in gold and 0.05~389g/t or less in silver, indicating a partial mineralization. The purpose of this paper is to understand the subsurface structures and the distribution of mineralized bodies in the Sambo mine using a combined method of Schlumberger, Wenner, and Dipole-di-pole resistivity surveys on the surface and the resistivity tomography survey in boreholes. The result of three-dimensional resistivity inversion showed that the mineralized body is extended to 240m long in the N10°~20°E direction, with 30m wide and 80 m thick from the surface. The low resistivity zones (<1,000ohm-m) determined from the resistivity image were in good agreement with the mineralized bodies and weak zones identified from the logged cores.

The Numerical Study on Capacity Evaluation of Exposed Steel Column-Base Plate Connection (노출형 철골기둥-베이스 플레이트 접합부의 내력평가를 위한 수치적 연구)

  • Lee, Kwang-Ho;You, Young-Chan;Choi, Ki-Sun;Koo, Hye-Jin;Yoo, Mi-Na
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.20 no.5
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    • pp.26-34
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    • 2016
  • The failure modes of steel column-base plate connection arranged on the basis of AISC Design Guide-#1 and -#10 are base plate tension and compression side flexural yielding, yielding, pull-out and shear failure of anchor rod, concrete crushing in concrete footing and steel column yielding. The bending moment capacity and failure mode in this connection are predicted using limit-state function and we compare these results and test result. In the case that thickness of base plate is relatively thick, bending moment capacity and failure mode in steel column-base plate connection accurately predicted. But in the case that thickness of base plate is relatively thin and axial force do not exist, prediction of failure mode in this connection is somewhat inaccurate.

Quality Characteristics of Semi-dry Noodles with different Water Contents (수분함량에 따른 반건조 우리밀 국수의 품질 특성)

  • Park, Bock-Hee;Park, Yang-Kyun;Jo, Kwang-Ho;Jeon, Eun-Raye;Koh, Kyeong-Mi;Choi, Yong-Beom
    • Journal of the Korean Society of Food Culture
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    • v.32 no.2
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    • pp.135-143
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    • 2017
  • This study evaluated the quality characteristics of semi-dried noodles prepared with different water contents (wet noodles; 32, 24, 22, 20%, dry noodles; 12%). The drying process was carried out in a drying chamber at $13{\sim}18^{\circ}C$ temperature and 75~95% humidity. The proximate composition of Korean wheat flour was as follows: water $22.1{\pm}3.64%$, protein $8.6{\pm}0.13%$, fat $1.3{\pm}0.10%$, ash $0.7{\pm}0.02%$, carbohydrates $67.3{\pm}0.10%$. As water contents decreased, both L and b values significantly decreased before cooking of noodles, whereas L, a, and b values were not significantly different after cooking of noodles. Weight, water absorption, and volume of cooked noodles significantly increased as water content decreased, whereas turbidity of soup was not significantly different. Cutting hardness before cooking of noodles significantly increased as water content decreased. Sections of noodles after cooking by SEM (scanning electron microscopy) showed roughness and fewer round starch particles as water content decreased. For overall preferences according to the sensory evaluation, noodles prepared with different water contents were not significantly different. According to the results, semidried noodles have development potential to complement the disadvantages of both wet noodles and dry noodles.

Building Integrated Vegetation Systems into the New Sainsbury's Building Based on BIM

  • Lee, Dong-Kyu
    • Journal of KIBIM
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    • v.4 no.2
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    • pp.25-32
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    • 2014
  • Today, there is a growing need of environment-friendly buildings, so-called 'green', facilities, and energy saving buildings to decrease environmental pollutants released into cities by construction activities. Green-Building Information Modeling (Green-BIM) is a purpose-built solution which supports to forecast energy consumption of 3-D model of a building by augmenting its primary 3-D measurements (width, height and depth) with many more dimensions (e.g. time, costs, social impacts and environmental consequences) throughout a series of sequential phases in the lifecycle of a building. The current study was carried out in order to integrate vegetation systems (particularly green roof and green wall systems) and investigate thermal performance of the new Sainsbury's building which will be built on Melton road, Leicester, United Kingdom. Within this scope, a 3-D building model of the news Sainsbury's building was first developed in $Autodesk^{(R)}$ $Revit^{(R)}$ and this model was then simulated in $Autodesk^{(R)}$ $Ecotect^{(R)}$once weather data of the construction site was obtained from $Autodesk^{(R)}$ Green Building $Studio^{(R)}$. This study primarily analyzed data from (1) solar radiation, (2) heat gains and losses, and (3) heating and cooling loads simulation to evaluate thermal performance of the building integrated with vegetation system or conventionally available envelops. The results showed that building integrated vegetation system can potentially reduce internal solar gains on the building rooftops by creating a 'bioshade'. Heat gains and losses through roofs and walls were markedly diminished by offering greater insulation on the building. Annual energy loads for heating and cooling were significantly reduced by vegetation more significantly through the green roof system in comparison to green wall system.

A Study on the Size of TMD Patient's Condyle Head (악관절장애환자의 하악과두 크기에 관한 연구)

  • Lee, Doo-Hee;Oh, Soon-Ho;Suh, Chang-Ho;Kim, Joon-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.417-422
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    • 2001
  • Objective: In many TMD cases, deformed and reduced condyle heads were frequently observed. This study was prepared to compare the dimensions between normal and symptomatic condyles, using MR images. Materials: One hundred and twenty one patients with clinical signs and MRI-confirmed diagnosis of disc displacement were selected for this study. Thirty eight TMJs from nineteen asymptomatic volunteers who had no clinical symptoms and no disc displacement on sagittal and coronal view of MRI, were served as normal. Methods: Symptomatic condyles were classified according to the severity of the anterior disc displacement. The amount of anterior disc displacement was evaluated at sagittal section, and they were classified into 4 groups as normal(N), little(G0), mild(G1), moderate(G2) and severe displacement(G3). The dimentions of condyle were measured at the 200% magnified view, by digitizing program. All dimensions were compared among each groups on the central section of sagittal and coronal views, and the statistical analysis was performed. Results: The mean value of anteroposterior length of normal condyle was $0.79{\pm}0.13cm$ at sagittal section and mediolateral length was $2.12{\pm}0.22cm$ on coronal section. The mean value of anteroposterior length of symptomatic condyle was $0.67{\pm}0.16cm$ at sagittal section and mediolateral length was $1.97{\pm}0.28cm$ on coronal section. Conclusions: The size of symptomatic condyle was smaller than normal TMJ. The size of condyle was decreased as the amount of the disc displacement was increased. The dimensional change was found on the anterior articular surface of condyle at the mild or moderate disc displacement. And at the case of severe disc displacement, dimensional change was found on the superior articular surface.

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A STUDY ON THE MORPHOLOGY OF MANDIBULAR CONDYLE (MRI를 이용한 한국인 하악과두의 형태에 관한 연구)

  • Lee, Doo-Hee;Oh, Soon-Ho;Suh, Chang-Ho;Kim, Joon-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.423-427
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    • 2001
  • Objective: This study was prepared to figure out a certain dimension and morphology of the condyle at the central, medial and lateral aspects on MR images of asymptomatic volunteers, which could be comparable with those of the TMD patients' condyle. Materials: Sixty TMJs from 30 asymptomatic volunteers(15 male, 15 female) who had no clinical symptoms and no disc displacement on sagital and coronal view of MRI were served as normal. Method: MR images were taken from the asymptomatic volunteers and the dimension of the anteroposterior length, mediolateral width, height, convexities were measured through the images on the sagittal and coronal sections of mandibular condyle. Then, these data were collected and analyzed. Result: The mean value of anteroposterior length was $8.00{\pm}1.21mm$ at central section and mediolateral length was $21.40{\pm}2.32mm$ on coronal view. The anterior condylar length at medial side was the shortest and the convexity of anterior slop at the lateral side was proved to be the flattest among 3 sections. There were little dimensional and morphological differences at sagittal sections, but the mediolateral width of condyle at coronal section was significantly different between male and female. Conclusion: In sagittal sections, the anterior condyle length was shortest at medial side and the convexity of anterior slop was flattest at lateral side, and there were little dimensional and morphologic differences between male and female. In coronal section, male's condyle was more wider and flatter than female's.

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The effect of a desensitizer and $CO_2$ laser irradiation on bond performance between eroded dentin and resin composite

  • Ding, Meng;Shin, Sang-Wan;Kim, Min-Soo;Ryu, Jae-Jun;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • v.6 no.3
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    • pp.165-170
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    • 2014
  • PURPOSE. This study was aimed to evaluate effect of the desensitizing pretreatments on the micro-tensile bond strengths (${\mu}TBS$) to eroded dentin and sound dentin. MATERIALS AND METHODS. Forty-two extracted molars were prepared to form a flat dentin surface, and then they were divided into two groups. Group I was stored in distilled water while group II was subjected to a pH cycling. Each group was then subdivided into three subgroups according to desensitizing pretreatment used: a) pretreatment with desensitizer (Gluma); b) pretreatment with $CO_2$ Laser (Ultra Dream Pluse); c) without any pretreatment. All prepared surfaces were bonded with Single Bond 2 and built up with resin composite (Filtek Z250). The micro-tensile bond test was performed. Fracture modes were evaluated by stereomicroscopy. Pretreated surfaces and bonded interfaces were characterized by scanning electron microscope (SEM). The data obtained was analyzed by two-way ANOVA (${\alpha}$=0.05). RESULTS. For both sound and eroded dentin, samples treated with desensitizer showed the greatest ${\mu}TBS$, followed by samples without any treatment. And samples treated with $CO_2$ laser showed the lowest ${\mu}TBS$. SEM study indicated that teeth with eroded dentin appeared prone to debonding, as demonstrated by existence of large gaps between adhesive layers and dentin. CONCLUSION. Pretreatment with Gluma increased the ${\mu}TBS$ of Single Bond 2 for eroded and sound teeth. $CO_2$ laser irradiation weakened bond performance for sound teeth but had no effect on eroded teeth.