• Title/Summary/Keyword: empirical study

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Effects of Private Insurance on Medical Expenditure (민간의료보험 가입이 의료이용에 미치는 영향)

  • Yun, Hee Suk
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.99-128
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    • 2008
  • Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

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Effect of Water Temperature on Ammonia Excretion of Juvenile Starry Flounder Platichthys stellatus (강도다리 Platichthys stellatus 치어의 암모니아 배설에 미치는 수온의 영향)

  • Oh, Sung-Yong;Jang, Yo-Soon;Noh, Choong Hwan;Choi, Hee Jung;Myoung, Jung-Goo;Kim, Chong-Kwan
    • Korean Journal of Ichthyology
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    • v.21 no.1
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    • pp.1-6
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    • 2009
  • The effect of water temperature on fasting and post-prandial total ammonia excretion (TAN) of the starry flounder Platichthys stellatus (mean body weigh : $42.4{\pm}3.4g$) was studied. The fasting and post-prandial TAN excretions were measured under three different water temperatures (10, 15 and $20^{\circ}C$) for 24 hours using a recirculating system. In each treatment three replicates were set up and total 45 fish were used. Fish were taken to the indoor aquarium, acclimated over 10 days at three temperatures, and transferred to TAN measuring system for measurements of TAN excretion at the same temperatures. After 3 days of starvation, fasting TAN excretion was measured at each temperature. To investigate post-prandial TAN excretion, fish were hand-fed to satiation level with a commercial diet containing 50.2% crude protein for 7 days, two times daily 08 : 00 and 16 : 00 h. The fasting and postprandial TAN excretion increased with increased water temperature (p<0.05). Mean fasting TAN excretion rates at 10, 15 and $20^{\circ}C$ were 10.9, 11.2 and $12.2mg\;TAN\;kg\;fish^{-1}\;h^{-1}$, respectively. The value at $20^{\circ}C$ was higher than those at 10 and $15^{\circ}C$ (p<0.05), but there was no significant difference between $10^{\circ}C$ and $15^{\circ}C$. Mean post-prandial TAN excretion rates at 10, 15 and $20^{\circ}C$ were 33.0, 43.4 and $55.3mg\;TAN\;kg\;fish^{-1}\;h^{-1}$, respectively. Two peaks of post-prandial TAN excretions were observed, and the second peak was always greater than the first. The post-prandial TAN excretion rate reached to the maximum after 10 hours from the first feeding at $10^{\circ}C$($45.3mg\;TAN\;kg\;fish^{-1}\;h^{-1}$), $15^{\circ}C$ ($64.5mg\;TAN\;kg\;fish^{-1}\;h^{-1}$) and $20^{\circ}C$ ($83.2mg\;TAN\;kg\;fish^{-1}\;h^{-1}$), respectively. The TAN loss for ingested nitrogen at $20^{\circ}C$ (48.8%) was higher than that for $10^{\circ}C$ (43.0%) and $15^{\circ}C$ (45.7%). This study provides empirical data for estimating ammonia excretion and managing culture management of starry flounder under given temperatures.

A Meta-Analysis of Korean Literatures about Sick Role Behavior of Pulmonary Tuberculosis Patients applied Health Belief Model (건강신념모형을 적용한 폐결핵 환자의 환자역할행태 연구에 대한 메타분석)

  • Kim, Chun-Bae;Jo, Heui-Sug;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.1-13
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    • 2003
  • Objectives: The purpose of this study is to summarize results from 11 domestic studies about sick role behavior applied health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. Methods: We collected the existing literatures by using major web search of 'pulmonary tuberculosis patients', 'health belief model', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Results: Among 66 articles, 11 studies were selected for quantitative meta-analysis. The knowledge level about pulmonary tuberculosis had more effect for only sick role behavior as general characterisitcs(d=0.7870). All the components of health belief model produced significant effects on sick role behavior with the magnitude of effect size from 0.31 to 0.73. The largest effects were benefits on actions of sick role behavior. Conclusions: Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of sick role behavior among the type of health related behavior in pulmonary tuberculosis patients. Strategic intervention including health education, etc. based on health belief model showed clear advantage in improvement of behavioral change.

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The Achievements and limitations of the U. S. Welfare Reform (미국 복지개혁의 성과와 한계)

  • Kim, Hwan-Joon
    • Korean Journal of Social Welfare
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    • v.53
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    • pp.129-153
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    • 2003
  • This study examines the socio-economic impacts of recent welfare reform in the United States. Based on the neo-conservative critique to the traditional public assistance system for low-income families, the 1996 welfare reform has given greater emphases on reducing welfare dependency and increasing work effort and self-sufficiency among welfare recipients. In particular, the welfare reform legislation instituted 60-month lifetime limits on cash assistance, expanded mandatory work requirements, and placed financial penalties for noncompliance. With the well-timed economic boom in the second half of the 1990s, the welfare reform seems to achieve considerable progress; welfare caseload has declined sharply to reach less than 50% of its 1994 peak, single mothers' labor force participation has increased substantially, and child poverty has decreased. In spite of these good signals, the welfare reform also has several potential problems. Many welfare leavers participate in the labor market, but not all (or most) of them. The economic well being of working welfare leavers did not increased significantly, because earnings increase was canceled out by parallel decrease in welfare benefits. Furthermore, most of working welfare leavers are employed in jobs with poor employment stability and low wages, making them highly vulnerable to frequent layoff, long-time joblessness, persistent poverty, and welfare recidivism. Another serious problem of the welfare reform is that a substantial number of welfare recipients are faced with extreme difficulties in finding jobs, because they have severe barriers to employment. The new welfare system with 5-year time limit can severely threaten the livelihoods of these people. The welfare reform presupposes that welfare recipients can achieve self-reliance by increasing their labor market activities. However, empirical evidences suggest that many people are unable to respond to the new, work-oriented welfare strategy. It may be a very difficult task to achieve both objectives of the welfare reform((1) providing adequate income security for low-income families and (2) promoting self-sufficiency) at the same time, because sometimes they are conflicting each other. With this in mind, a possible solution can be to distinguish welfare recipients into "(Very)-Hard-to-Employ" group and "(Relatively)-Ready-to-Work" group, based on elaborate examinations of a wide range of personal conditions. For the former group, the primary objective of welfare policies should be the first one(providing income security). For the "Ready-to-Work" group, follow-up services to promote job retention and advancement, as well as skill-training and job-search services, are very important. The U. S. experiences of the welfare reform provide some useful implications for newly developing Korean public assistance policies for the able-bodied low-income population.

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Optimum Population in Korea : An Economic Perspective (한국의 적정인구: 경제학적 관점)

  • Koo, Sung-Yeal
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.1-32
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    • 2005
  • The optimum population of a society or country can be defined as 'the population growth path that maximizes the welfare level of the society over the whole generations of both the present and the future, under the paths allowed by its endowments of production factors such as technology, capital and labor'. Thus, the optimum size or growth rate of population depends on: (i) the social welfare function, (ii) the production function, and (iii)demographic economic interrelationship which defines how the national income is disposed into consumption(birth and education of children included) and savings on the one hand and how the demographic and economic change induced thereby, in turn, affect production capacities on the other. The optimum population growth path can, then, be derived in the process of dynamic optimization of (i) under the constraints of (ii) and (iii), which will give us the optimum population growth rate defined as a function of parameters thereof. This paper estimates the optimum population growth rate of Korea by: specifying (i), (ii), and (iii) based on the recent development of economic theories, solving the dynamic optimization problem and inserting empirical estimates in Korea as the parametric values. The result shows that the optimum path of population growth in Korea is around TFR=1.81, which is affected most sensitively, in terms of the size of the partial elasticity around the optimum path, by the cost of children, share of capital income, consumption rate, time preference, population elasticity of utility function, etc. According to a survey implemented as a follow up study, there are quite a significant variations in the perceived cost of children, time preference rate, population elasticity of utility across different socio-economic classes in Korea, which implied that, compared to their counterparts, older generation and more highly educated classes prefer higher growth path for the population of Korea.

Treatment of Isoniazid-Resistant Pulmonary Tuberculosis (Isoniazid 내성 폐결핵의 치료실태와 치료성적)

  • Koh, Won-Jung;Kwon, O Jung;Yu, Chang-Min;Jeon, Kyeongman;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.248-260
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    • 2004
  • Background : As an effective regimen for isoniazid (INH)-resistant pulmonary tuberculosis, several treatment regimens have been recommended by many experts. In Korea, a standard regimen has not been established for INH-resistant tuberculosis, and the treatment by individual physicians has been performed on an empirical bases. The purpose of the present study was to retrospectively describe the treatment characteristics and evaluate the treatment outcomes of patients with INH-resistant tuberculosis. Materials and Methods : Sixty of 69 patients reported to have INH-resistant tuberculosis from 1994 to 2001 were retrospectively analyzed. Exclusion criteria included: death from other causes, with the exceptions of tuberculosis and incomplete treatment, including a patient's transfer-out. Results : A previous tuberculosis history was found in 28 (46.7%) patients. The sputum smear for acid-fast bacilli was positive in 44 (73.3%) patients, and 30 (50.0%) had cavitary disease. Streptomycin resistance coexisted in 25.0% of isolates. INH was to be prescribed continuously, even after INH resistance was reported, in 86.0% of patients. The treatment regimens were diverse between the patients according to drug regimen composition and treatment duration. The most frequent prescribed regimen included rifampin, ethambutol and pyrazinamide, with and without INH, for the full 12-month term of treatment. Treatment failure occurred in 13 (21.7%) patients. Cavitary disease (p=0.005) and a treatment regimen with second-line drugs, excluding rifampin (p=0.015), were associated with treatment failure. One patient experienced a relapse. Conclusions : Standardized treatment guidelines will be needed in Korea to improve the treatment efficacy for INH-resistant tuberculosis.

A Study for the Methodology of Analyzing the Operation Behavior of Thermal Energy Grids with Connecting Operation (열 에너지 그리드 연계운전의 운전 거동 특성 분석을 위한 방법론에 관한 연구)

  • Im, Yong Hoon;Lee, Jae Yong;Chung, Mo
    • KIPS Transactions on Computer and Communication Systems
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    • v.1 no.3
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    • pp.143-150
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    • 2012
  • A simulation methodology and corresponding program based on it is to be discussed for analyzing the effects of the networking operation of existing DHC system in connection with CHP system on-site. The practical simulation for arbitrary areas with various building compositions is carried out for the analysis of operational features in both systems, and the various aspects of thermal energy grids with connecting operation are highlighted through the detailed assessment of predicted results. The intrinsic operational features of CHP prime movers, gas engine, gas turbine etc., are effectively implemented by realizing the performance data, i.e. actual operation efficiency in the full and part loads range. For the sake of simplicity, a simple mathematical correlation model is proposed for simulating various aspects of change effectively on the existing DHC system side due to the connecting operation, instead of performing cycle simulations separately. The empirical correlations are developed using the hourly based annual operation data for a branch of the Korean District Heating Corporation (KDHC) and are implicit in relation between main operation parameters such as fuel consumption by use, heat and power production. In the simulation, a variety of system configurations are able to be considered according to any combination of the probable CHP prime-movers, absorption or turbo type cooling chillers of every kind and capacity. From the analysis of the thermal network operation simulations, it is found that the newly proposed methodology of mathematical correlation for modelling of the existing DHC system functions effectively in reflecting the operational variations due to thermal energy grids with connecting operation. The effects of intrinsic features of CHP prime-movers, e.g. the different ratio of heat and power production, various combinations of different types of chillers (i.e. absorption and turbo types) on the overall system operation are discussed in detail with the consideration of operation schemes and corresponding simulation algorithms.

A Study on the Archival Basis of History by Simaqian and Herodotus (『사기』와 『역사』에 담긴 기록학의 기초 역사-인간[Homo Historicus], 사마천과 헤로도토스)

  • Oh, Hang Nyeong
    • The Korean Journal of Archival Studies
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    • no.65
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    • pp.365-396
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    • 2020
  • I examined the archival basis of two historians who wrote history books with the same title of 'History'; Simaqian of ancient China and Herodotus of Halikarnassos. I examined a prejudice to these two history books, a misunderstanding of them as an imagination rather than a history. How can an imagination become a history? First, I explained the common characteristics found in their compilation and writing of 'History.' Simaqian and Herodotus did their field-works in historical sites, gathered oral-histories, and arranged archives they collected. These two historians heavily engaged in archival works in terms of verifying authenticity and reliability of their sources on the basis of historical empiricism. There are some misunderstanding on their archival endeavor and on the very nature of archives and historical studies as empirical studies. Furthermore, this misunderstanding regarding them as literature came from a confusion over the concept of literature. The creativity of literature is not equal to the "fictitiousness" of history despite historical works sometimes may give us an impression by the way of describing and providing insight into a certain event(s) and a person(s). As Herodotus said, a recognition of the differences of each race and human is a departure of historical archiving of the valuable experiences of human-beings. By doing so, natural results of archival behaviors, preservation of the records, and consistent inquiry of historian-archivists become a humanistic passage overcoming the current wrong trends of historical studies confined to a narrow nation-history.

Persistence of Fungicide Pencycuron in Soils (토양 중 살균제 Pencycuron의 잔류 특성)

  • An, Xue-Hua;An, Wen-Hao;Im, Il-Bin;Lee, Sang-Bok;Kang, Jong-Gook
    • The Korean Journal of Pesticide Science
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    • v.10 no.4
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    • pp.296-305
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    • 2006
  • The adsorption and persistence of pencycuron {1-(4-chlorobenzyl) cyclopentyl-3-phenylurea} in soils were investigated under laboratory and field conditions to in order to assess the safety use and environmental impact. In the adsorption rate experiments, a significant power function of relation was found between the adsorbed amount of pencycuron and the shaking time. Within one hour following the shaking, the adsorption amounts in the SCL and the SiCL were 60 and 65% of the maximum adsorption amounts, respectively. The adsorption reached a quasi-equilibrium 12 hours after shaking. The adsorption isotherms followed the Freundlich equation. The coefficient (1/n) indicating adsorption strength and degree of nonlinearity was 1.45 for SCL and 1.68 to SiCL. The adsorption coefficients ($K_d$) were 2.31 for SCL and 2.92 to SiCL, and the organic carbon partition coefficient, $K_{oc}$, was 292.9 in SCL and 200.5 inSiCL. In the laboratory study, the degradation rate of pencycuron in soils followed a first-order kinetic model. The degradation rate was greatly affected by soil temperature. As soil incubation temperature was increased from 12 to $28^{\circ}C$, the residual half life was decreased from 95 to 20 days. Arrhenius activation energy was 57.8 kJ $mol^{-1}$. Furthermore, the soil moisture content affected the degradation rate. The half life in soil with 30 to 70% of field moisture capacity was ranged from 21 to 38 days. The moisture dependence coefficient, B value in the empirical equation was 0.65. In field experiments, the half-life were 26 and 23 days, respectively. The duration for period of 90% degradation was 57 days. The difference between SCL and SiCL soils varied to pencycuron degradation rates were very limited, particularly under the field conditions, even though the characteristics of both soils are varied.

An Integrated Model based on Genetic Algorithms for Implementing Cost-Effective Intelligent Intrusion Detection Systems (비용효율적 지능형 침입탐지시스템 구현을 위한 유전자 알고리즘 기반 통합 모형)

  • Lee, Hyeon-Uk;Kim, Ji-Hun;Ahn, Hyun-Chul
    • Journal of Intelligence and Information Systems
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    • v.18 no.1
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    • pp.125-141
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    • 2012
  • These days, the malicious attacks and hacks on the networked systems are dramatically increasing, and the patterns of them are changing rapidly. Consequently, it becomes more important to appropriately handle these malicious attacks and hacks, and there exist sufficient interests and demand in effective network security systems just like intrusion detection systems. Intrusion detection systems are the network security systems for detecting, identifying and responding to unauthorized or abnormal activities appropriately. Conventional intrusion detection systems have generally been designed using the experts' implicit knowledge on the network intrusions or the hackers' abnormal behaviors. However, they cannot handle new or unknown patterns of the network attacks, although they perform very well under the normal situation. As a result, recent studies on intrusion detection systems use artificial intelligence techniques, which can proactively respond to the unknown threats. For a long time, researchers have adopted and tested various kinds of artificial intelligence techniques such as artificial neural networks, decision trees, and support vector machines to detect intrusions on the network. However, most of them have just applied these techniques singularly, even though combining the techniques may lead to better detection. With this reason, we propose a new integrated model for intrusion detection. Our model is designed to combine prediction results of four different binary classification models-logistic regression (LOGIT), decision trees (DT), artificial neural networks (ANN), and support vector machines (SVM), which may be complementary to each other. As a tool for finding optimal combining weights, genetic algorithms (GA) are used. Our proposed model is designed to be built in two steps. At the first step, the optimal integration model whose prediction error (i.e. erroneous classification rate) is the least is generated. After that, in the second step, it explores the optimal classification threshold for determining intrusions, which minimizes the total misclassification cost. To calculate the total misclassification cost of intrusion detection system, we need to understand its asymmetric error cost scheme. Generally, there are two common forms of errors in intrusion detection. The first error type is the False-Positive Error (FPE). In the case of FPE, the wrong judgment on it may result in the unnecessary fixation. The second error type is the False-Negative Error (FNE) that mainly misjudges the malware of the program as normal. Compared to FPE, FNE is more fatal. Thus, total misclassification cost is more affected by FNE rather than FPE. To validate the practical applicability of our model, we applied it to the real-world dataset for network intrusion detection. The experimental dataset was collected from the IDS sensor of an official institution in Korea from January to June 2010. We collected 15,000 log data in total, and selected 10,000 samples from them by using random sampling method. Also, we compared the results from our model with the results from single techniques to confirm the superiority of the proposed model. LOGIT and DT was experimented using PASW Statistics v18.0, and ANN was experimented using Neuroshell R4.0. For SVM, LIBSVM v2.90-a freeware for training SVM classifier-was used. Empirical results showed that our proposed model based on GA outperformed all the other comparative models in detecting network intrusions from the accuracy perspective. They also showed that the proposed model outperformed all the other comparative models in the total misclassification cost perspective. Consequently, it is expected that our study may contribute to build cost-effective intelligent intrusion detection systems.