• Health Policy and Management
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• v.17 no.2
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• pp.1-17
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• 2007

Limited coverage for health care services of National Health Insurance(NHI) in Korea has been ongoing policy issue but additional NHI financing through raising contribution or taxes in order to improve coverage faces substantial obstacles. Private health insurance(PHI) is often considered as an alternative financing source to improve coverage. Recent reform that attempted to stretch the role of PHI allowed life insurance companies to provide complementary PHI, indemnity plan which will pay for uncovered services by NHI and out-of-pocket spending for covered services. Although complementary PHI may relieve financial burden of patients, it may significantly raise NHI spending as well as total health expenditure since little out-of-pocket spending may increase utilization of health care. So far, there has not been enough discussion about concerns of potential adverse effect resulting from extended role of PHI. This study investigated potential increase of NHI spending followed by extension of complementary PHI through sensitivity analysis. The amount of NHI spending for services that would be covered by complementary PHI was calculated using 2005 NHI statistics and expected complementary PHI enrollment rate by age and sex. Expected utilization increases were obtained based on price elasticities$(-0.2{\sim}-0.5)$ from previous studies and expected coverage rate$(50{\sim}80%)$ of complementary PHI and then converted to monetary figures. Because coverage rate of complementary PHI has not been determined yet, we employed the sensitivity analysis using coverage rate of $50{\sim}80%$. Findings demonstrate that additional spending for health care services is expected to be $426{\sim}1,702$ billion won, corresponding amount payed by NHI $298{\sim}1,192$ billion won. In conclusion, since complementary PHI may raise NHI spending significantly, there should be an agreement whether this additional cost would be accountable and acceptable in our society. Potential inefficiency resulting from extended role of complementary PHI should be considered since public and private financing do not operate in isolation and there should be more discussion on proper role of PHI in Korea.

• Korean Journal of Social Welfare
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• v.37
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• pp.195-216
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• 1999

Adolescents whose families receive public assistance are primary interest in the article because they experience disproportionate shares of the burden of poverty and psychosocial stress and are at substantially high risk. To explain the psychosocial stresses of high-risk adolescents in poverty, this study analyzed the inter-relations and interactions of major variables: 1) stress related life condition, 2)individual & environmental resources, 3) emotional, behavioral, and academic adjustment. Data came from the survey of 351 students living in the families receiving public assistance. The major findings were as follows. High-risk adolescents in poverty suffered from chronic stresses related life conditions, including family environmental stress, financial & medical stress and stigmatic stress. As the effects of stress increased, depression/anxiety and delinquency of poor youth increased. The psychosocial adjustment of poor youth at risk was most effected by the stress resulted from family environment. Though they were suffered from stresses related poor environment, adolescents in poverty adjusted well, if they had individual and environmental resources including self-esteem democratic parenting and supportive school climate. In conclusion, this study confirmed that emotional, behavioral, and academic adjustment of adolescents in poverty was affected by various stresses from life conditions and individual and environmental resources. In order to improve adjustment of poor youth at risk, life conditions have to be improved and psychosocial resources to be increased. These findings have provided practical implications for social workers helping high-risk adolescents in poverty.

• Korean Journal of Social Welfare
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• v.57 no.2
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• pp.165-184
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• 2005

Japan has remained a welfare laggard among advanced industrial democracies. Therefore, the introduction of the public long-term care insurance(koteki kaigo hoken in Japanese) in April of 2000 looks very unique in terms of the Japanese social security tradition, because it can be interpreted as the expansion of social security system and the weakening of the market power over the livelihood of the ordinary people. In the era of globalization, in which even the highly developed welfare states are forced to shrink their social security systems, Japan, a welfare laggard, looks like being headed to the opposite direction. This article aims to define the character of the public long-term care insurance, and thereby, to evaluate the recent social policy of the Japanese government. This study follows the social democratic model in the study of the welfare state development, which assumes that, under the condition of a weak social democratic party and a fragmented labor movement, the introduction of the long-term care insurance is not equal to the improvement of the Japanese social security system. The main argument of this article is that the long-term care insurance, notwithstanding its appearance as an expansion of public sphere, is part of market-oriented neo-liberal social reforms, which have remained the main feature of the Japanese social policies since the mid-1970's. For this, this study will do a longitudinal analysis on the social consequences of the long-term care insurance incurred to the Japanese social security system for the long-term care, focusing on the income redistribution, the marketization of long-term care sector and the changes in the financial burden of the government, social insurers and general citizens.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5063-5069
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• 2016

Background: Breast cancer is the most common cancer among women in most countries of the world. It is ranked first in females in Morocco (accounting for 33.4% of the total cancer burden) and more than 60% of cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important aspect of breast cancer treatment. The objective of this study was to describe self-reported HRQOL in patients with breast cancer and to investigate its associations with sociodemographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and the Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study, with a mean age of 55.6 (SD. 11.2) years, 70% being married. The majority had stage II (45.9%) and a few cases stage IV (12.9%) lesions. The participants' global health mean score was 68.5 and in "functional scales", social functioning scored the highest (Mean 86.2 (SD=22.7)). The most distressing symptom on the symptom scale was financial difficulties (Mean 63.2 (SD=38.2)). Using the disease specific tool, it was found that future perspective scored the lowest (Mean 40.5 (SD=37.3)). On the symptom scale, arm symptoms scored the highest (Mean 23.6 (SD=21.6)). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasized that the general HRQOL for our study population is lower than for corresponding populations in other countries. This study provided baseline information on the quality of life for a large sample of Moroccan women diagnosed with breast cancer.

• Journal of Navigation and Port Research
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• v.39 no.1
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• pp.69-75
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• 2015

The concrete purpose of this study is to suggest actually a debt ratio to optimize the capital structure providing a kind of approach to estimate the proper debt ratio with an analytical model and empirical data in Korean shipping industry. The mathematical and analytical model is started from the first equation about ROE, return of net operating income on equity, with an independent variable, debt ratio. It is constructed with several parameters, ROS(return of operating income on sales), TAT(total assets turnover), and NFCL(net finance cost to liabilities). There could not be a certain relationship between debt ratio and ROS or TAT, while some correlation or causality between debt ratio and NFCL. In other words, most of firms with high debt ratio is likely to burden higher finance cost than others with low one. In this case, there is a linearity relationship between debt ratio and NFCL, so then the second equation considering this relation could be included within the analytical approach of this paper. To be short, if the criteria of adequate debt ratio has to be defined as some level of debt ratio to optimize ROE, the ROE could be illustrated as a quadratic equation to debt ratio from two equations. Next, this research estimated those parameters' numbers through the single regression method with data over 12 years of Korean shipping industry, and identified empirically the fact that optimal debt ratio would be approximately 400%. To conclude, if that industry's sales and operating incomes are stable, the debt ratio could be accepted until twice of 200% had forced in order to guarantee its financial safety in past time.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.264-273
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• 2011

This study subject is to provide appropriately basic information about annually increased implant treatment by their lost teeth base on increasing old people and also analyze factors influencing implant treatment decisions for patient. For about 3 month from July on the 2010, This survey was carried out at 13 dental clinic as target of 217 patients on categorized into implant treatment-group and non-treatment-group in Seoul and Gyeonggi-do. Implant treatment-group showed highest portion at 50(30.3%), non- Implant treatment-group showed highest portion at 20's(35.7%), And The patients of implant treatment-group are good oral condition, and they showed a positive attitude. Result of analysis by multiple logistic analysis(regression), Factors of influencing implant treatment decision are age, gender, period of education, monthly income, condition of periodontal tissue, regular checkup, counseling attitude, trust in hospital. Therefore, proactive management about the necessity of regular dental check-up is needed the education and promotion. And medical team should have efforts to Improving technique of medical consultations and Improving the trust of the hospital's for implant treatment decision. Also, The patient's subjective determine rather than it is important to preparing to facilitate decision of specific clinical basis. And The government's financial support and policy alternatives are certainly required in order to be implant treatment without cost burden.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.60-73
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• 2000

Purpose : The purpose of this study was to describe a total pain model in patients with terminal cancer and to identify factors relating to total pain using the Twycross Pain Management Model, which included physical, psycho-social and spiritual pain. Method : The study was a retrospective descriptive study. The first stage included 87 patients who received hospice service at Y hospital in 1997. The second stage included five model patients who suffer severe pain as selected by the four hospice nurses. Data collection was from 1) chart analysis and 2) in-depth interviews with the hospice nurses about their selected patients. Data analysis was performed using SPSS-WIN and content analysis. Result : 1) The main problems of 3 patient with terminal cancer were pain(77%), constipation (25.3%), family coping(35.6%), psycho-spiritual distress(17.2%)and other symptoms. 2. The Twycross model was a useful model. However, new items were added; loneliness, depression, and no improvement in condition as depression factors. In anger, new items were anger due to family neglect, at God and in relationships. The case studies identified the followsing; 1) Patient suffer from physical pain as well as multiple other symptoms when cancer is advanced. 2) Body concept, role change, threat to self concept, fear of pain, fear of death, anxiety, family conflict, financial burden, spiritual distress, hope for a cure, are all affected. Conclusion : 1) It is believed that the Twycross model is useful but further tests and revisions are necessary for deciding priorities in the care plan. 2) Pain management must improve culturally appropriate and family support, psychological, spiritual care are imperative for patient with terminal cancer. 3) Further study is recommended to test correlations of depression, anxiety, spiritual distress and family coping using valid instruments. A qualitative study on the spiritual journey of the patient with terminal cancer is also recommended.

• Korea Journal of Hospital Management
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• v.20 no.3
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• pp.45-55
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• 2015

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

• Korean Journal of Social Welfare
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• v.58 no.2
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• pp.167-195
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• 2006

The purpose of this study is to suggest the revision direction of the Korean Child Welfare Law based on the results of the comparative analysis on the Korean Child Welfare Law and the Japanese Child Welfare Law. The main results are: Both laws have only two provisions about children's participation right. The child protective system in Japan secures the swiftness of within-two-months period of temporary protection through the child consulting center, the investigation right by the child welfare worker, publicity, enforcement on the parents' rights, and the network with the nearest child supporting center. Furthermore, those provisions with the notifying obligation by a finder of the child who needs protection and the limit of protection period are guaranteed in order to ensure the effectiveness of law enforcement. However, Korean child protective system functions only as pre-substitutive service. While the provisions for the disability children account for 21.2% of the total Japanese law, there is no provision on that in the Korean law. The Japanese law is substantially different from the Korean law in a sense that it obligates the minimum quality criteria of child service and national financial burden on the child welfare. While the Japanese law clearly stipulates the national responsibility in relation to the degree of the rights, the Korean law does not directly touch upon it. Furthermore, the Japan's law guarantees that not only children but also protectors retain the right to choose and apply for services.

• Journal of Intelligence and Information Systems
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• v.12 no.2
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• pp.125-144
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• 2006

The development of mobile applications is fast in recent years. However, nearly all applications are for messaging, financial, locating services based on simple interactions with mobile users because of the limited screen size, narrow network bandwidth, and low computing power. Processing an algorithm for supporting a group decision process on mobile devices becomes impossible. In this paper, we introduce the mobile-oriented simple interactive procedure for support a group decision making process. The interactive procedure is developed for multiple objective linear programming problems to help the group select a compromising solution in the mobile Internet environment. Our procedure lessens the burden of group decision makers, which is one of necessary conditions of the mobile environment. Only the partial weak order preferences of variables and objectives from group decision makers are enough for searching the best compromising solution. The methodology is designed to avoid any assumption about the shape or existence of the decision makers' utility function. For the purpose of the experimental study of the procedure, we developed a group decision support system in the mobile Internet environment, MOBIGSS and applied to an allocation problem of investor assets.