• Title/Summary/Keyword: insurance agent

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Serum 2,3,7,8-Tetrachlorodibenzo-p-dioxin Levels and Their Association With Age, Body Mass Index, Smoking, Military Record-based Variables, and Estimated Exposure to Agent Orange in Korean Vietnam Veterans

  • Yi, Sang-Wook;Ohrr, Heechoul;Won, Jong-Uk;Song, Jae-Seok;Hong, Jae-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.5
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    • pp.226-236
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    • 2013
  • Objectives: The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. Methods: Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximitybased exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. Results: The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. Conclusions: The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.

A Proposal of study Designs and Methods for Evaluating the Adverse Health Effects of Agent Orange among Korean Vietnam Veterans (고엽제의 건강위해성 평가를 위한 연구설계와 방법 제안)

  • Yi, Sang-Wook;Won, Jong-Uk;Hong, Jae-Seok;Ohrr, Hee-Choul
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.3
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    • pp.228-236
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    • 2001
  • Objectives : To propose a feasible, valid and appropriate study designs and epidemiologic methods for evaluating the adverse health effects of Agent Orange-chemical defoliants used in Vietnam- in Korea. Methods : A literature study was peformed on Agent Orange, herbicides, pesticides and dioxins. The study subjects, study design, exposure assessment and health outcomes assessment were examined in each study. The potential data sources for the study subjects, study design, exposure assessment and health outcomes assessment in Korea were investigated. Results and Conclusion : In earlier Korean studies, research subjects for studying the effects of Agent Orange were identified from the patients or persons who claimed to have Agent Orange-related diseases due to the difficulties in identifying the entire population of Vietnam veterans in Korea. In this study, an attempt was made to identify the total number of Vietnam veterans in Korea. As a result, the addresses of 20,000 Vietnam veterans were obtained. It is proposed that a retrospective cohort design on a sample of the total number of Vietnam veterans is a feasible and appropriate study design. Self report questionnaires and military records were proposed to assess the exposure level. It is believed that measuring the plasma or tissue TCDD should be used only for a validation study assessing the level of exposure. For the health outcomes assessment, it is possible to obtain the mortality, cancer frequency, physical examination, screening and medical insurance record data.

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A Study on the Role of Third Party in Import and Export Management

  • Jin-Hwan KIM
    • East Asian Journal of Business Economics (EAJBE)
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    • v.11 no.2
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    • pp.39-57
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    • 2023
  • Purpose - This paper is to examine the work of a third party in the process of import and export management. In other words, the purpose of this paper is investigate the status and functional role of a third party in relation to each terms of the trade contract. Research design, data, methodology - This study consists of 5 chapters through literature survey. It will examine the involvement of the third party through each terms. Chapter 1 introduction, Chapter 2 deals with trade contracts, Chapter 3 investigates the shipping terms, payment terms, and insurance terms, and Chapter 4 reviews with commercial arbitration. And in Chapter 5, it looks at the conclusion and implications. Results - The relevant party in the import and export management process may be a third party through outsourcing, not the principal. At this time, in fulfilling each condition of trade, it can be seen that the implementation of tasks through the participation of a third party with high expertise can more smoothly and productively implement the overall import and export management. Therefore, it can be seen that the implementation of the trade business in which the third party participated can be interpreted in terms of derivative effects and at the same time can be a way to improve the principal's competitiveness procedurally. Conclusions -Through this study, in the import and export management, the performance of the work through the agent makes the entire process more smooth and efficient. Outsourcing of roles using the expertise of a third party, a subcontractor rather than a principal, is desirable and important.

Cancer Mortality and Morbidity Based on Secondary Data Analysis of Health Among Residents Around Waegwan, Gyeongsangbuk-do, Korea (건강관련 2차 자료에 근거한 왜관 지역주민의 암 발생 현황)

  • Lee, Kwan;Lim, Hyun-Sul;Min, Young-Sun;Lee, Duk-Hee;Ju, Young-Su;Yang, Won-Ho;Cho, Yong-Sung;Kim, Geun-Bae
    • Journal of Environmental Health Sciences
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    • v.39 no.4
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    • pp.335-345
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    • 2013
  • Objectives: As the suspicion was raised that 'Agent Orange' was reclaimed 30 years ago at Camp Carol, located in Waegwan, Gyeongsangbuk-do, the government conducted an investigation of the influence of environmental and health effects around Camp Carol through a public-private joint investigation team. As part of the investigation of population health effects, this study was carried out in order to observe changes and regional differences in diseases, particularly cancer, by year. Methods: We authors conducted an analysis of secondary health data, such as cancer registration data, mortality data, and health insurance data. We drew an age standardized incidence ratio (SIR), death rate (SDR), mortality ratio (SMR), and health care utilization rate using these data. Results: For gastric cancer in women, and other cancers in men, a significant increase in incidence was observed compared to the control area. For biliary tract cancer, gallbladder cancer, and thyroid cancer in women, and prostate cancer in men, a significant decrease in incidence was observed compared to the control area. In the national statistical analysis of data, such as health insurance data and mortality data, we did not observe a significant increase at the Waegwan region compared to other regions. Conclusions: We must consider the limitations of this study. Because thirty years have passed from the time of the estimated landfill of 'Agent Orange', recent national statistical data may not reflect the past real situation. Therefore, the monitoring of secondary data for health effects at the municipal level should be carried out continuously.

Treatment Patterns of Osteoporosis and Factors Affecting the Prescribing of Bone-forming Agents: From a National Health Insurance Claims Database (건강보험 청구자료를 이용한 골다공증 치료제의 처방 양상과 골형성촉진제 처방에 미치는 영향요인)

  • Jeong, Jihae;Shin, Ju-Young
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.1
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    • pp.27-34
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    • 2021
  • Objective: To analyze osteoporosis treatment patterns and teriparatide prescription-associated factors in Korea by using a national health insurance claims database. Methods: We utilized the Health Insurance Review & Assessment Service National Patients Sample claims database to identify patients (aged ≥50 years) with at least one osteoporosis claim (International Classification of Disease 10th revision code: M80, M81, M82) and at least one prescription for osteoporosis medication (antiresorptive agents: bisphosphonates, selective estrogen receptor modulators, denosumab, and calcitonin; bone-forming agent: teriparatide) in 2018. Demographic characteristics and healthcare utilization patterns were analyzed. Factors associated with teriparatide prescriptions were assessed using a multivariate logistic regression model. Results: Records showed that 44,815 patients were prescribed osteoporosis medications in 2018; the percentage of patients prescribed each treatment was as follows: 86.6% bisphosphonates, 13.9% selective estrogen receptor modulators, 3.1% calcitonin, 2.1% denosumab, and 0.7% teriparatide. A greater proportion of patients prescribed teriparatide were ≥75 years (53.4% vs. 33.8%) and had fractures (63.9% vs. 12.8%) compared to the same for antiresorptives (p<0.001). Patients prescribed teriparatide had higher Charlson comorbidity index values (1.2±1.3 vs. 0.9±1.2) and were more frequently hospitalized (0.8±1.3 vs. 0.1±0.5) than those prescribed antiresorptives (p<0.001). Elderly patients (≥75 years old; adjusted OR=1.66; 95% CI 1.16-2.38) and those with fractures (adjusted OR=6.23; 95% CI 4.76-8.14) were more likely to be prescribed teriparatide than antiresorptives. Conclusion: Patients prescribed teriparatide were older and more likely to have severe osteoporosis than those prescribed antiresorptives.

Prescribing Pattern and Safety Analysis of Nonsteroidal Anti-inflammatory Drug and Gastro- Protective Agent following Reimbursement Guidelines Relaxation (요양급여심사기준 완화에 따른 비스테로이드성 항염제 및 위장관 보호제 처방 변화 및 안정성 분석)

  • Han, Mi Hye;Noh, Eunsun;Nam, Jin Hyun;Lee, Sang Won;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.4
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    • pp.250-257
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    • 2017
  • Objective: The prevalence rate of osteoarthritis in Koreans aged 50 years or older is 14.3%, and the total amount of medical costs is more than KRW 1 trillion. Recently, the reimbursement guidelines for osteoarthritis treatment have changed. Methods: In this study, we sought to describe prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and gastro-protective agent (GPA) and analyze the clinical and economic impacts of the new policy using the national health insurance claims data. The incidence of upper gastrointestinal adverse event by policy change was identified through the odds ratio, and changes in medicine and medical costs related to osteoarthritis through mean and median. Results: There were 204,552 patients before the reimbursement guidelines relaxation and 239,710 after it, a 17.2% rise. The prescription ratio was 3.3% for the patients prescribed with COX-2 selective NSAIDs alone and 1.3% for those with both COX-2 selective NSAIDs and GPA combination before the reimbursement guidelines relaxation. The reimbursement guidelines relaxation significantly increased their ratios to 6.9% and 2.8%, respectively. Gastrointestinal adverse events significantly reduced by 1.21%p after reimbursement guidelines relaxation. The average medicine cost per person increased significantly to KRW 140,291 from KRW 137,323 after the reimbursement guidelines relaxation, while the average medical cost per person slightly decreased from KRW 311,605 to KRW 310,755 after the relaxation, showing no meaningful difference. Conclusion: The reimbursement guidelines relaxation may influence on decreasing the upper gastrointestinal adverse event, increasing the medicine costs and maintaining the medical costs for osteoarthritis.

The Function of Strategic Purchasing and Its Application to the Korean National Health Insurance System (의료보장제도 운영에 있어서 전략적 구매의 개념과 한국 제도에의 적용)

  • Kim, Duck-Ho;Chung, Seol Hee
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.504-516
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    • 2018
  • Many countries have tried to reform financing systems toward UHC and paid attention to the function of strategic purchasing. This study was performed to examine theoretical foundations and the function of strategic purchasing. And we examined the functions of strategic purchasing in Korea based on the framework proposed by Preker(2005). For this purpose, we reviewed literature related to purchasing. we defined the strategic purchasing as strategic activities to provide health care services people need within a given budget, which is carried out by certain organizations, purchasing organizations. These activities include selecting appropriate providers, designing and operating the payment system, setting the price, and determining the target populations and their needs etc. The relationships among government, purchasers and healthcare providers can be explained by the principal-agent theory. In addition to Preker's framework, we emphasized the importance of the infrastructure such as decision making support systems, information systems, health care resource management systems, or expenditure monitoring systems. The National Health Insurance Service and the Health Insurance Review & Assessment Service play major roles in performing strategic purchasing.

Suggestion for Emotional Labor of Agent in Customer Center : Focusing on Verbal Abuse (고객센터 상담사의 감정노동에 관한 제언(언어폭력을 중심으로))

  • Kim, Hee-Jung;Park, Deuk
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2013.07a
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    • pp.169-172
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    • 2013
  • 본 논문에서는 서비스업 종사자들의 감정노동에 따른 언어폭력의 실례를 파악하여 보고자 한다. 폭력은 외부로 가해지는 신체적 상해로 인지하고 있으나 언어폭력에 대한 인식은 상대적으로 미약하다. 외적으로 드러나는 상해가 아니어서 언어적 폭력의 강도는 더욱 심해지고 있으며, 자신의 감정 해소를 위한 수단으로 악이용되는 사례도 다분하다. 언어폭력이 미치는 영향 및 잘못된 인식 개선과 사회적, 제도적 대응 방안 마련 등 문제 제기를 통해 앞으로 심층적 연구를 하고자 한다.

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Prescription Patterns and Appropriateness of Topical Mupirocin in Ambulatory Care using the Korean National Health Insurance Claims Database (건강보험심사평가원 환자 표본 자료를 활용한 mupirocin 외래처방 패턴 분석 및 처방적절성 평가)

  • Suh, Jinuk;Jeong, Kyeong Hye;Kim, Eunyoung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.238-244
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    • 2016
  • Background: Mupirocin, a topical antimicrobial agent has been used for patients with methicillin-resistant Staphylococcus aureus and recently mupirocin resistance was issued in some studies. The objective of this study was to analyze prescription patterns of topical mupirocin, to evaluate appropriateness of prescriptions in the ambulatory setting, and to compare frequency of mupirocin usage in South Korea with that in United States. Methods: Topical mupirocin prescription patterns (the number of prescription and a prescription period), and appropriateness of prescription (including a prescription rate over 10 days, a repeat prescription rate within 30 days and a prescription rate within labeled indications) were analyzed using the 2012 Health Insurance and Review and Assessment service-National Patient Sample dataset of South Korea. The National Ambulatory Medical Care Survey dataset was used to quantify topical mupirocin prescription in United States for comparison. Results: In South Korea, the prescriptions rate for use over 10 days was 3%, the repeat prescription rate within 30 days was 8.87% and the prescription proportion within labeled indications was 33.84%. The most frequent diagnostic code was nonbacterial infection. The prescription rate per 1000 population of topical mupirocin in South Korea was calculated to be 46.07, whereas in United States was calculated to be 13.10. Conclusion: Topical mupirocin has been used frequently and inappropriately, so further studies are required to investigate the rationale behind such prescribing mupirocin patterns.

Current status and future tasks of visiting oral health care services for elders (우리나라 노인 방문 구강건강관리 서비스의 현황과 향후과제)

  • Lee, Sue-Hyang;Bae, Soo-Myoung;Shin, Bo-Mi;Lee, Hyo-Jin;Shin, Sun-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.4
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    • pp.457-467
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    • 2020
  • Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.