• Journal of Preventive Medicine and Public Health
• /
• v.35 no.1
• /
• pp.49-56
• /
• 2002

Objectives : To identify the relationship between the use of medical services by workers with three types of respiratory diseases(total respiratory diseases, acute upper respiratory infections and chronic lower respiratory diseases) and exposure to hazardous agents after controlling for other factors affecting medical services use, such as characteristics of the enterprises(scale, industry type) and employee demographics (sex, age). Methods : The study population comprised 28,882 workers who had undergone general or special medical examinations at the industrial health center at least once between Jan 1995 and Dec 1997 and had possessed medical insurance during the period. We combined medical examination data with medical insurance data in order to analyze the relationship between exposure to hazardous agents and respiratory diseases, Results : Among the 28,882 study subjects, 17,454 employees(60.4%) used medical services more than once during 3-year study period, owing to more than one kind of respiratory diseases. In logistic regression analysis, sex, age and the size of the enterprises proved to be significant variables on the use of medical services for all three types of respiratory disease; The use of medical services increased with employee age. Women used more medical services than men and the employees in the large-scale enterprises used more services than employees in small-scale enterprises. However, exposure to dust or organic solvents did not affect medical service use due to total respiratory diseases or acute upper respiratory infections. Only in the case of chronic lower respiratory diseases did workers exposed to dusts(OR=1.12, 95% CI=1.01-1.24) or organic solvents(OR=1.19, 95% CI=1.05-1.35) use more medical services than those not exposed. Conclusions : Workers exposed to dusts or organic solvents are particularly apt to suffer from chronic lower respiratory diseases and use medical services more often than those not exposed. That is, chronic exposure to hazardous agents such as dusts and organic solvents is believed to be harmful and to cause respiratory symptoms and diseases.

• The Korean Journal of Financial Management
• /
• v.23 no.1
• /
• pp.227-242
• /
• 2006

This paper analyzes insurance crimes using a game theoretic model. In blackmailing cases involving automobile accidents, insurance criminals deliberately induce innocent drivers(victims) to commit a moving violation such as crossing over the center dividing yellow line, and collide with the victims. After the collision, the criminals and the victims effectively engage in a bargaining game over the amount of the settlement for the damage. Because the penalty for that kind of moving violation is very severe (even criminally prosecuted), the victims do not have much bargaining power. Exploiting the weak bargaining power of the victims, the criminals demand and receive huge compensation (including settlement) from the victims. In the model, it is shown that under the current law agents have perverse incentives leading to insurance crimes. The criminals have incentive to induce car collisions and extract huge settlement from the victims. Based on the analysis, it is suggested that lowering the severity of penalty for certain kind of violation may be needed to prevent insurance crimes, in addition to increasing the crime investigation activities and strengthening punishment for insurance criminals.

• Journal of the Korean housing association
• /
• v.25 no.2
• /
• pp.99-107
• /
• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
• /
• 2002.03a
• /
• pp.39-51
• /
• 2002

Online exchange is a cost-effective approach to trade goods and information among multiple sellers and buyers. Shipping industry includes lots of global entities such as shippers, liners, ship owners and shipping agents. Marine insurance companies and ship repairers and many other groups are also supporting the industry. However, international shipping exchanges are located on few cities in the world. Its our motivation that a shipping market can be online so that market participants do the dealing while sitting where they are with more efficient manner, preferable price and larger pool of candidates of trading partners. This paper presents Korean governmental project of building a cyber shipping exchange. The exchange covers ship sale and purchase, charter, insurance, freight futures, repairs, supplying of ships oil and database service. The workflows of each business were analyzed and designed to fit for online environment. The project includes design of trading mechanism, online documents, data flow, data storage and security. Online match making and trading mechanisms such as auction, reverse auction, bid are used. The whole trading process involves multiple organizations and business processes. So, this Paper focuses on how each organization would play their roles so that users can complete transactions with integrated and transparent view. The online exchange selves also as maritime portal site that links to other sites for cooperation vertically or horizontally, and serves database and information in global perspective. This paper also issues and discusses the justification of an online shipping exchange

• Health Policy and Management
• /
• v.25 no.4
• /
• pp.256-263
• /
• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.3
• /
• pp.221-227
• /
• 2010

The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care. This is a case report of active gingival bleeding care via dental crown removal and emergency primary endodontic drainage as a last method in liver cirrhosis patient with advanced periodontitis.

• Korean Journal of Clinical Pharmacy
• /
• v.21 no.2
• /
• pp.156-160
• /
• 2011

서론: 본 연구는 불필요한 소화기관용 약제의 처방이 한국에서의 처방전 당 약물 개수를 증가시키는 것과의 연관성을 검토하고자 수행되었다. 연구방법: 연구를 위한 자료로 건강보험심사평가원의 처방전 데이터와 환자의 기타 모든 의료보험 청구데이터를 이용하였고, 두 데이터셋을 연결하여 처방전들을 소화기관용 약제의 필요성에 따라 소화기관질환 그룹, 관절염질환 그룹,소화기관용 약제 처방이 불필요할 것으로 그 외 질환 그룹으로 구분, 분리하였다. 결과: 처방전 당 약물의 평균 개수의 분포는 세 그룹에서 비슷한 양상을 보였는데, 관절염질환 그룹과 그 외 질환 그룹의 거의 절반 이상은 한 개의 소화기관용 약제를 포함하였다. 세 그룹 모두 처방전 당 약물 개수와 처방전 당소화기관용 약제의 개수가 1차 선형관계를 보였다. 그 외 질환 그룹에서는 처방전 당 전체 약물이 평균 6개를 넘는 경우, 적어도 한 개의 소화기관용 약제가 포함되었다. 본 연구는 불필요한 소화기관용 약제를 처방하는 것은 다제처방의 매우 유의한 예측인자임을 보였다. 결론: 향후, 약제 처방전의 질을 향상시키기 위해서는 각각의 약물을, 특히 소화기관용 약제를, 처방 시 약제의 불가피한 필요성에 대해 판단할 수 있어야 할 것이다.

• Journal of Preventive Medicine and Public Health
• /
• v.22 no.2 s.26
• /
• pp.223-235
• /
• 1989

To grasp the idea about how drugs are used under Medical Insurance Scheme, the amount and share of drug cost in the total medical fee have been reviewed and analyzed for different types of patients (in-patient out-patient), medical institutions and frequently seen diseases and following findings were revealed. In 1986, drug cost took 32.78% of total medical fee for in-patients and 32.98% for out-patients averaged over 30% share as a whole. When drug cost per case in 1980 be indexed to 100, it has shown steady growth to become 200 for in-patients and about 150 for out-patients in 1986. The contribution of drug cost to the total medical fee is, regardless of patient type-in-patients and out-patients, the highest in University hospitals and followed by General hospitals, Hospitals and Clinics in decending order That for the most frequent 10 diseases came out the highest,79 a with the essential benign hypertension of out-patients in the General hospitals, 61% for the gastric ulcer of out-patients in Hospitals and 33% for the female genital diseases of out-patients in Clinics. The drug cost of oral formula was contributed the most, 7.93% by cardiovascular agents followed by hepatic detoxicants(5.47%) and out-patients(4.93%), and that of injectable formula was contributed the most by antibiotics(24.17%), followed by protein amino-acid preparations(6.19%). The order of drug usage by specialty for the in-patients was the highest with internal medicine followed by general surgery and E.N.T, and that for the out-parients was in the order of Internal medicine, neuropsychology and Ob/Gy. This study revealed that the drug dependency was characteristically different to specialty. In view of the fact that drug cost on average exceeds over 30% of total medical fee, proper drug administration appears to be vitally important for the stabilization of the financial standing of the Medical Insurance Scheme. As a consequence, drug usage guidelines including antibiotics usage shall be established first of all and the voluntary participation for the regulation of drug usage and propagation of the guidelines to medical institutions are strongly coerced.

• Journal of The Korean Ophthalmological Society
• /
• v.59 no.11
• /
• pp.1039-1048
• /
• 2018

Purpose: To evaluate the effects of anti-vascular endothelial growth factor (VEGF) treatment on the healthcare-related finances of patients with age-related macular degeneration. Methods: Changes in health care financing due to newly introduced benefit standards were predicted over the coming 5-year period (2018-2022). We also analyzed the financial impact of scenarios in which agents similar to anti-VEGF, such as the over-licensed drug bevacizumab, were introduced. For this purpose, the future number of patients receiving anti-VEGF treatments was estimated for various scenarios based on National Health Insurance Corporation claims data followed by an estimate of the financial burden. Results: In the case of age-related macular degeneration, the current standard of care (14 times in a lifetime) was maintained in scenario 1. In 2018, the insurance budget for the coming 5-year period was estimated at approximately 440.3 billion won. The insurance cost for that period was estimated at approximately 560.1 billion won under the revised standard of December 2017 (scenario 2). For scenarios wherein, after 2020, similar treatments (scenario 3) and bevacizumab (scenario 4) were introduced, the estimated health insurance costs were 521 billion won and 419.7 billion won, respectively. Conclusions: Health insurance costs are projected to increase substantially due to the elimination of the 14 time pay standard; however, the actual budget will only moderately increase, due to new limitations of visual acuity ${\leq}0.1$ or in case of scarring/atrophic lesions. Clinically similar agents and bevacizumab could be considered as alternatives to anti-VEGF treatment for age-related macular degeneration.

• Journal of Family Resource Management and Policy Review
• /
• v.8 no.1
• /
• pp.15-28
• /
• 2004

Financial planning in the United States has evolved since 1980 from a field comprised of specialists, such as insurance agents, bankers, accountants, and stock brokers, offering particular services to clients, to the situation today, where most professionals offering financial services to households market themselves as comprehensive financial planners. The breadth of knowledge required for financial planning can be seen in the 106 topics covered by the Certified Financial Planner(CFP) Exam. This study reviews the actual conditions of financial planning in the U.S. including suppliers of financial services to household, the philosophy of financial planning, and the financial planning process as described by the CFP Board. Also, this study discusses related research about problems and challenges faced by households in financial planning in the U.S.