• The Korean Journal of Quaternary Research
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• v.2 no.1
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• pp.25-50
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• 1988

The survival of rich evidence of palaeolithic occupation found in the Imjin-Hant'an River basin was possible due to many fortuitous geological conditions provided there. Formation of the basalt plain in a narrow valley system which developed during the late Mesozoic insured the appearance of a basin of sedimentation in which archaeological sites would be preserved with relatively minor post-depositional disturbance. Geomagnetic and K-Ar dating indicates that lava flows occurred during the Brunes Normal Epoch. During and after the process of basin sedimentation, erosion of the plain was confined to the major channel of the present river system which developed along the structural joints formed by the lava flow. Due to characteristic columnar structure and platy cleavage of the basalt bedrock, erosion of the basalt bedrock occurred mainly in vertical direction, developing deep but narrow entrenched valleys cut into the bedrock. Consequently, the large portion of the site area remained intact. Cultural deposits formed on top of the basalt plain were left unmodified by later fluvial disturbances due to changes in the Hant'an River base-level, since they were formed about 20 to 40m above the modern floodplain. Sedimentological evidence of cultural deposits and palynological analysis of lacustrine bed formed in the tributary basin of the Hant'an River indicate that hominid occupation occurred in this basin under rapidly deteriorating climatic conditions. From three thermoluminescence dates, the timing of hominid occupation as represented by 'Acheulian-like' bifaces apparently occur sometime during 45,000 BP. Thus, deposition of cultural layers in this basin approximately coincides with the beginning of the second stadial of the final glacial, during which the Korean Peninsula must have had provided a sanctuary for prolonged human occupation.

• The Journal of the Korean life insurance medical association
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• v.4 no.1
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• pp.44-76
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• 1987

Present study was undertaken to establish the modified Broca's indices to estimate standard body weight by using a total of 5,496 insured persons who were medically examined at the Honam Medical Room of Dong Bang Life Insurance Company Ltd. from January, 1983 to January, 1986. The results were as follows: 1. The linear regression equations of body weight to $height^3$ to estimate standard body weight were as follows: In male, for $18{\sim}19$ age group $y=7.272{\times}10^{-6}{\times}x^3+23.560$ for $20{\sim}29$ age group $y=8.187{\times}10^{-6}{\times}x^3+22.031$ for $30{\sim}39$ age group $y=8.627{\times}10^{-6}{\times}x^3+23.169$ for $40{\sim}49$ age group $y=9.561{\times}10^{-6}{\times}x^3+20.994$ for $50{\sim}59$ age group $y=8.604{\times}10^{-6}{\times}x^3+23.081$ and for all ages group $y=7.778{\times}10^{-6}{\times}x^3+25.929$ In female, for $18{\sim}19$ age group $y=8.252{\times}10^{-6}{\times}x^3+18.920$ for $20{\sim}29$ age group $y=7.715{\times}10^{-6}{\times}x^3+22.409$ for $30{\sim}39$ age group $y=8.808{\times}10^{-6}{\times}x^3+21.440$ for $40{\sim}49$ age group $y=9.691{\times}10^{-6}{\times}x^3+21.940$ for $50{\sim}59$ age group $y=12.550{\times}10^{-6}{\times}x^3+11.031$ and for all ages group $y=7.300{\times}10^{-6}{\times}x^3+26.601$ In both sexes, for all ages group $y=8.342{\times}10^{-6}{\times}x^3+22.998$ 2. The modified Broca's index is expressed by formula $\{height(cm)-100\}{\times}K(kg)$. K is obtained from the following formula standard weight to average height estimated $\frac{by\;means\;of\;linear\;regression\;equation(kg)}{\{Average\;height(cm)-100\}{\times}K(kg)}$=1 Author's modified Broca's indices are as follows: In male, for $18{\sim}19$ age group $\{height(cm)-100\}{\times}0.85(kg)$ for $20{\sim}29$ age group $\{height(cm)-100\}{\times}0.90(kg)$ for $30{\sim}39$ age group $\{height(cm)-100\}{\times}0.95(kg)$ for $40{\sim}49$ age group $\{height(cm)-100\}{\times}1.00(kg)$ for $50{\sim}59$ age group $\{height(cm)-100\}{\times}0.95(kg)$ and for all ages group $\{height(cm)-100\}{\times}0.95(kg)$ In female, for $18{\sim}19$ age group $\{height(cm)-100\}{\times}0.90(kg)$ for $20{\sim}29$ age group $\{height(cm)-100\}{\times}0.90(kg)$ for $30{\sim}39$ age group $\{height(cm)-100\}{\times}1.00(kg)$ for $40{\sim}49$ age group $\{height(cm)-100\}{\times}1.05(kg)$ for $50{\sim}59$ age group $\{height(cm)-100\}{\times}1.05(kg)$ and for all ages group $\{height(cm)-100\}{\times}1.00(kg)$ In both sexes, for all age group $\{height(cm)-100\}{\times}0.95(kg)$ 3. Several types of modified Broca's index recommended by author are as follows: I. In male, for $18{\sim}29$ age group $\{height(cm)-100\}{\times}0.90(kg)$ and for $30{\sim}59$ age group $\{height(cm)-100\}{\times}0.95(kg)$ In female, for $18{\sim}29$ age group $\{height(cm)-100\}{\times}0.90(kg)$ and for $30{\sim}39$ age group $\{height(cm)-100\}{\times}1.00(kg)$ II. In male, for all ages group $\{height(cm)-100\}{\times}0.95(kg)$ In female, for all ages group $\{height(cm)-100\}{\times}1.00(kg)$ III. In both sexes, for all ages group $\{height(cm)-100\}{\times}0.95(kg)$ Note: The first type of modified Broca's index is the most precise one in estimating standard body weight among several types established by author. 4. Error of estimated standard body weight appearing by applying modified Broca's indices is generally greater in short build persons than in tall build persons and is more dominant especially in female group.

• Journal of the Korean Society of Marine Environment & Safety
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• v.26 no.1
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• pp.57-64
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• 2020

The IOPC Fund general assembly reported that the International Convention on Liability and Compensation for Damage in Connection with the Carriage of Hazardous and Noxious Substances by Sea (known as the HNS Convention) will meet the requirement for the convention to take ef ect between 2021 and 2022. When the convention comes into effect, the liability-limit insurance of the HNS transport ship will be enforced and the shipper receiving the HNS will pay the share of the contribution from the International Fund for damages exceeding the limit of the ship's liability insurance. Korea is one of the major shipping and shipper countries in the world; thus, this study aimed to the need to analyze the effect of the convention on the related industries. The survey of ships and contribution targets analyzed the research data of the Ministry of Oceans and Fisheries. The P&I premium estimation was reviewed by the Korea Shipping Association and the K P&I as insured ships. In addition, the contribution of the HNS cargo volume was analyzed in an annual report by a representative international association for each cargo. About 1,500 ocean-going and domestic vessels have been identified as ships subject to the convention. The effect of changes in premiums under the convention was minimal for most ships. The effect of the shipping industry is expected, with about 150 domestic tankers expected to increase insurance premiums. In the case of shipper industries, 52 freight terminals were found to be eligible for the payment of the share of the international fund, as the proportion of freight volume in Korea was ranked second to fourth in the world by individual HNS accounts. This implies the obligation to pay contributions according to the convention. Considering the status of HNS transport ships entering and leaving ports and the quantity of HNS cargo, it can be concluded that the validity of Korea's convention is sufficient and that, it is necessary to coordinate with global major shipper countries.

• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.1-21
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• 1997

In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

• Korean Journal of Health Education and Promotion
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• v.21 no.4
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• pp.121-135
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• 2004

This study aims to analyze the oral health status of the elderly. Study subjects were 9,340 elderly aged over 65 who took the health examination (the first) for the local insured when the National Health Insurance Corporation carried out its survey from January to December, 2002. The subjects took an oral examination and filled in the questionnaire. Major results from the analysis are as follows: 1. Analysis of Oral Health Behavior For oral health behavior, 38.2％ of total subjects had visited a dental hospital (or clinic) in the last one year in the order of the elderly of big cities (48.3％), the elderly of medium cities (43.9％), and the elderly of rural areas (29.0％)(P<0.001). Elderly men had a higher rate than elderly women, and the younger age had a higher rate(P<0.01). For experience of oral prophylaxis, 12.3％ of the total elderly had experienced it in the order of the elderly of big cities (18.8％), the elderly of medium cities (16.0％), and the elderly of rural areas (6.4％) (P<0.001). For elderly men, the younger age had a higher rate of oral prophylaxis. The number of toothbrushing in order was twice(47.5％), once (26.7％), three times (25.0％), and none (0.7％). The younger age brushed their teeth more often (P<0.001). 2. Analysis of Oral Health Status The rate of caries was 10.6％ of the elderly surveyed. By area, the elderly of rural areas had a higher rate of caries than the elderly of cities (p<0.001) and elderly men were higher than elderly women (p<0.001). By age, many elderly aged over 80 had more than two caries. For missing teeth, the elderly of rural areas had a higher rate than the elderly of cities (p<0.001) and the older age had a higher rate(p<0.001). The rate of periodontal disease was 43.2％ of the total elderly. By area, the elderly of big cities (46.2％) had a higher rate of periodontal disease than the elderly of medium cities (39.4％) and rural areas (43.6％)(p<0.001), and elderly men (46.4％) were higher than elderly women (40.2％)(p<0.001). By age, the lower age had a higher rate of peridontal disease (p<0.001). Dental abrasion was observed in 16.9％ of the total elderly. The elderly of cities (21.0％) had a higher rate than the elderly of rural areas (12.0％)(p<0.001) and elderly men (21.3％) were higher than elderly women (12.8％)(p<0.001). Also the lower age had more dental abrasion symptoms (p<0.001). For needing a denture, the rate among the elderly was 48.5％ and was higher for the elderly of rural areas(20.9％), than the elderly of big cities(7.0％) and medium cities (10.5％)(p<0.001). For the rate of denture wearing, the elderly of rural areas(41.8％) were higher than the elderly of big cities (27.7％) and medium cities (28.2％ )(p<0.001). For the relation of drinking and smoking to oral health, the elderly who had a higher frequency of drinking, had a higher rate of caries (p<0.001)periodontal disease(p<0.001) and missing teeth(p<0.001) Smokers had a higher rate of caries (p<0.001), periodontal disease (p<0.05), and missing teeth (p<0.001) than nonsmokers.

• 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.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.91-95
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• 2004

This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

• Journal of Korea Port Economic Association
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• v.30 no.4
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• pp.111-130
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• 2014

The article 742(2) of the Korean Commercial Code allowed the third party to invoke a direct action against the insurer under a liability insurance. Meanwhile, the owners of the vessel enter into the P&I Insurance Contract with the P&I Club to indemnify all kinds of liability or expenses involved in the operation of its vessel. However, the Rule Book under the P&I Insurance mostly included the Pay to be Paid Clause which precludes the third party's direct action. Recently, the Seoul Central District Court passed a judgement on the validity of the Pay to be Paid Clause under the Korean law against the third party i.e. the cargo insurer having the right of subrogation. The court held that (1) the third party's right of direct action is not the right to claim insurance money but the right to claim damages against the P&I Club, (2) the insurer under a liability insurance is deemed to assume liability jointly and severally with the insured against the third party, (3) the Article 742(2) of the Korean Commercial Code is considered as a compulsory provision because it was invented to protect the innocent third party, the Paid to be Paid Clause is thus null and void. The purpose of this article is to evaluate the appropriateness of this court's judgments by comparative analysis of Korean and English law, and to suggest the relevant amendments of the Korean Commercial Code in order to prevent further legal disputes. The article criticizes the decision of the Seoul Central District Court, taking the attitude that, since the third party's right is the right to claim insurance money, the Paid to be Paid Clause is valid against the third party.

• Journal of Preventive Medicine and Public Health
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• v.22 no.4 s.28
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• pp.578-590
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• 1989

This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.