• Health Policy and Management
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• v.27 no.3
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• pp.211-218
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• 2017

Background: Korea set up new diagnosis related group (DRG) as demonstration project in 2009. The new DRG was reformed in 2016. The main purpose of study is to identify the effect of reform on accuracy of payment. Methods: This study collected inpatient data from a hospital which contains medical information and cost from 2015 to 2016. The dependent variables were accuracy of total, bundled, unbundled payment, and payment for procedures. To analyze the effect of reform, this study conducted a multi-variate regression analysis adjusting for confounding variables. Results: The accuracy of payment increased after policy reform. The accuracy of total, bundled, unbundled payment, and payment for procedures significantly increased 3.90%, 2.92%, 9.03%, and 14.57% after policy reform, respectively. The accuracy of unbundled payment showed the largest increase among dependent variables. Conclusion: The results of study imply that policy reform enhanced the accuracy of payment. The government needs to monitor side effects such as increase of non-covered services. Also, leads to a considerable improvement in the value of cost unit accounting as a strategic play a role in development of DRG.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• International Journal of Computer Science & Network Security
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• v.23 no.3
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• pp.169-176
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• 2023

The vehicular ad hoc network (VANET) is currently an important approach to improve personal safety and driving comfort. ANEL is a MAC-based authentication scheme that offers all the advantages of MAC-based authentication schemes and overcomes all their limitations at the same time. In addition, the given scheme, ANEL, can achieve the security objectives such as authentication, privacy preservation, non-repudiation, etc. In addition, our scheme provides effective bio-password login, system key update, bio-password update, and other security services. Additionally, in the proposed scheme, the Trusted Authority (TA) can disclose the source driver and vehicle of each malicious message. The heavy traffic congestion increases the number of messages transmitted, some of which need to be secretly transmitted between vehicles. Therefore, ANEL requires lightweight mechanisms to overcome security challenges. To ensure security in our ANEL scheme we can use cryptographic techniques such as elliptic curve technique, session key technique, shared key technique and message authentication code technique. This article proposes a new efficient and light authentication scheme (ANEL) which consists in the protection of texts transmitted between vehicles in order not to allow a third party to know the context of the information. A detail of the mapping from text passing to elliptic curve cryptography (ECC) to the inverse mapping operation is covered in detail. Finally, an example of application of the proposed steps with an illustration

• Korean Journal of Medicinal Crop Science
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• v.24 no.2
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• pp.101-109
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• 2016

Background: The purpose of this study was to evaluate methods to reduce seeding expenses, thereby increasing farm income. This study investigated the effects of rain shelter controlled cultivation and adapted seeding times on the stable seed production of Scutellaria baicalensis Georgi. Methods and Results: Seed germination was conducted under 10 condition compose to control, water washing, cold storage at $4^{\circ}C$ for 15 days, seed sterilization with a benomyl pesticides, hormone treated seed by submerging in 100 ppm $GA_3$ with the cold storage at $20^{\circ}C$ and $25^{\circ}C$, darkness in a covered petridish and illuminated with a 1,500 Lux lamp. There were three cultivation type, open cultivation with non-woven fabric mulching, cultivation with a vinyl covering and rain sheltered in a plastic greenhouse. Sowing dates were April 27, May 18, June 7 and June 28, 2013. Plants were spaced 10 cm apart in rows 30 cm apart. Mixed oil cake fertilizer, $N-P_2O_5-K_2O$ (12-10-10) was applied at $600kg{\cdot}10a^{-1}$. Conclusions: Optimum germination occured in darkness at $25^{\circ}C$ and cold storage after submerging in $GA_3$. The highest seed yields ($4.5kg{\cdot}10a^{-1}$) occurred in the plastic greenhouse for the April 25 sowing. The highest root yield (17%) was found on April 1, under greenhouse conditions.

• Health Policy and Management
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• v.24 no.2
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• pp.181-190
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• 2014

Background: Demands are recently rising for the securement of procedural justification of policy decision-making. This study aims to improve the procedure of making a decision to expand health insurance benefit package from the perspective of building a social consensus. Methods: Major priority principles were firstly derived through literature search. Weights for such principles were calculated through an analytic hierarchy process, based upon the survey conducted for the health policy experts. Priority for 11 non-covered services was assessed by applying the weights as above to the results of the questionnaire survey targeted at people including members of related committees or societies. Results: Weights for priority principles were in the order of 'severity/urgency (0.428)', 'cost-effectiveness (0.318)', 'substitutability (0.164),' and 'accountability (0.090)'. What was obtained by applying these weights to the results of the questionnaire survey was considerably in line with what health experts classified those items into 3 groups depending on their own judgement of service necessity (consistent with 9 services out of 11). Conclusion: Results of the study are suggestive as to how far a brief assessment by experts could be utilized in case there are constraints on time and expenses in implementing all the process to secure procedural justification. Various attempts and endeavors need to be made to secure procedural justification that will not mar efficiency of decision-making in the days to come.

• Journal of Preventive Medicine and Public Health
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• v.41 no.5
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• pp.287-294
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• 2008

Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

• Journal of Venture Innovation
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• v.3 no.1
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• pp.165-182
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• 2020

This research shows solutions for relieving the reversibility of the VAT system, and the solutions will be reviewed with current issues about supporting welfare. The Followings provide practical implementing solutions for each issue. Since the VAT is taxed for all goods and services as a general consumption tax, it is efficient tax policy for resource allocation comparing to income tax. On the other hand, because of the reversibility of the tax burden is also treated as a non-effective tax system for fair taxation. Even it is a non-effective tax system, the VAT system takes the most portion from the total national tax. In South Korea economic system, it is hard to raise the VAT rate because the economic effects are tremendous. For the long-term, the possibility of increasing the VAT rate is unavoidable, considering the economy, society, environment and energy, and aging. Therefore, a variety of substituted policies for the reversibility should be covered once there is a conference for the increase in the VAT rate. This research provides foundational solutions by acknowledging the reversibility of the tax burden in terms of the effective value-added tax rate. The followings are four solutions. First, it is required to adjust the duty-free system for relieving the reversibility and expand the tax-free system as well as individual consumption tax items. Second, The relief of reversibility should be worked by imposing higher the tax rate for high-income people' goods and services. Third, the adjustment of the duty-free system could be considered due to relieve the reversibility of the VAT. Last, it is considered to adjust of the simplified taxation system because the simplified taxation system is seriously against the tax-transfer principles.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3465-3468
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• 2016

Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

• Asian-Australasian Journal of Animal Sciences
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• v.10 no.6
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• pp.581-586
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• 1997

The present study analysed the various productive and reproductive characteristics of 1/2 Pabna Milking Cows (PMC)-1/2 Sahiwal (S) and 1/4 PMC-3/4 S collected from the Pabna milkshed area at Baghabarighat, Sirajgonj, Bangladesh. The studied traits were birth weight (BWT), age at puberty (AP), number of services per conception (NSC), post partum heat period (PPHP), gestation period (GP), daily milk yield (DMY), lactational production (LP), lactation length (LL), fat percentage and solids-not-fat percentage (SNFP). Five individual Sahiwal sires were used for the upgrading of Pabna Milking Cows. The used data covered from 1987 to 1994. Least-squares analysis of variance showed that genetic group had a significant effect on BWT (P < 0.05), AP (p < 0.01), DMY (p < 0.01), LP (p < 0.001), LL (p < 0.05), FP (p < 0.05) and SNFP (p < 0.01). Genetic group had non-significant effect on NSC, GP and PPHP. The effect of sire was significant on BWT (p < 0.01), NSC (p < 0.01), LP (p < 0.05) and LL (p < 0.05). The AP, NSC, DMY, LP, LL and SNFP were higher in 1/2 PMC-1/2S cows; BWT and PPHP were higher in 1/4 PMC-3/4S but GP and FP were almost same in both genetic groups. From this study it may be concluded that production and use of 1/2 PMC-1/2S would seem more profitable for commercial milk production in the Bangladesh Milk Producers' Cooperative Union Limited (BMPCUL) area and at the same time emphasis should be given on rigorous sire selection.

• Horticultural Science & Technology
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• v.31 no.1
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• pp.32-37
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• 2013

Relationships among climate changes, early frost, and fruit growth were studied during the final month to harvest of late-maturing 'Fuyu' persimmon (Diospyros kaki) to assess the changes in fruit characteristics during this critical period. The heavy frost on Nov. 16 defoliated more than 70% of the leaves, but with little damage on the fruits. However, all the leaves were defoliated by the heavy frost on Nov. 20, and all the fruits were cold-damaged by $-3.3^{\circ}C$ on Nov. 21. Fruit weight increased by 8-25 g per week from Oct. 25 (142 days after full bloom) to Nov. 15, reaching to 250 g, but it decreased by 3-4 g per week after the frost. Hunter a value of fruit skin gradually increased until the last harvest on Nov. 29 with a temporary halt in early Nov. when temperature was high, whereas fruit firmness rapidly decreased after the frost on Nov. 21. Fruit soluble solids were $15.7-16.1^{\circ}Brix$ for the final month. When some branches were covered with non-woven fabrics to avoid direct contact with frost, the fruits on the branches were not visually damaged by the low temperature although 40-60% of their leaves were defoliated on Nov. 16. However, low temperature on Nov. 20 and 21 defoliated all the leaves, causing cold damage on the fruits. There was a highly significant correlation between the fruit diameter and its weight ($R^2$ = 0.73-0.91). So, the regression equations could be used to estimate weight from diameter of the fruits sampled from the branches with the non-woven fabrics. The calculated fruit weight reached to a maximum of 240 g on Nov. 15. Daily increases in fruit weight were 1.1-2.5 g from Oct. 25 to 31, 1.9-3.5 g from Oct. 31 to Nov. 7, and 1.4-1.6 g from Nov. 7 to 12. However, fruit weight decreased by 0.3-1 g per day after the cold damage on Nov. 21. The results indicate that the most appropriate harvest time could be dependent on relationship of fruit growth to climate.