• Journal of Genetic Medicine
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• v.4 no.2
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• pp.167-178
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• 2007

Purpose : The necessity of professional non-MD genetic counselor has been recently emphasized in a medical field. By conducting a national survey on the demands for generic counseling and professional non-MD generic counselor, we can make a long-term master plan to execute the educational program for professional genetic counselors and indeed promote genetic counseling in Korean health care service in a systemic manner. Methods : The survey has been conducted from September 3rd to October 4th of 2007 in a way of e-mail, telephone interview, fax, and direct contacts. It's targets were senior researchers and professors in medical and non-medical institutions, policy makers, research institutions or foundations. The survey questions consist of 16 questionnaires. Results : As a result of survey, 102 of 650 people responded. 80% of respondents indicated that genetic counseling is needed as a health care service and 34% among them considered it as "the most needed". In addition, 77% of the respondents showed that, it is necessary to have a professional non-MD genetic counselor with a master degree or higher in the field of medical genetics and among them 29% thought it as "the most necessary". A 77% of respondents considered that the cost of genetic counseling should be covered by health insurance and among them, 29% answered "strongly agreed". A 56% of respondents chose the answer of "They have a plan to hire the professional non-MD genetic counselor" in their institution, and among them 71% selected "within 5 years" in terms of when to hire. Also, they tend to expect the role of the professional non-MD genetic counselor to be not only "genetic counselor" (60%), but also "researcher" (42%), "educator" (18%) and "clinical laboratory coordinator" (19%). Conclusion : The 102 of 650 people responded to the survey. Based upon the nationwide survey over the needs on genetic counseling in health care service and demands on the professional non-MD genetic counselor, systematic educational program for the genetic counseling, with reimbursement coverage for counseling service by health insurance should be emphasized in development of a master plan.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4031-4039
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• 2015

The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

• 한국노년학
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• v.25 no.2
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• pp.109-126
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• 2005

Recently it has been encouraged in developed countries that labor force participation of the elderly is one of the means to cut down the cost of social welfare for them. However, empirical studies have rarely explored how work in later life contributes to national economy. Especially, even though 56.6 percent of elderly workers aged 65 and older engaged in agriculture and forestry in Korea, their contribution has been socio-economically overlooked. This study aims at examining the effect of farming labor in later life on social welfare expenditure. For this purpose, social welfare expenditure was defined as social benefits provided for the elderly by the social security in public sector and measured as transportation allowance, pension, livelihood aid, medical aid, and health insurance in 2003. Data were obtained from National Health Insurance Cooperation and 37 town/village offices and analyzed by 3 age groups; 65~74, 75~84, and 85 and over using SPSS/PC windows program. Results showed that both livelihood and medical support in all age groups were expended more to non-farm than to farm workers. The amount differences per person between them were 113,959~361,132 won in livelihood support and 15,644~51,418 won in medical support. Also, participation in farming influence reduction of livelihood expenditure for the group 65~74 and 75~84 and that of medical expenditure only for the group 65~74. Based on these results, it was estimated the amount of social welfare expenditure reduced by farming labor in later life. The limit of this study and the policy implications of the results are discussed.

• Korea Journal of Hospital Management
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• v.14 no.4
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• pp.71-87
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• 2009

This study was conducted to present strategies for efficient use of older people's medical expense and efficient management of hospital beds 삭제by analyzing factors which influenced medical charge of inpatients with stroke and medical charge of each medical treatment. The subjects was 1,070 inpatients with stroke in Academic hospital. The result of this study can be summarized as follows. In the case of cerebral hemorrhage, the rate of female was higher than that of male. In the case of cerebral infarction, the rate of male was higher than that of female. With increase of age, patients with cerebral hemorrhage decreased and patients with cerebral infarction increased. Medical charge for cerebral hemorrhage was 12,600,000 won, while that for cerebral infarction was 572,000 won. The medical charge with surgery was four times of that with non-surgery. The total medical charge for inpatients with stroke was 6,860,000 won. The patient payed 2,240,000 won(32.6%) and National Health Insurance Corporation payed 4,620,000 won(67.3%). Among charges of specific medical treatments, operation and treatment charge was highest(27.7%) in the case of cerebral hemorrhage, while examination charge was highest(32.2%)in the case of cerebral infarction. This study will provide basic information for efficient use of Medical Charge for Inpatients with Stroke.

• Journal of Digital Convergence
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• v.14 no.9
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• pp.139-147
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• 2016

Korea is ahead of the launch of internet banking professional following to America, Europe and Japan. Internet banking is a professional non-store bank to conduct business such as deposits and loans on the internet and call centers. It is operating in a low-cost structure and minimizes the loans and deposits, various fees than traditional banks and obtains a profit. In order to be successful internet banking professional to develop a differentiated work with the existing banks should be competitive. In this paper, we explore and analyze the cases of Japan and the United States to present the future direction of domestic Internet banking professional future. Also it is expected to enable faster and more convenient one-stop financial services. Internet specialized bank is expected to continue to develop further by the inevitable competition with conventional banks as developing differentiated financial services. Deregulation of banks and industries and participation of various companies of security, insurance, telecommunications, and retail are expected to lead to the convergence among industries and development of new financial services.

• Health Policy and Management
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• v.25 no.3
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• pp.240-251
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• 2015

Background: Dentist's income is quite variable. We investigate the factors underlying the distribution of dental revenue and dentist income. Methods: Financial and structural variables of private dental practices(N=13,967) were examined with 2010 Economic Census microdata which include non-insurance revenue. We conducted quantile regression method(QRM) and ordinary least square(OLS) in treating skewness and heteroskedasticity of distributions. The effective estimation for the upper and lower range of distribution becomes possible by QRM. Results: Mid-career dentists are shown to have higher revenue and income. Male dentists achieve the higher revenue and income than female dentists in all quantiles. Group practices show lower income per owner than solo practices significantly. The revenue and income are increased with increasing size of clinics. The high cost in renting the clinic office is found to have a big positive effect on the revenue but a little positive effect on the income. Interestingly the density of dentists shows negative effect on the lowest quantile of the revenue but positive effect on the highest quantile. The lowest quantile of the revenue in the capital areas have the relatively high revenue. The lowest quantile of the income in metropolitan city show higher income than those in other areas significantly. Conclusion: The suggested QRM is shown to have more effective and efficient tool in finding out determinants of dentists' revenue and income of our concern. The results of this study are expected to be employed for dentists preparing for the opening practices in their organizational settings and locational selections. The distributional efficiency of dental human resources could be accomplished if policy makers guide dentists with this knowledge.

• Journal of dental hygiene science
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• v.6 no.2
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• pp.133-138
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• 2006

To find out influence of water fluoridation program on the economic benefit effect, this study analyzed comparatively dental treatment indicators obtained from dental clinics at Sangdang-gu in Chenongju City, fluoridated community and Manan-gu in Anyang City, non-fluoridated community, from January 1, 2003 to the end of June, and the results are as follows: 1. If water fluoridation program is carried out in Anyang, non-fluoridated community, the number of treatment from caries and disease of tissues around dental pulp and root apex from age 6 to 18 for the first half of year 2003 is expected to decrease by 1,272, 636 for low estimation, and 1,908 for high estimation. And the treatment cost is expected to decrease by 40,888,000 Wons, 20,444,000 Wons for low estimation, and 61,333,000 Wons for high estimation. 2. Assuming that water fluoridation program is spread to all over the country, the number of treatment per year is expected to decrease by 2,492,018, 1,246,009 for low estimation, and 3,738,027 for high estimation. And the treatment cost is expected to decrease by 80,105,075,000 Wons, 40,052,537,000 Wons for low estimation and 120, 157,612,000 Wons for high estimation respectively. 3. For Yeong-un water supply management office which has 48,925 water supply personnel, the benefit/cost rate was 2.9 times, and for Jibuk water supply management office which has 239,751 water supply personnel, the benefit/cost rate was 9.0 times. As the water supply personnel increased, the cost increase of water fluoridation program was little and as the scale got large, the economic effect was very large. Improving national oral health is thought to be associated with expense retrenchment of oral health insurance financial. So it may need to extend using tap water to all the area of the country and additionally establish confidence through an active public relations and education of water fluoridation program.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• Journal of Advanced Navigation Technology
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• v.21 no.3
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• pp.230-242
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• 2017

A significant rise in product-liability cost is expected due to the newly passed product liability amendment Bill approved during the assembly plenary session on March 30, 2017. Korean government legal service(KGLS) filed a damage suit against Korea aerospace industries, Ltd.(KAI) and Hanwha Techwin Co., Ltd., the manufactures of the KUH-1 Surion helicopter crashed. KGLS alleged claims under the product liability Act, the warrant liability Act and the non-performance of contract act. The accountability limits of military aircraft manufacturers was a highly divisive issue among related scholars and legal practitioners. The bottom line was that military aircraft manufacturers had no product-liability insurance available. The United States courts have, therefore, developed the government contractor defense(GCD) and it was recognized by the U.S. Supreme Court in Boyle v. United Technologies corporation(1988). product liability insurances for military aircraft manufacturers are excessively expensive and it cannot be added onto the military procurement cost accounting. However, having an aircraft accident without one can be ruinously expensive. Therefore, the manufacturers should promptly set up appropriate risk management measures. This thesis will first review the advance GCD theory, and then find a way to either reform government contract related regulations.