• Journal of Preventive Medicine and Public Health
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• v.52 no.1
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• pp.21-29
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• 2019

Objectives: The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality. Methods: We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes. Results: We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality. Conclusions: The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.11 no.2
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• pp.126-134
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• 2001

Statistical approaches for analysis of data from the limited number of samples in ship building industry(SBI) collected by an industrial hygienist for checking compliance to an occupational standard were considered. Sampling for compliance usually has been guided by judgment selection, rather than true randomness, resulting in the creation of compliance samples which approximate a censored sample from the upper tail of the exposure distribution. Similar exposure groups(SEGs) including welding and painting process were established to assess representative values in each groups after reviewing the whole production line in SBI. For the convenient statistical approaches, the code has assigned to each SEGs. The descriptive statistics and probability plotting were used to yield the representative values in each SEGs. In the first step, SEGs of 558 were established from 5 ship building companies. The 38 SEGs showed the uncertainty are divided into each 5 companies and assessed the representative values again. The 44 SEGs in each companies was not showed the normal and lognormal distribution was analyzed each data. And also, recommendation was suggested to resolve the uncertainty in each groups.

• Health Policy and Management
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• v.21 no.1
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.592-603
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• 1998

This study was conducted to estimate incidence rate of female breast cancer in a defined area of Chungchongbuk-do in Korea. The presumptive breast cancer cases were selected from two different sources, i.e., medical utilization database of the National Health Insurance Corporation and the database from the National Cancer Registry. Medical students visited each hospital where the presumptive cases had been treated as a breast cancer patient, and made a dictation of medical record of each patient based on the claims stored in the Insurance Corporation from January to December 1995. The diagnoses in the claims included one of the following diagnostic codes; ICD-9 174-175(malignant neoplasms of the breast), 233(carcinoma in situ of the breast and genito-urinary system)or ICD-10 C50(malignant neoplasms of the breast), D05(carcinoma in situ of the breast and genito-urinary system). Each case has been confirmed as having a breast cancer by a breast surgeon through a medical record review. Age-standardized incidence rate of female breast cancer to the Korean population was estimated to be 10.5(95%confidence interval : 8.1-12.9)per 100,000 persons in 1995. Age-standardized rate to the world population was 9.8 per 100,000 persons, and the truncated rate for ages 35-64 was 27.2 per 100,000 persons. Validity of these estimates is discussing in comparison with previous methods of incidence estimation in Korea.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.287-294
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• 2002

Objectives : To examine whether cumulative chronic stress influences the immune status, and to verify the effect of social support on the relationship between these two dimensions in male manufacturing workers. Methods : A total of 39 workers were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand and decision latitude), psychosocial distress, and social support. The serum levels of CD4 and CD8 were measured as immune markers, and were collected between 8:00 and 10:00am in order to standardize the markers. Nonparametric statistics were used to estimate the differences between job characteristics and the immune markers. Results : General characteristics, and health-related behaviors, were not associated with CD4, CD8 or CD4/CD8. No relationships were found between job characteristics and the mean levels of immune reactivity. These results were consistent, even after controlling for social support. Social support failed to modify the relationship toward work demand, decision latitude or psychosocial distress to CD4, CD8, and CD4/CD8. Conclusion : Cumulative chronic life stress might not influence the immune status, and the effects of social support on the immune function under chronic stress, may not play a crucial role in modifying the relationships. This implication supports that the effect of stress on the immune function may be determined by the characteristics of that stress. further research should effectively considers the type, magnitude and timing of a stress event, and modifiable factors, such as personality traits, coping style, and hormone excretion levels, on the alteration of immune status.

• Journal of Preventive Medicine and Public Health
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• v.52 no.2
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• pp.82-91
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• 2019

Objectives: Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea. Methods: Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups. Results: A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a $1^{\circ}C$ increase in pneumonia temperature above the threshold of $6^{\circ}C$ was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed. Conclusions: The term 'pneumonia temperature' is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.

• Journal of Preventive Medicine and Public Health
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• v.35 no.4
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• Proceedings of the KIEE Conference
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• 2001.11a
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• pp.198-200
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• 2001

In this paper, we describe the developed learning tool of expert system for preventive diagnosis of substation power equipments. The expert system was programmed by using the diagnosis methods as like gas analysis in oil and partial discharge, hottest temperature, the current of OLTC driving meter, the current of fan and pump in MTr and driving coil current in GCB and leakage current in LA. The learning tool is composed of the expert system and the explanation of diagnosed examples and the applied rules and it well worked according to the rule.

• Journal of Preventive Medicine and Public Health
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• v.53 no.4
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• pp.285-288
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• 2020

The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.

• Industrial Engineering and Management Systems
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• v.7 no.2
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• pp.113-125
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• 2008

This paper presents a model for designing cellular manufacturing systems (CMS) by integrating system cost, machine reliability, and preventive maintenance (PM) planning. In a CMS, a part is processed using alternative process routes, each consisting of a sequence of visits to machines. Thus, a level of 'system reliability' is associated with the machines along the process route assigned to a part type. Assuming machine reliabilities to follow the Weibull distribution, the model assigns the machines to cells, and selects, for each part type, a process route which maximizes the overall system reliability and minimizes the total costs of manufacturing operations, machine underutilization, and inter-cell material handling. The model also incorporates a reliability based PM plan and an algorithm to implement the plan. The algorithm determines effective PM intervals for the CMS machines based on a group maintenance policy and thus minimizes the maintenance costs subject to acceptable machine reliability thresholds. The model is a large mixed integer linear program, and is solved using LINGO. The results point out that integrating PM in the CMS design improves the overall system reliability markedly, and reduces the total costs significantly.