• 제목/요약/키워드: recall insurance

검색결과 9건 처리시간 0.027초

최적 리콜보험상품 설계에 관한 연구 (The Design of Optimal Recall Insurance Product)

  • 김두철
    • 한국산학기술학회논문지
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    • 제3권4호
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    • pp.325-332
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    • 2002
  • 본 논문은 최적리콜보험계약의 설계와 관련된 논문의 survey이다. 리콜보험 뿐만이 아니라 최적보험계약을 만들기 위해서는 보험계약의 조건들이 내생적이라는 가정하에서 연구모형을 구축하고 분석의 과정에서는 보험구매를 위한 의사결정 원칙으로 기대효용이론, 비기대효용이론, 및 상태귀속적인 (state-dependent) 효용함수를 사용하였다. 어떠한 이론을 사용하더라도 최적보험의 조건들은 존재한다. 다만 계약조건에 관련되어서는 보험의 비용, 자기부담금, 보상한도액 등이 차이가 날 수 있다. 보험의 비용은 지급보험금과 선형, 오목형, 볼록형의 관계가 성립할 수 있으나 잠식비용과 고정비용의 존재를 인정하여야 한다. 이를 바탕으로 최적보험을 위한 비용 설계가 이루어져야 한다. 또한 전부보험이냐 일부보험이냐를 결정하는 자기부담금의 존재는 일률자기부담금형태와 점감식자기부담금형태가 가능하다. 자기부담금 수준의 결정과 관련하여 담보되는 모든 위험에 동일한 수준을 적용시킬 것인가 혹은 차별화시킬 것인가는 보험의 종류에 따라 달라질 수밖에 없다. 보상한도와 관련되어서는 특히 리콜보험에 있어서는 기업의 파산위험성이 상당히 존재하고 있으므로 계약당사자의 파산선고를 포함한 이익이 충분히 고려되어야 한다. 또한 제약조건으로는 불완전시장에 대한 이해를 필요로 하며 담보할 수 없는 배경위험의 존재에 대한 배려가 있어야 한다.

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A Reform Program for Reliability Insurance Rate-Making System

  • Hong, Yeon-Woong
    • Journal of the Korean Data and Information Science Society
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    • 제16권2호
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    • pp.263-270
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    • 2005
  • The reliability guarantee insurance policy for parts and materials was introduced to the market in 2003. This policy indemnifies manufactures for the repair/failure costs, recall expenses. In this paper, owing to the nature of the policy, we propose a new rate-making system considering the type of product and industry, quality control circumstances, record of guarantee performance, and exposures.

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신뢰성 보험의 요율체계 개선 방안에 관한 연구

  • 홍연웅
    • 한국데이터정보과학회:학술대회논문집
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    • 한국데이터정보과학회 2004년도 추계학술대회
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    • pp.43-51
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    • 2004
  • The reliability guarantee insurance policy for parts and materials was introduced to the market in 2003. This policy indemnifies manufactures of products for the repair/failure costs, recall expenses of products and business interruption losses found to be defective by users or demand companies during the terms of guarantee and after the user acquired physical possession of the product. In this paper, owing to the nature of the policy, we propose a new rate-making system considering the type of product and industry, quality control circumstances, record of guarantee performance, and exposure.

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건강보험 청구 데이터를 활용한 머신러닝 기반유방암 환자의 생존 여부 예측 (The Prediction of Survival of Breast Cancer Patients Based on Machine Learning Using Health Insurance Claim Data)

  • 이덕규;변경근;이형동;신선희
    • 한국산업정보학회논문지
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    • 제28권2호
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    • pp.1-9
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    • 2023
  • 유방암 관련 기존 AI 연구는 보조적인 진단 예측이나 임상적 요인에 따른 진료 결과를 예측하는 주제가 많았다. 또한 연구기관의 코호트 자료나 일부 환자 자료를 이용하는 경우가 대부분이었다. 본 논문에서는 건강보험심사평가원이 보유하고 있는 전 국민 유방암 환자의 전수 데이터를 활용하여 유방암 환자의 40~50대와 다른 연령대 간의 생존 여부 예측과 생존 여부에 미치는 요인의 차이점을 분석했다. 그 결과, 환자들의 생존 여부 예측 정밀도는 40~50대가 평균 0.93으로 60~80대 0.86 보다 높았으며, 요인에 있어서도 40~50대는 치료횟수(46%)가, 60~80대는 나이(32%)의 변수 중요도가 제일 높았다. 기존 연구와 성능 비교 결과, 평균 정밀도가 0.90으로 기존 논문의 정밀도 0.81보다 높았다. 적용 알고리즘별 성능 비교 결과, 의사결정나무(Decision Tree), 랜덤포레스트(Random Forest) 및 그래디언트부스팅(Gradient Boosting)의 전체 평균 정밀도는 0.90, 재현율은 1.0으로 연령대 그룹 내에서 동일하였으며, 다층퍼셉트론(Multi-Layer Perceptron)의 정밀도는 0.89, 재현율은 1.0 이었다. 심평원의 전 국민 심사청구 빅데이터 가치 활용을 제고하기 위해 비전문가용 머신러닝 자동화(Auto ML) 도구를 사용한 더 많은 연구가 진행되기를 바란다.

장애인 치과 병·의원 개원 유도를 위한 적절한 보조금 산정에 대한 연구 (SUBSIDY ESTIMATION FOR INDUCING OPENING OF DENTAL HOSPITAL OR CLINIC FOR THE DISABLED)

  • 송창목;현홍근;신터전;김영재
    • 대한장애인치과학회지
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    • 제12권2호
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    • pp.55-65
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    • 2016
  • The objective of this study was to estimate the proper amount of subsidy required to operating dental hospital or clinic for the disabled. Models for estimating operating profit of general dental hospital/clinic and opportunity cost of operating dental hospital/clinic for the disabled was formulated. Data were collected from various sources such as the annual reports of Purme Hospital, one of the running dental hospitals for the disabled, statistics from Healthcare Bigdata Hub, operated by Health Insurance Review & Assessment Service of Korean Government, and the deliberation data of non-reimbursable treatments in Seoul Dental Hospital for the Disabled. A dental hospital/clinic for the disabled was less profitable than a general dental hospital/clinic, of which the reason is that the chair time for the average patient is longer. However, It was false that a dental hospital/clinic for the disabled scored less average insurance fee for a treatment. Disabled patients had more frequent prosthodontic treatments, which had a high average insurance fee. There were some groups of treatments that could yield higher profitability in a dental hospital/clinic for the disabled; recall checks, and periodontal treatments.

Long-term outcomes after peri-implantitis treatment and their influencing factors: a retrospective study

  • Lee, Sung-Bae;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • 제52권3호
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    • pp.194-205
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    • 2022
  • Purpose: This study aimed to determine the long-term outcomes after peri-implantitis treatment and the factors affecting these outcomes. Methods: This study included 92 implants in 45 patients who had been treated for peri-implantitis. Clinical data on the characteristics of patients and their implants were collected retrospectively. The change in the marginal bone level was calculated by comparing the baseline and the most recently obtained (≥3 years after treatment) radiographs. The primary outcome variable was progression of the disease after the treatment at the implant level, which was defined as further bone loss of >1.0 mm or implant removal. A 2-level binary logistic regression analysis was used to identify the effects of possible factors on the primary outcome. Results: The mean age of the patients was 58.7 years (range, 22-79 years). Progression of peri-implantitis was observed in 64.4% of patients and 63.0% of implants during an observation period of 6.4±2.7 years (mean±standard deviation). Multivariable regression analysis revealed that full compliance to recall visits (P=0.019), smoking (P=0.023), placement of 4 or more implants (P=0.022), and marginal bone loss ≥4 mm at baseline (P=0.027) significantly influenced the treatment outcome. Conclusions: The long-term results of peri-implantitis treatment can be improved by full compliance on the part of patients, whereas it is impaired by smoking, placement of multiple implants, and severe bone loss at baseline. Encouraging patients to stop smoking and to receive supportive care is recommended before treatment.

한 농촌 지역사회 기반 당뇨병 환자의 등록관리 중재의 효과: 투약순응도에 대한 이중차이분석을 중심으로 (Effect of Community-Based Interventions for Registering and Managing Diabetes Patients in Rural Areas of Korea: Focusing on Medication Adherence by Difference in Difference Regression Analysis)

  • 손효림;박소윤;용희정;채성현;김은정;원은숙;김윤아;배세진;김춘배
    • 보건행정학회지
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    • 제33권1호
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    • pp.3-18
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    • 2023
  • Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

민관협력을 통한 고혈압.당뇨병 등록.관리사업의 접근 전략: 홍천군 사례의 정책적 함의 (Accessible Strategy of the Registration & Management of Hypertension and Diabetes Mellitus Patients through the Public-Private Partnership: Policy Implications Fron the Hongcheon-gun Case)

  • 변도화;김은정;박명배;손효림;박혜경;김춘배
    • 보건교육건강증진학회지
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    • 제30권4호
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    • pp.111-123
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    • 2013
  • Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

혈액투석환자의 사회경제적 수준에 따른 영양소 섭취상태의 평가 - 충남지역을 중심으로 - (Evaluation of Nutrient Intakes in the Hemodialysis Patients According to the Socioeconomic Status - In Daejeon and Chungnam Areas -)

  • 정영진;박유신;김한숙;장유경;김찬
    • Journal of Nutrition and Health
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    • 제35권5호
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    • pp.544-557
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    • 2002
  • This study was performed to evaluate the quality of nutrient intakes of the hemodialysis patients (26 men and 23 women) according to the socioeconomic status by 3-day dietary recall in Daejeon city and Chungnam area, Korea. Mean age of the subjects was 50.7 yrs and BMI was 22.0 $\pm$ 0.4 kg/$m^2$. Education level was divided into two groups ($\leq$ 9 years: LE group, 9 years: HE group), and monthly family income level was divided into three groups (< 500,000 won: LI group, 500,000-1,499,999 won: MI group, $\geq$ 1,500,000 won : HI group). The data were analyzed by Student t-test and Oneway ANOVA using SPSS 9.0 version at p < 0.05 level. Intakes of energy, carbohydrates, cholesterol, potassium, thiamin and riboflavin were significantly higher in HE group than in LE group (p < 0.05). Intakes of all the nutrients except protein and phosphorus were less than Korean RDA, and INQs (Index of Nutritional Quality) of most nutrients were lower than 1.0 but cholesterol, phosphorus. thiamin and niacin being over 1.0 in HE group. MAR (Mean adequacy ratio) of all the nutrients (e.g., energy, protein, calcium, phosphorus, iron, vitamin A, vitamin C, thiamin, riboflavin and niacin) was significantly higher in HE group (0.61 $\pm$ 0.04) than in LE group (0.48 $\pm$ 0.03) at p = 0.036. Intakes of energy, protein (total, animal and plant), fat, cholesterol, potassium, calcium, phosphorus, iron, vitamin A, thiamin and riboflavin were also significantly higher in HI group than in LI and MI group (p < 0.05). Daily intakes of most nutrients were less than Korean RDA except protein ed phosphorus in HI poop, and INQs of thiamin, niacin and phosphorus were higher than 1.0, while those of calcium, iron, vitamin A and riboflavin were lower than 1.0. MAR of energy and 9 nutrients was significantly higher in HI group (0.70 $\pm$ 0.04) than in LI group (0. 56 0.04) and MI poop (0.47 $\pm$ 0.03) at p = 0.000. In conclusion, quality of nutrient intakes, especially energy and protein, was significantly influenced by socioeconomic status such as education and monthly income (p < 0.05). This result suggests that it would be very helpful to develop nutritional education programs considering hemodialysis patients' education levels, and to improve public supports (e.g., medical insurance system, low-rate lease system of dialysis equipments, etc.) focusing on the patients' family income levels f3r their better nutrition and health.