• Title/Summary/Keyword: 건강 주의 영역

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Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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Correlation of Hepatic $^{18}F-Fluorodeoxyglucose$ Uptake with Fatty Liver (간의 $^{18}F-Fluorodeoxyglucose$ 섭취 양상과 지방간의 관계)

  • An, Young-Sil;Yoon, Joon-Kee;Hong, Seon-Pyo;Joh, Chul-Woo;Yoon, Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.243-248
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    • 2006
  • Purpose: Liver demonstrates heterogeneous FDG uptake and sometimes it shows abnormally increased uptake even though there is no malignant tissue. However, there was no previous study to correlate these various pattern of hepatic FDG uptake with benign liver disease. Therefore, we evaluated the significance of hepatic FDG uptake associated with various clinical factors including fatty liver, liver function tests and lipid profiles. Materials and Methods: We reviewed a total of 188 patients (male/female: 120/68, mean age: $50{\pm}9$) who underwent PET/CT for screening of malignancy. Patients with DM, impaired glucose tolerance, previous severe hepatic disease or long-term medication history were excluded. The FDG uptake in liver was analyzed semi-quantitatively using ROI on transaxial images (segment 8) and we compared mean standardized uptake value (SUV) between fatty liver and non-fatty liver group. We also evaluated the correlation between hepatic FDG uptake and various clinical factors including serum liver function test (ALT, AST), ${\gamma}-GT$, total cholesterol and triglyceride concentration. The effect of alcoholic history and body mass index on hepatic FDG uptake was analyzed within the fatty liver patients. Results: The hepatic FDG uptake of fatty liver group was significantly higher than that of non-fatty liver group. Serum total cholesterol and triglyceride concentration showed significant correlation with hepatic FDG uptake. However, there was no significant correlation between other factors (ALT, AST, and ${\gamma}-GT$) and FDG uptake. Also there was no difference of mean SUV between normal and abnormal groups on the basis of alcoholic history and body mass Index within fatty liver patients. Fatty liver and high serum triglyceride concentration were the independent factors affecting hepatic FDG uptake according to multivariate analysis. Conclusion: In conclusion, hepatic FDG uptake was strongly correlated with fatty liver and serum triglyceride concentration.

Evaluation of Therapeutic Effects of Cognitive-Behavioral Therapy in Patients with Panic Disorder using Serial $^{99m}Tc-ECD$ Brain Perfusion (공황장애 환자에서 $^{99m}Tc-ECD$ 뇌관류 SPECT를 이용한 인지행동치료 효과 평가)

  • Kim, Jung-Hee;Song, Ho-Chun;Yang, Jong-Chul;Lee, Byeong-Il;Heo, Young-Jun;Bom, Hee-Seung;Park, Tae-Jin;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.302-308
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    • 2006
  • Purpose: Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regnioal cerebral blood flow (rCBF) after CBT in patients with panic disorder. Materials and Methods: Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial $^{99m}Tc-ECD$ brain perfusion SPECT images were acquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Results: Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced ($14.9{\pm}3.9\;vs.\;7.0{\pm}1.8$, p<0.05; $30.3{\pm}8.5\;vs.\;21.6{\pm}3.4$, p<0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. Conclusion: These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder.

The analysis of physical features and affective words on facial types of Korean females in twenties (얼굴의 물리적 특징 분석 및 얼굴 관련 감성 어휘 분석 - 20대 한국인 여성 얼굴을 대상으로 -)

  • 박수진;한재현;정찬섭
    • Korean Journal of Cognitive Science
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    • v.13 no.3
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    • pp.1-10
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    • 2002
  • This study was performed to analyze the physical attributes of the faces and affective words on the fares. For analyzing physical attributes inside of a face, 36 facial features were selected and almost of them were the lengths or distance values. For analyzing facial contour 14 points were selected and the lengths from nose-end to them were measured. The values of these features except ratio values normalized by facial vortical length or facial horizontal length because the face size of each person is different. The principal component analysis (PCA) was performed and four major factors were extracted: 'facial contour' component, 'vortical length of eye' component, 'facial width' component, 'eyebrow region' component. We supposed the five-dimensional imaginary space of faces using factor scores of PCA, and selected representative faces evenly in this space. On the other hand, the affective words on faces were collected from magazines and through surveys. The factor analysis and multidimensional scaling method were performed and two orthogonal dimensions for the affections on faces were suggested: babyish-mature and sharp-soft.

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Analyzing Heart Rate Variability for Automatic Sleep Stage Classification (수면단계 자동분류를 위한 심박동변이도 분석)

  • 김원식;김교헌;박세진;신재우;윤영로
    • Science of Emotion and Sensibility
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    • v.6 no.4
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    • pp.9-14
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    • 2003
  • Sleep stages have been useful indicator to check a person's comfortableness in a sleep, But the traditional method of scoring sleep stages with polysomnography based on the integrated analysis of the electroencephalogram(EEG), electrooculogram(EOG), electrocardiogram(ECG), and electromyogram(EMG) is too restrictive to take a comfortable sleep for the participants, While the sympathetic nervous system is predominant during a wakefulness, the parasympathetic nervous system is more active during a sleep, Cardiovascular function is controlled by this autonomic nervous system, So, we have interpreted the heart rate variability(HRV) among sleep stages to find a simple method of classifying sleep stages, Six healthy male college students participated, and 12 night sleeps were recorded in this research, Sleep stages based on the "Standard scoring system for sleep stage" were automatically classified with polysomnograph by measuring EEG, EOG, ECG, and EMG(chin and leg) for the six participants during sleeping, To extract only the ECG signals from the polysomnograph and to interpret the HRV, a Sleep Data Acquisition/Analysis System was devised in this research, The power spectrum of HRV was divided into three ranges; low frequency(LF), medium frequency(MF), and high frequency(HF), It showed that, the LF/HF ratio of the Stage W(Wakefulness) was 325% higher than that of the Stage 2(p<.05), 628% higher than that of the Stage 3(p<.001), and 800% higher than that of the Stage 4(p<.001), Moreover, this ratio of the Stage 4 was 427% lower than that of the Stage REM (rapid eye movement) (p<.05) and 418% lower than that of the Stage l(p<.05), respectively, It was observed that the LF/HF ratio decreased monotonously as the sleep stage changes from the Stage W, Stage REM, Stage 1, Stage 2, Stage 3, to Stage 4, While the difference of the MF/(LF+HF) ratio among sleep Stages was not significant, it was higher in the Stage REM and Stage 3 than that of in the other sleep stages in view of descriptive statistic analysis for the sample group.

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Estimation of Ground-level PM10 and PM2.5 Concentrations Using Boosting-based Machine Learning from Satellite and Numerical Weather Prediction Data (부스팅 기반 기계학습기법을 이용한 지상 미세먼지 농도 산출)

  • Park, Seohui;Kim, Miae;Im, Jungho
    • Korean Journal of Remote Sensing
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    • v.37 no.2
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    • pp.321-335
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    • 2021
  • Particulate matter (PM10 and PM2.5 with a diameter less than 10 and 2.5 ㎛, respectively) can be absorbed by the human body and adversely affect human health. Although most of the PM monitoring are based on ground-based observations, they are limited to point-based measurement sites, which leads to uncertainty in PM estimation for regions without observation sites. It is possible to overcome their spatial limitation by using satellite data. In this study, we developed machine learning-based retrieval algorithm for ground-level PM10 and PM2.5 concentrations using aerosol parameters from Geostationary Ocean Color Imager (GOCI) satellite and various meteorological parameters from a numerical weather prediction model during January to December of 2019. Gradient Boosted Regression Trees (GBRT) and Light Gradient Boosting Machine (LightGBM) were used to estimate PM concentrations. The model performances were examined for two types of feature sets-all input parameters (Feature set 1) and a subset of input parameters without meteorological and land-cover parameters (Feature set 2). Both models showed higher accuracy (about 10 % higher in R2) by using the Feature set 1 than the Feature set 2. The GBRT model using Feature set 1 was chosen as the final model for further analysis(PM10: R2 = 0.82, nRMSE = 34.9 %, PM2.5: R2 = 0.75, nRMSE = 35.6 %). The spatial distribution of the seasonal and annual-averaged PM concentrations was similar with in-situ observations, except for the northeastern part of China with bright surface reflectance. Their spatial distribution and seasonal changes were well matched with in-situ measurements.

Effect for Wellness of Blood Flow Restriction Aerobic Exercise Program - Focusing on Mscle Ativity and Mtor Nurons - (혈류제한 유산소운동 프로그램의 웰니스를 위한 효과검정 - 근활성도와 운동신경원을 중심으로 -)

  • Jeong, Dae-Keun;Kang, Jeong-Il;Jang, Jun-Min
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.7
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    • pp.225-233
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    • 2021
  • This study quantitatively compares and analyzes lower extremity muscle activity and motor neurons by performing blood flow-restricting aerobic training in the lower extremities, which is closely related to aerobic capacity for health, in normal people, and provides basic data to suggest the effectiveness of an effective blood-restricting exercise program. would like to provide A group of 10 people who applied aerobic exercise on a treadmill by restricting blood flow to 140 mmHg of pressure was set as Experimental Group I. And 11 people who applied only aerobic exercise on a treadmill were randomly assigned as a control group. The intervention program was implemented on a treadmill for 4 weeks, 3 times a week, once a day, for 30 minutes once. In addition, muscle activity and motor neurons were measured and analyzed using surface electromyography before intervention. As a result of the study, the muscle activity of the rectus femoris, biceps femoris, tibialis anterior and gastrocnemius was significantly increased (p<.001) in the pre-and-poster comparison within the group of experimental group I (p<.001). In the pre-and-poster comparison of the control group, the muscle activity of the rectus femoris, biceps femoris, tibialis anterior and gastrocnemius was significantly increased (p<.001). In comparison of changes between groups, there was a significant difference in the activity of the rectus femoris muscle (p<.05). Combining aerobic exercise in parallel with lower extremity blood flow restriction can be developed into an injury prevention exercise program that can restore functional activity in rehabilitation training for elite athletes and elderly people with weak joints. In addition, based on these results in future research, it is considered that it is necessary to expand the scope of non-normal subjects and conduct various studies according to the pressure intensity.

Development and evaluation of Home Economics teaching·learning process plans applied Problem Based Learning focusing on 'food and nutrition' unit for students with intellectual disability (지적장애 학생을 위한 문제중심학습(PBL) 적용 가정과 식생활 교수·학습 과정안 개발과 평가)

  • Kim, yun-ju;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.30 no.2
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    • pp.39-56
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    • 2018
  • The purpose of this study was to develop Home Economics(HE) teaching and learning process plans applied Problem Based Learning(PBL) focusing on 'food and nutrition' unit for students with intellectual disability and to evaluate the effects of the HE instruction on their food choice·management knowledge and problem-solving skills after implementing the instruction for students with intellectual disability. To develop HE teaching and learning process plans applied PBL focusing on 'food and nutrition' unit for students with intellectual disability, problems that arise in daily life to trigger interest of students were firstly developed. The selected problems and teaching and learning process plans were reviewed for validity by one home economics education professor and three teachers who are experts in special education. This study used the one group pretest and posttest design, sampling 6 students who are in special-education middle school with the intellectual disability. After HE instruction of 6 sessions applied PBL method, this study tested the effects of the instruction. The first three sessions taught how to choose and keep food. The fourth session taught purchasing food ingredients and keeping them for sandwiches. The fifth and sixth sessions let the students make sandwiches and give them to others. The instruments of the study comprised of tools for food choice and management knowledge, tools for problem-solving skills evaluation, self-evaluation sheets, evaluation form of course satisfaction for students, evaluation form of behavior in class for teachers, and daily observation journal and all tools. These instruments were proved to have reliability and validity. The results of this study are as follows. First, all six students who took HE instruction applied PBL method focusing on 'food and nutrition' unit scored 30 points higher out of 100 points after taking the instruction in food choice and management knowledge and scored 5 points higher out of 14 points in problem-solving skills on average. Therefore, it was interpreted that HE instruction applied PBL affected the food choice·management knowledge and the problem solving skills of students with intellectual disability. Secondly, the students with intellectual disability participated actively in HE instruction applied PBL focusing on 'food and nutrition' unit and expressed satisfaction. Three special education experts evaluated HE teaching·learning process plans applied PBL focusing on 'food and nutrition' unit to be well-developed. This study showed that HE instruction applied PBL focusing on 'food and nutrition' unit allowed the students with intellectual disability to acquire comprehensive skills in choosing, keeping, and making safe food and helped them solve problems of their life by themselves. Therefore I suggest that Home Economics should be adopted as a formal subject matter in special school curriculum for students with intellectual disability.

The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

The Advancement of Underwriting Skill by Selective Risk Acceptance (보험Risk 세분화를 통한 언더라이팅 기법 선진화 방안)

  • Lee, Chan-Hee
    • The Journal of the Korean life insurance medical association
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    • v.24
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    • pp.49-78
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    • 2005
  • Ⅰ. 연구(硏究) 배경(背景) 및 목적(目的) o 우리나라 보험시장의 세대가입율은 86%로 보험시장 성숙기에 진입하였으며 기존의 전통적인 전업채널에서 방카슈랑스의 도입, 온라인전문보험사의 출현, TM 영업의 성장세 等멀티채널로 진행되고 있음 o LTC(장기간병), CI(치명적질환), 실손의료보험 등(等)선 진형 건강상품의 잇따른 출시로 보험리스크 관리측면에서 언더라이팅의 대비가 절실한 시점임 o 상품과 마케팅 等언더라이팅 측면에서 매우 밀접한 영역의 변화에 발맞추어 언더라이팅의 인수기법의 선진화가 시급히 요구되는 상황하에서 위험을 적절히 분류하고 평가하는 선진적 언더라이팅 기법 구축이 필수 적임 o 궁극적으로 고객의 다양한 보장니드 충족과 상품, 마케팅, 언더라이팅의 경쟁력 강화를 통한 보험사의 종합이익 극대화에 기여할 수 있는 방안을 모색하고자 함 Ⅱ. 선진보험시장(先進保險市場)Risk 세분화사례(細分化事例) 1. 환경적위험(環境的危險)에 따른 보험료(保險料) 차등(差等) (1) 위험직업 보험료 할증 o 미국, 유럽등(等) 대부분의 선진시장에서는 가입당시 피보험자의 직업위험도에 따라 보험료를 차등 적용중(中)임 o 가입하는 보장급부에 따라 직업 분류방법 및 할증방식도 상이하며 일반사망과 재해사망,납입면제, DI에 대해서 별도의 방법을 사용함 o 할증적용은 표준위험율의 일정배수를 적용하여 할증 보험료를 산출하거나, 가입금액당 일정한 추가보험료를 적용하고 있음 - 광부의 경우 재해사망 가입시 표준위험율의 300% 적용하며, 일반사망 가입시 $1,000당 $2.95 할증보험료 부가 (2) 위험취미 보험료 할증 o 취미와 관련 사고의 지속적 다발로 취미활동도 위험요소로 인식되어 보험료를 차등 적용중(中)임 o 할증보험료는 보험가입금액당 일정비율로 부가(가입 금액과 무관)하며, 신종레포츠 등(等)일부 위험취미는 통계의 부족으로 언더라이터가 할증율 결정하여 적용함 - 패러글라이딩 년(年)$26{\sim}50$회(回) 취미생활의 경우 가입금액 $1,000당 재해사망 $2, DI보험 8$ 할증보험료 부가 o 보험료 할증과는 별도로 위험취미에 대한 부담보를 적용함. 위험취미 활동으로 인한 보험사고 발생시 사망을 포함한 모든 급부에 대한 보장을 부(不)담보로 인수함. (3) 위험지역 거주/ 여행 보험료 할증 o 피보험자가 거주하고 있는 특정국가의 임시 혹은 영구적 거주시 기후위험, 거주지역의 위생과 의료수준, 여행위험, 전쟁과 폭동위험 등(等)을 고려하여 평가 o 일반사망, 재해사망 등(等)보장급부별로 할증보험료 부가 또는 거절 o 할증보험료는 보험全기간에 대해 동일하게 적용 - 러시아의 경우 가입금액 $1,000당 일반사망은 2$의 할증보험료 부가, 재해사망은 거절 (4) 기타 위험도에 대한 보험료 차등 o 비행관련 위험은 세가지로 분류(항공운송기, 개인비행, 군사비행), 청약서, 추가질문서, 진단서, 비행이력 정보를 바탕으로 할증보험료를 부가함 - 농약살포비행기조종사의 경우 가입금액 $1,000당 일반사망 6$의 할증보험료 부가, 재해사망은 거절 o 미국, 일본등(等)서는 교통사고나 교통위반 관련 기록을 활용하여 무(無)사고운전자에 대해 보험료 할인(우량체 위험요소로 활용) 2. 신체적위험도(身體的危險度)에 따른 보험료차등(保險料差等) (1) 표준미달체 보험료 할증 1) 총위험지수 500(초과위험지수 400)까지 인수 o 300이하는 25점단위, 300점 초과는 50점 단위로 13단계로 구분하여 할증보험료를 적용중(中)임 2) 삭감법과 할증법을 동시 적용 o 보험금 삭감부분만큼 할증보험료가 감소하는 효과가 있어 청약자에게 선택의 기회를 제공할수 있으며 고(高)위험 피보험자에게 유용함 3) 특정암에 대한 기왕력자에 대해 단기(Temporary)할증 적용 o 질병성향에 따라 가입후 $1{\sim}5$년간 할증보험료를 부가하고 보험료 할증 기간이 경과한 후에는 표준체보험료를 부가함 4) 할증보험료 반환옵션(Return of the extra premium)의 적용 o 보험계약이 유지중(中)이며, 일정기간 생존시 할증보험료가 반환됨 (2) 표준미달체 급부증액(Enhanced annuity) o 영국에서는 표준미달체를 대상으로 연금급부를 증가시킨 증액형 연금(Enhanced annuity) 상품을 개발 판매중(中)임 o 흡연, 직업, 병력 등(等)다양한 신체적, 환경적 위험도에 따라 표준체에 비해 증액연금을 차등 지급함 (3) 우량 피보험체 가격 세분화 o 미국시장에서는 $8{\sim}14$개 의적, 비(非)의적 위험요소에 대한 평가기준에 따라 표준체를 최대 8개 Class로 분류하여 할인보험료를 차등 적용 - 기왕력, 혈압, 가족력, 흡연, BMI, 콜레스테롤, 운전, 위험취미, 거주지, 비행력, 음주/마약 등(等) o 할인율은 회사, Class, 가입기준에 따라 상이(최대75%)하며, 가입연령은 최저 $16{\sim}20$세, 최대 $65{\sim}75$세, 최저보험금액은 10만달러(HIV검사가 필요한 최저 금액) o 일본시장에서는 $3{\sim}4$개 위험요소에 따라 $3{\sim}4$개 Class로 분류 우량체 할인중(中)임 o 유럽시장에서는 영국 등(等)일부시장에서만 비(非)흡연할인 또는 우량체할인 적용 Ⅲ. 국내보험시장(國內保險市場) 현황(現況)및 문제점(問題點) 1. 환경적위험도(環境的危險度)에 따른 가입한도제한(加入限度制限) (1) 위험직업 보험가입 제한 o 업계공동의 직업별 표준위험등급에 따라 각 보험사 자체적으로 위험등급별 가입한도를 설정 운영중(中)임. 비(非)위험직과의 형평성, 고(高)위험직업 보장 한계, 수익구조 불안정화 등(等)문제점을 내포하고 있음 - 광부의 경우 위험1급 적용으로 사망 최대 1억(億), 입원 1일(日) 2만원까지 제한 o 금융감독원이 2002년(年)7월(月)위험등급별 위험지수를 참조 위험율로 인가하였으나, 비위험직은 70%, 위험직은 200% 수준으로 산정되어 현실적 적용이 어려움 (2) 위험취미 보험가입 제한 o 해당취미의 직업종사자에 준(準)하여 직업위험등급을 적용하여 가입 한도를 제한하고 있음. 추가질문서를 활용하여 자격증 유무, 동호회 가입등(等)에 대한 세부정보를 입수하지 않음 - 패러글라이딩의 경우 위험2급을 적용, 사망보장 최대 2 억(億)까지 제한 (3) 거주지역/ 해외여행 보험가입 제한 o 각(各)보험사별로 지역적 특성상 사고재해 다발 지역에 대해 보험가입을 제한하고 있음 - 강원, 충청 일부지역 상해보험 가입불가 - 전북, 태백 일부지역 입원급여금 1일(日)2만원이내 o 해외여행을 포함한 해외체류에 대해서는 일정한 가입 요건을 정하여 운영중(中)이며, 가입한도 설정 보험가입을 제한하거나 재해집중보장 상품에 대해 거절함 - 러시아의 경우 단기체류는 위험1급 및 상해보험 가입 불가, 장기 체류는 거절처리함 2. 신체적위험도(身體的危險度)에 따른 인수차별화(引受差別化) (1) 표준미달체 인수방법 o 체증성, 항상성 위험에 대한 초과위험지수를 보험금삭감법으로 전환 사망보험에 적용(최대 5년(年))하여 5년(年)이후 보험 Risk노출 심각 o 보험료 할증은 일부 회사에서 주(主)보험 중심으로 사용중(中)이며, 총위험지수 300(8단계)까지 인수 - 주(主)보험 할증시 특약은 가입 불가하며, 암 기왕력자는 대부분 거절 o 신체부위 39가지, 질병 5가지에 대해 부담보 적용(입원, 수술 등(等)생존급부에 부담보) (2) 비(非)흡연/ 우량체 보험료 할인 o 1999년(年)최초 도입 이래 $3{\sim}4$개의 위험요소로 1개 Class 운영중(中)임 S생보사의 경우 비(非)흡연우량체, 비(非)흡연표준체의 2개 Class 운영 o 보험료 할인율은 회사, 상품에 따라 상이하며 최대 22%(영업보험료기준)임. 흡연여부는 뇨스틱을 활용 코티닌테스트를 실시함 o 우량체 판매는 신계약의 $2{\sim}15%$수준(회사의 정책에 따라 상이) Ⅳ. 언더라이팅 기법(技法) 선진화(先進化) 방안(方案) 1. 직업위험도별 보험료 차등 적용 o 생 손보 직업위험등급 일원화와 연계하여 3개등급으로 위험지수개편, 비위험직 기준으로 보험요율 차별적용 2. 위험취미에 대한 부담보 적용 o 해당취미를 원인으로 보험사고(사망포함) 발생시 부담보 제도 도입 3. 표준미달체 인수기법 선진화를 통한 인수범위 대폭 확대 o 보험료 할증법 적용 확대를 통한 Risk 헷지로 총위험지수 $300{\rightarrow}500$으로 확대(거절건 최소화) 4. 보험료 할증법 보험금 삭감 병행 적용 o 삭감기간을 적용한 보험료 할증방식 개발, 고객에게 선택권 제공 5. 기한부 보험료할증 부가 o 위암, 갑상선암 등(等)특정암의 성향에 따라 위험도가 높은 가입초기에 평준할증보험료를 적용하여 인수 6. 보험료 할증법 부가특약 확대 적용, 부담보 병행 사용 o 정기특약 등(等)사망관련 특약에 할증법 확대, 생존급부 특약은 부담보 7. 표준체 고객 세분화 확대 o 콜레스테롤, HDL 등(等)위험평가요소 확대를 통한 Class 세분화 Ⅴ. 기대효과(期待效果) 1. 고(高)위험직종사자, 위험취미자, 표준미달체에 대한 보험가입 문호개방 2. 보험계약자간 형평성 제고 및 다양한 고객의 보장니드에 부응 3. 상품판매 확대 및 Risk헷지를 통한 수입보험료 증대 및 사차익 개선 4. 본격적인 가격경쟁에 대비한 보험사 체질 개선 5. 회사 이미지 제고 및 진단 거부감 해소, 포트폴리오 약화 방지 Ⅵ. 결론(結論) o 종래의 소극적이고 일률적인 인수기법에서 탈피하여 피보험자를 다양한 측면에서 위험평가하여 적정 보험료 부가와 합리적 가입조건을 제시하는 적절한 위험평가 수단을 도입하고, o 언더라이팅 인수기법의 선진화와 함께 언더라이팅 인력의 전문화, 정보입수 및 시스템 인프라의 구축 등이 병행함으로써, o 보험사의 사차손익 관리측면에서 뿐만 아니라 보험시장 개방 및 급변하는 보험환경에 대비한 한국 생보언더라이팅 경쟁력 강화 및 언더라이터의 글로벌화에도 크게 기여할 것임.

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