• The Korean Journal of Health Service Management
• /
• v.4 no.2
• /
• pp.23-31
• /
• 2010

This study analyzed whether the patients' visits to oriental medicine hospitals were influenced by the Euclidean distance from patients' residence to oriental medicine hospitals. Patient who visited two oriental medicine hospitals in a metropolitan area were selected for study sample. The number of patient from each Dong (which is the smallest administrative district) to two hospitals was calculated based on claims data in 2008. ArcGIS was used to calculate the distance. Distance variable was not statistically significant in regression analysis after controlling the difference of socio-economic status of people in each Dong. It seems that distance factor did not play an important role in deciding whether to use the services of oriental medicine hospitals in a metropolitan area.

• Journal of Preventive Medicine and Public Health
• /
• v.31 no.3 s.62
• /
• pp.471-480
• /
• 1998

This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

• Korean Journal of Heritage: History & Science
• /
• v.52 no.1
• /
• pp.148-169
• /
• 2019

The purpose of this paper is to understand characteristics and trends of calligraphy styles through the analysis of handwriting. Renowned Calligraphy of Korea (海東名迹, Haedong Myeongjeok) is the first collection of famous Korean calligraphers' masterpieces and was published by Shin Gongje (申公濟, 1469-1536) in the early sixteenth century. While my previous studies have focused on analyzing the publishing backgrounds of and differences among the wood block editions and stone-carved editions of the various remaining copies of Renowned Calligraphy of Korea, this study examines the calligraphy style in the early Joseon period as represented within the collection itself. This study tries to identify the aspects of style transitions among two categories of calligraphy: (1) the calligraphy style of scribes who were in charge of documentation in the central administrative institutions (館閣) and (2) the calligraphy style passed down among the Goryeong Shin clan (高靈申氏). This study verifies that various styles which emerged based on the influence of the revivalism of the late Yuan dynasty gained acceptance in the early Joseon period while the traditional Wang Xizhi style was still in use. The most notable revelation of this study is that the calligraphy style of Kangli Naonao (康里??), a Yuan dynasty calligrapher from a remote region to the west of China, appears to have become acceptable during this period. Indeed, various Yuan dynasty styles were flowing into Korea during the late Goryeo and the early Joseon period that stand in contrast to Zhao Mengfu's "pine-snow calligraphy style." Finally, the authenticity of the Eo Sukguan (魚叔權)'s record in A Storyteller's Miscellany (稗官雜記, Paegwanjapgi) is reviewed in this study. Eo claims that writing attributed to Park Gyeong in Renowned Calligraphy of Korea was actually Shin Jageon's. However, the analysis of the relationship between Shin and Park based on their backgrounds and their political positions suggests that Eo's claim is not valid.

• Journal of Korean Academy of Nursing
• /
• v.35 no.8
• /
• pp.1493-1499
• /
• 2005

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
• /
• v.33
• /
• pp.121-144
• /
• 2007

The International Chamber of Commerce has been the world's leading organization in the field of international commercial dispute resolution. Established in 1923 as the arbitration body of ICC, the International Court of Arbitration has pioneered international commercial arbitration as it is known today. The ICC International Court of Arbitration is the world's foremost institution in the resolution of international business disputes. While most arbitration institutions are regional or national in scope, the ICC Court is truly international. The purpose of this paper is to examine their advantages and to introduce main contents provided in ICC Rules of Arbitration as follows; First, before the actual merits of the case can be addressed, the Arbitral Tribunal must first draw up the Terms of Reference. The Terms of Reference should include the particulars listed in the ICC Rules. Apart from the full names and description of the parties and arbitrators, the place of arbitration and a summary of the parties' respective claims, they contain particulars concerning the applicable procedural rules and any other provisions required to make the Award enforceable at law Second, the Scrutiny is a fundamental feature of ICC arbitration and is one that distinguishes it from the other major international arbitration rules. The scrutiny system has two aspects ; the first is to identify or modify the defects of form, while the second is to draw the arbitrators' attention to points of substance. Third, as soon as practicable, the Court fixes an advance on costs intended to cover the estimated fees and expenses of the arbitrators, as well as the administrative expenses of ICC. Specially, the advance on costs fixed by the Court shall be payable in equal shares by the Claimant and Respondent. Finally, the parties are also free to select the arbitrator or arbitrators of their choice. The Court or the Secretary General confirms arbitrators nominated by the parties. Taking a step forward, to upgrade the quality of the award of KCAB, it is desirable to consider how to incorporate the main contents of the ICC Arbitration into Korea Commercial Arbitration Rules.

• Journal of Preventive Medicine and Public Health
• /
• v.47 no.4
• /
• pp.206-215
• /
• 2014

Objectives: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. Methods: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. Results: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. Conclusions: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

• Proceeding of Spring/Autumn Annual Conference of KHA
• /
• 2008.11a
• /
• pp.437-441
• /
• 2008

The community mixed-support facility in Japan is making efforts to try various approaches according to the changes made to allow the privatization of public facilities on the basis of Act on Special Measures for Urban Regeneration since 2004. Due to this change in policy, the community mixed-support facility is now taking further steps in trying to implement variety of approaches in the perspective of urban regeneration and urban maintenance and at the same time the trend of installation of community facility has gone through vivid changes for the last 20 years. The causes of this are from the social demand that claims for of new facilities and the change in the subsidy system in relation to equality in facility installation. Examples of the first cause can be the building of perpetuating educational society, an execution or a movement towards the society of gender equality, a countermovement for an aging society as well as a welfare society, and recently social phenomenon related to consumption is becoming an issue. And for the last, the number of construction of facilities is increasing that grow out of the traditional facility system. The complex of community mixed-support facility will provide public administrative and community mixed-support services to local people as well as to form a notion of community and a feeling of solidarity. Ultimately, this will develop local areas by regional interchanging of information. In this very research, we will analyze the community mixed-support facility and its characteristics as well as its implications and consider the types of complex through many preceding instances in Japanese community mixed-support facility.

• Health Policy and Management
• /
• v.26 no.1
• /
• pp.39-50
• /
• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• Journal of the Korean Operations Research and Management Science Society
• /
• v.37 no.4
• /
• pp.211-223
• /
• 2012

This study purposed to evaluate the influences of rival hospitals on the number of patients who visited the a study territory hospital. Spatial analysis technique was used to measure the impact of rival hospitals in study region. Selected hospitals were all medical school affiliated hospitals which were located in Daejeon metropolitan city and Chungchungnamdo. Patient data was collected from the claims data of the study hospital, and the number of inpatient and outpatients who visited the study hospital between January and June in 2008 were calculated on the smallest administrative district, Eup, Myeon, and Dong, in study region. To control the differences of regional characteristics among Eup, Myeon, Dong, socio-economic variables (total population, number of people aged over 65, number of basic livelihood security recipients, distance from the study hospital to the centroid point of each Eup, Myeon, Dong, number of business, and number of employees) were included in analysis model. These variables were collected from the annual year book of city as well as county located in study region. Cluster analysis classified the study region into three groups by using the difference of between th actual number of inpatient/outpatient and the predicted number of inpatient/outpatient in Eup, Myeon, and Dong. Most areas around the rivalry hospitals were categorized into same group. Multiple regression analysis indicated that areas around rivalry hospitals had statistically significantly negative relationship with the number of inpatients and outpatients who visited the study hospital. As the buffer size was increased from 5Km to 10Km, the standardized regression coefficients were decreased. These study results confirmed that rivalry hospitals in region had negative impacts on the performance of hospitals. It suggests that hospitals will require not only to select their location to minimize the effects of rivalry hospitals, but also to establish their strategy to cope with the rivalry's threats in their region.

• The Korean Society of Law and Medicine
• /
• v.8 no.2
• /
• pp.119-164
• /
• 2007

Improving the formal objection system regarding reviewing medical expenses requires authority and confidence in the aspect of well-functioning the health insurance review and assessment system, legally and appropriately. The purposes of improvement of the formal objection system should aim for protecting the people's right of health. On handling the formal objections, the disputes of the rights should be settled economically and promptly by fairness, specialty, and objectivity in the health insurance review and assessment administration. Therefore, in order to promote the administrative specialty of health insurance, the formal objection committee needs to be organized independently and guaranteed expertly. Under the current formal objection system, however, the organization of committee lacks right-relief function, recognition and public relation as a health insurance appeal system, and related professional man powers. It is also analyzed that there are several controversial points, such as mass deliberation to the formal objection committee and its conference procedure. As a measure of improvement, it is analyzed that the committee needs to be organized independently with a proper number of professional man powers. The strict deliberation procedures and the prohibition of the decision-making by non-conference are also required to be empowered. The formal objection procedure provides the beneficiaries and the claims legitimately, so that it secures the legal relations on the health insurance system. Therefore, on the conference process of formal objection, the expert and guaranteed protection should be provided promptly, and its procedures to the appellants should also be assisted kindly.