• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.165-174
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• 2022

Background: One goal of the End tuberculosis (TB) Strategy is to see no TB-affected households experiencing catastrophic costs. Therefore, it is crucial for TB-elimination programs to identify catastrophic costs and their main drivers in order to establish appropriate health and social measures. This study aimed to measure the percent of catastrophic costs experienced by Egyptian TB patients and to identify its determinants. Methods: We conducted a prospective cohort study with 151 Egyptian TB patients recruited from two chest dispensaries from the Cairo governate from May 2019 to May 2020. We used a validated World Health Organization TB patient-cost tool to collect data on patients' demographic information, household income, and direct and indirect expense of seeking TB treatment. We considered catastrophic TB costs to be total costs exceeding 20% of the household's annual income. Results: Of the patients, 33% experienced catastrophic costs. The highest proportion of the total came in the pre-treatment stage. Being the main breadwinner, experiencing job loss, selling property, and the occurrence of early coronavirus disease 2019 lockdown were independent determinants of the incidence of catastrophic costs. Borrowing money and selling property were the most-often reported coping strategies adopted. Conclusion: Despite the availability of free TB care under the Egyptian National TB Program, nearly a third of the TB patients incurred catastrophic costs. Job loss and being the main breadwinner were among the significant predictors of catastrophic costs. Social protection mechanisms, including cash assistance and insurance coverage, are necessary to achieve the goal of the End TB Strategy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2713-2717
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• 2014

Background: Cancer imposes significant economic challenges for individuals, families, and society. Households of cancer patients often experience income loss due to change in job status and/or excessive medical expenses. Thus, we examined whether changes in economic status for such households is affected by catastrophic health expenditures. Materials and Methods: We used the Korea Health Panel Survey (KHPS) Panel $1^{st}-4^{th}$ (2008-2011 subjects) data and extracted records from 211 out of 5,332 households in the database for this study. To identify factors associated with catastrophic health expenditures and, in particular, to examine the relationship between change in economic status and catastrophic health expenditures, we conducted a generalized linear model analysis. Results: Among 211 households with cancer patients, 84 (39.8%) experienced catastrophic health expenditures, while 127 (40.2%) did not show evidence of catastrophic medical costs. If a change in economic status results from a change in job status for head of household (job loss), these households are more likely to incur catastrophic health expenditure than households who have not experienced a change in job status (odds ratios (ORs)=2.17, 2.63, respectively). A comparison between households with a newly-diagnosed patient versus households with patients having lived with cancer for one or two years, showed the longer patients had cancer, the more likely their households incurred catastrophic medical costs (OR=1.78, 1.36, respectively). Conclusions: Change in economic status of households in which the cancer patient was the head of household was associated with a greater likelihood that the household would incur catastrophic health costs. It is imperative that the Korean government connect health and labor policies in order to develop economic programs to assist households with cancer patients.

• Health Policy and Management
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• v.33 no.3
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• pp.363-369
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• 2023

The term "catastrophic health expenditure" means assessing the extent to which medical costs cause financial hardship for households. The aim of this research is to analyze the percentage of households that faced severe financial strain due to medical expenses from 2006 to 2021. This was achieved by utilizing data obtained from the National Survey of Tax and Benefit (NaSTaB), Korea Health Panel (KHP), and Households Income and Expenditure Survey (HIES). A trend analysis was conducted to examine the percentage of households that experienced catastrophic healthcare expenses. The households that experienced the catastrophic health expenditure was 2.49% in 2021 using the NaSTaB data. The trend analysis yielded a statistically significant result, indicating a decreasing trend (annual percent change [APC], -4.79; p<0.0001) in the proportion of households facing catastrophic health expenditures. Also, the results of the 2019 KHP and the 2021 HIES showed 1.09% and 2.44% for the households that experienced catastrophic health expenditure. The trend was increased according to the KHP (APC, 0.55; p=0.0004) and the HIES (APC, 7.04; p<0.0001). As a result, this study proposes that sustained attention and further interventions are necessary to ease the economic pressure caused by catastrophic health expenses, particularly for low-income households.

• Health Policy and Management
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• v.18 no.4
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• pp.23-48
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• 2008

Although the universal health insurance, National Health Insurance (NHI), have improved access to health care and financial burden of health care costs for Koreans, limited coverage of the NHI leads to high out-of-pocket payment for health care. This study examines financial burden of household health expenditures by income level. Data from the Urban Household Expenditure Survey from 1985 through 2005 is analyzed and household expenditure is used as a proxy measure for income. Health expenditures include spending for inpatient care, ambulatory care and pharmaceuticals. If a household spends health expenditure above 40% of household consumption except for foods, that is defined as catastrophic health expenditure. Access to health care for the lowest income group had been improved for two decades relative to other income groups as well as in absolute term. However, both financial burden of health expenditures and the proportion of households that experienced catastrophic health expenditure had been increased in the lowest income group. Study findings have several policy implications. First, in terms of financial burden of health expenditures. the differences among income groups decreased until 2000 but it was worsen in 2005. This suggests that recent policies for extending NHI coverage are not enough to improve the disparity by income level. Second, a differential catastrophic coverage by income level would be an effective strategy that relieves financial burden for low income group. Third, since the catastrophic coverage is applied to only covered services by the NHI, additional strategy for uncovered services should be considered.

• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.393-400
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• 2017

Objectives: To relieve the financial burden faced by households, the Korean National Health Insurance (NHI) system introduced a "copayment ceiling," which evolved into a differential ceiling in 2009, with the copayment ceiling depending on patients' income. This study aimed to examine the effect of the differential copayment ceiling on financial protection and healthcare utilization, particularly focusing on whether its effects varied across different income groups. Methods: This study obtained data from the Korea Health Panel. The number of households included in the analysis was 6555 in 2008, 5859 in 2009, 5539 in 2010, and 5372 in 2011. To assess the effects of the differential copayment ceiling on utilization, out-of-pocket (OOP) payments, and catastrophic payments, various random-effects models were applied. Utilization was measured as treatment days, while catastrophic payments were defined as OOP payments exceeding 10% of household income. Among the right-hand side variables were the interaction terms of the new policy with income levels, as well as a set of household characteristics. Results: The differential copayment ceiling contributed to increased utilization regardless of income levels both in all patients and in cancer patients. However, the new policy did not seem to reduce significantly the incidence of catastrophic payments among cancer patients, and even increased the incidence among all patients. Conclusions: The limited effect of the differential ceiling can be attributed to a high proportion of direct payments for services not covered by the NHI, as well as the relatively small number of households benefiting from the differential ceilings; these considerations warrant a better policy design.

• Proceedings of the Korean Geotechical Society Conference
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• 2001.10c
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• pp.19-27
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• 2001

Early detection of premonitory symptom of slope movement ensures tremendous saving of lives and repair costs from catastrophic disaster. Therefore, it is essential to constantly monitor the performance and integrity of both reinforced and un-reinforced cut slopes. We developed a novel monitoring system by using tension wire sensors. It's advantages are highly sensitivity, simple installation, large displacement measurement, durability of system, capability of remote sensing. Real-time measurement of slope surface movement is shown graphically and it gives a warning when the monitored value exceeds a given threshold level so that any sign of abnormal slope movement can be easily perceived.

• Journal of the Korean Geophysical Society
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• v.8 no.3
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• pp.137-143
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• 2005

Early detection of premonitory symptom of slope movement ensures tremendous saving of lives and repair costs from catastrophic disaster. Therefore, it is essential to constantly monitor the performance and integrity of both reinforced and un-reinforced cut slopes. We developed a novel monitoring system by using tension wire sensors. It's advantages are highly sensitivity, simple installation, large displacement measurement, durability of system, capability of remote sensing. Real-time measurement of slope surface movement is shown graphically and it gives a warning when the monitored value exceeds a given threshold level so that any sign of abnormal slope movement can be easily perceived.

• Proceedings of the Korean Geotechical Society Conference
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• 2000.11b
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• pp.60-76
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• 2000

Early detection in real-time response of slope movements ensures tremendous saving of lives and repair costs from catastrophic disaster Therefore, it is essential to constantly monitor the performance and integrity of slope-stabilizing structures such as Rock bolt, Nail and Pile during or after installation. We developed a novel monitoring system using Fiber Bragg Grating (FBG)sensor. It's advantages are highly sensitivity, small dimension and electro-magnetic immunity. capability of multiplexing, system integrity, remote sensing - these serve real-time health monitoring of the structures. Real-time strain measurement by the signal processing program is shown graphically and it gives a warning sound when the monitored strain state exceeds a given threshold level so that any sign of abnormal disturbance on the spot can be easily perceived.

• Proceedings of the Safety Management and Science Conference
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• 2011.04a
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• pp.67-77
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• 2011

The railroad system must ensure not only the safety of facilities but also the prevention of natural and environmental disasters. The infrastructure must be strengthened in order to prevent rail damage by natural disasters and other causes. Thus, it would be able to prevent damage due to such natural factors like heavy rain and snow fall, wind, and catastrophic earthquakes. It seems that it would be the best way to install safety facilities throughout the entire length of a route, but one would not be able to provide for the costs involved in this approach. Therefore, these facilities must be installed at selected locations that is the most vulnerable to disasters. In this paper we propose the examples of both foreign and domestic methods in order to prevent from damages caused by the above-mentioned natural disasters and others.

• Journal of the Korean Geophysical Society
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• v.8 no.1
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• pp.7-14
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• 2005

Early detection in real-time response of slope movements ensures tremendous saving of lives and repair costs from catastrophic disaster. Therefore, it is essential to constantly monitor the performance and integrity of slope-stabilizing structures such as Rock bolt, Nail and Pile during or after installation. We developed a novel monitoring system using Fiber Bragg Grating (FBG) sensor. It's advantages are highly sensitivity, small dimension and electro-magnetic immunity. capability of multiplexing, system integrity, remote sensing - these serve real-time health monitoring of the structures. Real-time strain measurement by the signal processing program is shown graphically and it gives a warning sound when the monitored strain state exceeds a given threshold level so that any sign of abnormal disturbance on the spot can be easily perceived.