• Title/Summary/Keyword: Claim Management

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Multi-faceted Citation Analysis for Quality Assessment of Scholarly Publications (학술논문 품질평가를 위한 다방면 인용분석방식)

  • Yang, Ki-Duk;Meho, Lokman
    • Journal of the Korean Society for information Management
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    • v.28 no.2
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    • pp.79-96
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    • 2011
  • Despite the widespread use, critics claim that citation analysis has serious limitations in evaluating the research performance of scholars. First, conventional citation analysis methods yield one-dimensional and sometimes misleading evaluation as a result of not taking into account differences in citation quality, not filtering out citation noise such as self-citations, and not considering non-numeric aspects of citations such as language, culture, and time. Second, the citation database coverage of today is disjoint and incomplete, which can result in conflicting quality assessment outcomes across different data sources. This paper discuss the findings from a citation analysis study that measured the impact of scholarly publications based on the data mined from Web of Science, Scopus, and Google Scholar, and briefly describes a work-in-progress prototype system called CiteSearch, which is designed to overcome the weaknesses of existing citation analysis methods with a robust citation-based quality assessment approach.

A Study on the Contractor's Liability for the Defects in the Public Construction Works (공공건설사업의 하자에 대한 수급인의 책임에 관한 연구)

  • Cho Young-Jun;Hyun Chang-Taek
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • autumn
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    • pp.46-53
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    • 2002
  • Although Public Construction Works in Korea have been executed according to Government Contract Act, and nature of contract is very complicated. So it is difficult to define liability for the defects. Therefore the studies on the defective performance and contractor's defects liability were remained one of the non-cultivated virgin land. As a result, contract privy waive the right to claim or generally resolve the problems. Therefore domestic and overseas liability for the defects was investigated and liability for the defects, under and after construction, on the defective performance and defects, was analysed. With a literature research, contractor's defect liability was systematically analyzed, problems were defined and resolution of the problem were suggested item by item in this study.

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Association between Introduction of the Diagnosis-Related Groups System for Anal Operation and Length of Stay: Higher Effectiveness at Hospitals with Longer Length of Stay

  • Park, Hye Ki;Chun, Sung-Youn;Choi, Jae-Woo;Kim, Seung-Ju;Park, Eun-Cheol
    • Health Policy and Management
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    • v.28 no.2
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    • pp.178-185
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    • 2018
  • Background: We investigated association between introduction of the diagnosis-related groups (DRG) system for anal operation and length of stay. Also, we investigated how it is different among hospitals with longer length of stay and among hospitals with shorter length of stay before introduction of the DRG system. Methods: We used data from Health Insurance Review and Assessment which were national health insurance claim data. Total 13,111 cases of anal surgery cases were included which were claimed by hospitals since July 2012 to June 2014. Two-level multivariable regression was conducted to analysis the association between length of stay and characteristics of hospital and patient. Results: Before introducing DRGs, the average length of stay was 5.41 days. After introducing DRGs, average length of stay was decreased to 3.92 days. After introducing DRGs, length of stay has decreased (${\beta}=-1.0450$, p<0.0001) and it was statistically significant. Among hospitals which had short length of stay (shorter than mean of length of stay) before introducing DRGs, effect of introducing DRGs was smaller (${\beta}=-0.4282$, p<0.0001). On contrary, among hospitals which had long length of stay (longer than mean of length of stay) before introducing DRGs, effect of introducing DRGs was bigger (${\beta}=-1.8280$, p<0.0001). Conclusion: Introducing DRGs was more effective to hospitals which had long length of stay before introducing DRGs.

A Real-Time Spatial DSS for Security Camera Image Monitoring

  • Park, Young-Hwan;Lee, Ook
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 1998.10a
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    • pp.413-414
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    • 1998
  • This paper presents a real-time Spatial Decision Support System(SDSS) for security camera image monitoring. Other SDSSs are not real-time systems, i.e., they show the images that are already transformed into data format such as virtual reality. In our system, the image is broadcasted in real-time since the purpose of the security camera needs to do it in real-time. With these real-time images, other systems do not add up anything more; the screen just shows the images from the camera. However in our system, we created a motion detection system so that the supervisor(Judge) of a sec.urity monitoring system does not have to pay attention to it constantly. In other words, we created a judge advising system for the supervisor of the security monitoring system. Most of small objects do not need the supervisor's attention since they could be birds, cats, dogs, etc. if they show up in the screen image. In this new system the system only report the unusual change to the supervisor by calculating the motion and size of objects in the screen. Thus the supervisor can be liberated from the 24-hour concentration duty; instead he/she can be only alerted when the real security threat such as a big moving object like an human intruder appears. Thus this system can be called a real-time Spatial DSS. The utility of this system is proved mathematically by using the concept of entropy. In other words, big objects like human intruders increase the entropy of the screen images significantly therefore the supervisor must be alerted. Thus by proving its utility of the system theoretically, we can claim that our new real-time SDSS is superior to others which do not use our technique.hnique.

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Benchmarking Research Based on Contract Documents for Successful ADR Implementation to Domestic Construction Industry (ADR 활성화를 위한 건설 계약서의 해외 사례 벤치마킹 연구)

  • Choi Jeong-Won;Kim Sang-Bum
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • 2004.11a
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    • pp.629-633
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    • 2004
  • The number of claims and disputes among project participants has been steadily increasing last a few years and it creates numerous conflicts and problems in the domestic construction industry. One of the root causes of claims and disputes can be explained by the fact that project objectives of participants are offer different and not aligned. This research is considered as a pre-study of developing a strategy to mitigate conflicts such as claims and disputes in the domestic construction industry by utilizing Alternative Dispute Resolution (ADR) techniques. This research focused on improving standard contrast documents to establish a systematic dispute resolution process which emphasize the ADR method. To do so, several well-recognized contract documents developed by FIDIC, AIA, ECC were throughly investigated and analyzed using a benchmarking process. Result of the research propose needs of improving the domestic construction document's some clauses and the details will be further Investigated through surveys and expert's opinions.

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Variations on Drug Utilization between the Types of Hospital in Some Frequent Diseases (일부 다빈도 질환에서 의료기관 유형별 의약품 사용의 변이)

  • 박실비아
    • Health Policy and Management
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    • v.9 no.2
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    • pp.118-138
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    • 1999
  • This study presents the variations on drug utilization for outpatients' URI, gastritis. and hypertension by the type of hospital- tertiary hospital. general hospital. hospital. clinic. It investigated drug expenses. daily drug expenses. days of medication. the highest price of the drugs used. and the number of the different drugs used for each disease and type of hospital. This study also performed analysis to see how much the variations of variables related to drug use affect the variations of drug expenses. The dependent variable was drug expenses and the independent variables were days of medication. the average price of the drugs used. and the number of the different drugs used. Analysis of the drug utilization was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Patients with secondary diseases were excluded. In this study. 379 patients with URI, 386 patients with gastritis. 1.257 patients with hypertension were included. It was founded that there were large variation on drug utilization between the types of hospital for same diseases. Days of medication were longest in tertiary hospitals and shortest in hospitals or clinics. Clinics showed the lowest daily drug expenses in all of the diseases investigated. Daily drug expenses were highest in general hospitals or hospitals. which also tended to use drugs of higher price than other types of hospital. General hospitals and hospitals had larger variations in daily drug expenses and the highest price of drugs. It suggested that drug might be utilized overly in general hospitals and hospitals and some other factors might influence on drug utilization in these hospitals. It was found that the variations of drug expenses were affected by the variations of drug price and days of medication rather than the number of the different drugs. Then the strategy to reduce the variations of drug utilization and to improve the quality of drug utilization should focus on the drug price and days of medication. Further study is needed to assess the quality as well as the variation of drug utilization and to show the factors which affect them.

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Effect of Socioeconomic Status on Healthcare Utilization in Patients with Rare and Incurable Diseases (희귀난치성질환자에서 사회경제적 수준이 의료이용에 미치는 영향)

  • Im, Jun;Kim, Myeong-Hee;Im, Jeong-Soo;Oh, Dae-Gyu
    • Health Policy and Management
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    • v.19 no.4
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    • pp.66-77
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    • 2009
  • This study aims to examine the effect of socioeconomic status (hereafter, SES) on healthcare utilization of the patients with rare and incurable diseases. Information of 2,973 patients who were self-employed insured and utilized healthcare service in 2007 was drawn from the National Health Insurance (hereafter, NHI) claim data. SES was set as four groups based on the monthly contribution. Outcome variable was the expense for outpatient and in-hospital services, which was log-transformed and square-rooted in oder to obtain normal distribution. Covariates included age, gender, residence and diagnosis. To examine the effects after controlling for covariates, we employed generalized estimating equation model, since patients with the same diagnosis are likely to have similar characteristics of demographics and healthcare utilization. Univariate statistics showed that lower SES was associated with less utilization of healthcare services. After controlling for covariates, a significantly smaller amount of money was expended for the lowest SES group compared to the highest one. Rural residence was associated with less utilization, except that residents in Seoul significantly more utilized outpatient services in tertiary hospitals. Considering that there is a subsidy program for the low income patients, such differences in healthcare utilization according to SES seems to result from the burden of out-of-pocket payments for uncovered services of the NHI.

Factors Influencing Physicians' Prescriptions in Some Frequent Diseases (일부 다빈도 질환에서 개원의의 의약품 처방에 영향을 미치는 요인)

  • 박실비아;문옥륜;강영호
    • Health Policy and Management
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    • v.8 no.2
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    • pp.166-190
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    • 1998
  • This study presents the status on drug prescription for clinic outpatients' bronchitis, gastritis, and gastric ulcer, and also the physician factors that affects their prescriptions. In this research project the physician factors are as follows: their demographic features, their work related features, education related features, drug information related features and drug promotion related features. The variables in drug prescriptions are drug expenses, daily drug expenses, days of medication, the highest price of the drugs used and the number of the different drugs used. Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Data on physicians' characteristics were collected by mailing surveys. Patients with secondary diseases were excluded. In this study, 388 adults with bronchitis, 1,038 children with bronchitis, 1,158 patients with gastritis, 369 patients with gastric ulcer were included. The older physicians tend to allow the lower drug costs: this explains that the older doctors who are more experienced less depend on the medicines. It can be also explained that doctors are likely to use the medicines that had been used for their intern and resident practice/training period. General practitioners give more intensive prescription compared to specialists. And specialists prescribed medicines to patients for longer period. The doctors' prescriptions for patients are largely affected by commercial sources. So objective and reliable sources for drug information is needed for patients' benefits. Physician factors explain better at the daily drug expenses, the drug price and the number of different drugs than days of medication. Gastric ulcer are better explained by the prescription model adopted in this study than other diseases.

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The Development of Evaluation Criteria Model for Discriminating Specialized General Hospital (종합전문요양기관 인정기준 모형 개발)

  • Chun Ki Hong;Kang Hye-Young;Kang Dae Ryong;Nam Chung Mo;Lee Gye-Cheol
    • Health Policy and Management
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    • v.15 no.4
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    • pp.46-64
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    • 2005
  • This study was conducted to verify the current criteria and classification system used to determine specialized general hospitals status. In this study, we proposed a new classification system which Is simpler and more convenient than the current one. In the new classification system clinical procedure was chosen as the unit of analysis in order to reflect all the resource consumption and the complexities and degree of medical technologies in determining specialized general hospitals. We developed a statistical model and applied this model to 117 general hospitals which claim their national insurance through electronic data interchange(EDI). Analysis based on 984 clinical procedures and medical facilities' characteristic variable discriminated specialized general hospital in present without misclassification. It means that we can determine specialized general hospital's permission In new way without using the current complicated criteria. This study discriminated specialized general hospital by the new proposed model based on clinical procedures provided by each hospital. For clustering the same types of medical facilities using 984 clinical procedures, we executed multidimensional scale analysis and divided 117 hospitals into 4 groups by two axises : a variety of procedure and the Proportion of high technology Procedure. Therefore, we divided 117 hospitals into 4 groups and one of them was considered as specialized general hospital. In discriminating analysis, we abstracted proportion of 16 clinical procedures which effect on discriminating the specialized general hospital in statistical system also we identify discriminating function which include these variables. As a result, we identify 2 discriminating functions, one is for current discriminating system and the other two is for new discriminating system of specialized general hospital.

The trend of national health insurance service use among pregnant and postpartum women aged 35 years and older (35세 이상 고령 임산부 진료실적 추이에 관한 연구)

  • Hwang, Rah-Il;Kim, Kyung-Ha;Yoon, Ji-Won;Lee, Jung-Suk
    • Health Policy and Management
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    • v.21 no.4
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    • pp.585-598
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    • 2011
  • This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.