• 간호행정학회지
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• 제14권3호
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• pp.219-228
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• 2008

Purpose: The purpose of this study was to develop a measurement scale of nursing competence for nurses working in general wards, and to test the validity and reliability of the scale. Method: A methodological study design was used, consisting of 3 steps as conceptual framework decision, measurement items development, and testing of validity and reliability. In order to verify content validity, 16 experts reviewed the concept of each competences and measurement items. The developed measurement items were tested from 301 nurses in one hospital. Factor analysis and item analysis were applied to establish the scale's construct validity and reliability. Result: The final scale consists of nine dimensions with 70 items. The overall scale reliability had a Cronbach's alpha of 0.98, and the demensions Cronbach's alpha ranged from 0.88 to 0.95. The factor loading of construct validity was from 0.40 to 0.83. The explained variance from the 9 extracted factors was 70.93% of the total variance, and final factors were labeled as critical thinking, resources management and professional development, ability of ward management, application of nursing process, ethical accountability, respectful consideration, patient centered approach, crisis management, and leadership. Conclusion: This measurement scale can be utilized to evaluate nursing competence for nurses working in general wards.

• 한국자동차공학회논문집
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• 제13권2호
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• pp.108-113
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• 2005

The damageability and repairability of similar platform type vehicles could be very concerned with design optimization. In all the vehicles crash tested, small size passenger vehicles were weakness in aspect of damageability and repairability. The most critical area appears to be repair cost considering that parts cost is the largest portion of total repair cost segments. Besides repair cost, attaching method of front sidemember and subframe are placed special importance for impact energy absorption and damageability and repairability. So in order to improve damageability and repairability of vehicle structure and body component of the monocoque type passenger vehicles, the end of front side member and front back beam should be designed with optimum level and to supply the end of front side member as a partial condition approx 300mm. The effectiveness of design concept on the 40% offset frontal impact characteristics of the passenger vehicle structure is investigated and summarized.

• Journal of Information Technology Applications and Management
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• 제25권4호
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• pp.185-196
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• 2018

This study investigates the social network among authors to improve the quality of Panel researches. Korea Health Panel (KHP), implemented by the collaborative work between KIHASA (Korea Institute for Health and Social Affairs) and NHIC (National Health Insurance Service) since 2008, provides a critical infrastructure for policy making and management for insurance system and healthcare service. Using bibliographic data extracted from academic databases, eighty articles were extracted in domestic and international journals from 2008 to 2014, April. Data were analyzed by NetMiner 4.0, social network analysis software, to identify the extent to which authors are involved in healthcare use research and the patterns of collaboration between them. Analysis reveals that most authors publish a very small number of articles and collaborate within tightly knit circles. Centrality measures confirm these findings by revealing that only a small percentage of the authors are structurally dominant, and influence the flow of communication among others. It leads to the discovery of dependencies between the elements of the co-author network such as affiliates in health panel communities. Based on these findings, we recommend that Korea Health Panel could benefit from cultivating a wider base of influential authors and promoting broader collaborations.

• The Journal of Asian Finance, Economics and Business
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• 제8권2호
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• pp.123-133
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• 2021

The purpose of this study was to analyze the influence of product quality factors, product risk, company reputation, and service quality on the purchase intention of insurance policies by customers in Indonesia. The variables in this study are product quality, service quality, company reputation, perceived risk, and purchase intention. This study uses a quantitative approach. Primary data were obtained from 154 respondents. Data processing and model testing use the Structural Equation Modeling procedure with Lisrel 8.80. At the significance level of 0.05, the research found that product quality had a positive and significant effect on purchase intention; product quality had a positive and significant effect on company reputation; product quality had a positive and significant effect on perceived risk perception; company reputation had a positive and significant effect on purchase intention; company reputation has a positive and insignificant effect on service quality; product quality has a positive, but non-significant effect on service quality; service quality has a positive and significant effect on purchase intention; perceived risk has a negative and significant effect on purchase intention; perceived risk has a positive and significant impact on service quality; and perceived risk has a positive and significant effect on company reputation.

• 항공우주정책ㆍ법학회지
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• 제5권
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• pp.101-118
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• 1993

Generally there is no law and liability system which applies particulary to commercial space ventures. There are several international treaties and national statutes which deal with space ventures, but their impact on the liability of commercial space ventures has not been significant. Every state law in the United States will impose both tort and contract liability on those responsible for injuries or losses caused by defective products or by services performed negligently. As with the providers of other products and services, those who participate in commercial space ventures have exposure to liability in both tort and contract which is limited to the extent of the resulting damage The manufacturer of a small and cheap component which caused a satellite to fail to reach orbit or to operate nominally has the same exposure to liability as the provider of launch vehicle or the manufacturer of satellite into which the component was incorporaded. Considering the enormity of losses which may result from launch failure or satellite failure, those participated in commercial space ventures will do their best to limit their exposure to liability by contract to the extent permitted by law. In most states of the United States, contracts which limit or disclaim the liability are enforceable with respect to claims for losses or damage to property if they are drafted in compliance with the requirements of the applicable law. In California an attempt to disclaim the liability for one's own negligence will be enforceable only if the contract states explicitly that the parties intend to have the disclaimer apply to negligence claims. Most state laws of the United States will refuse to enforce contracts which attempt to disclaim the liability for gross negligence on public policy grounds. However, the public policy which favoured disclaiming the liability as to gross negligence for providers of launch services was pronounced by the United States Congress in the 1988 Amendments to the 1984 Commercial Space Launch Act. To extend the disclaimer of liability to remote purchasers, the contract of resale should state expressly that the disclaimer applies for the benefit of all contractors and subcontractors who participated in producing the product. This situation may occur when the purchaser of a satellite which has failed to reach orbit has not contracted directly with the provider of launch services. Contracts for launch services usually contain cross-waiver of liability clauses by which each participant in the launch agrees to be responsible for it's own loss and to waive any claims which it may have against other participants. The crosswaiver of liability clause may apply to the participants in the launch who are parties to the launch services agreement, but not apply to their subcontractors. The role of insurance in responding to many risks has been critical in assisting commercial space ventures grow. Today traditional property and liability insurance, such as pre-launch, launch and in-orbit insurance and third party liability insurance, have become mandatory parts of most space projects. The manufacture and pre-launch insurance covers direct physical loss or damage to the satellite, its apogee kick moter and including its related launch equipment from commencement of loading operations at the manufacture's plant until lift off. The launch and early orbit insurance covers the satellite for physical loss or damage from attachment of risk through to commissioning and for some period of initial operation between 180 days and 12 months after launch. The in-orbit insurance covers physical loss of or damage to the satellite occuring during or caused by an event during the policy period. The third party liability insurance covers the satellite owner' s liability exposure at the launch site and liability arising out of the launch and operation in orbit. In conclusion, the liability in commercial space ventures extends to any organization which participates in providing products and services used in the venture. Accordingly, it is essential for any organization participating in commercial space ventures to contractually disclaim its liability to the extent permitted by law. To achieve the effective disclaimers, it is necessary to determine the applicable law and to understand the requirements of the law which will govern the terms of the contract. A great deal of funds have been used in R&D for commercial space ventures to increase reliability, safety and success. However, the historical reliability of launches and success for commercial space ventures have proved to be slightly lower than we would have wished for. Space insurance has played an important role in reducing the high risks present in commercial space ventures.

• 대한간호학회지
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• 제41권3호
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• pp.302-312
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• 2011

Purpose: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units. Methods: The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed. Results: Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%. Conclusion: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.

• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.19-28
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• 2018

Cancer is the leading cause of death in the Republic of Korea and cancer death accounts for 27.8% of the total deaths, which is not only a social issue but also a concern for the public. Among the cancer death rates, lung cancer mortality account for 34 deaths per 100,000 populations, making it the number one cancer death rate. In a preliminary report on cancer death in 2012, the lung cancer mortality ratio showed the regional variation indicating that there were differences in the qualitative level and the structure among the medical care benefit agency and in the assessment of the treatment process. Therefore, the Health Insurance Review and Assessment Service (HIRA) had begun evaluation of the assessment of lung cancer treatment since 2014 to improve the quality of lung cancer care through evaluation and feeds back the results of lung cancer care process. In this report, authors described the current Indicators for the lung cancer adequacy assessment proposed by HIRA and results of the evaluation reported in 2017.

• 보건행정학회지
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• 제22권4호
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.101-110
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• 2023

Background: Dentists make various efforts to reduce patients' anxiety and fear associated with dental treatment. Dental sedation is an advanced method that dentists can perform to reduce patients' anxiety and fear and provide effective dental treatment. However, dental sedation is different from general dental treatment and requires separate learning, and if done incorrectly, can lead to serious complications. Therefore, sedation is performed by a limited number of dentists who have received specific training. This study aimed to investigate the proportion of dentists who practice sedation and the main sedatives they use in the context of the Republic of Korea. Methods: We used the customized health information data provided by the Korean National Health Insurance. We investigated the number of dental hospitals or clinics that claimed insurance for eight main sedatives commonly used in dental sedation from January, 2007 to September, 2019 at the Health Insurance Review and Assessment Service. We also identified the changes in the number of dental medical institutions by region and year and analyzed the number and proportion of dental medical institutions prescribing each sedative. Results: In 2007, 302 dental hospitals prescribed sedatives, and the number increased to 613 in 2019. In 2007, approximately 2.18% of the total 13,796 dental institutions prescribed sedatives, increasing to 3.31% in 2019. In 2007, 168 institutions (55.6%) prescribed N₂O alone, and in 2019, 510 institutions (83.1%) made claims for it. In 2007, 76 (25.1%) hospitals made claims for chloral hydrate, but the number gradually decreased, with only 29 hospitals (4.7%) prescribing it in 2019. Hospitals that prescribed a combination of N₂O, chloral hydrate, and hydroxyzine increased from 27 (8.9%) in 2007 to 51 (9%) in 2017 but decreased to 38 (6.1%) in 2019. The use of a combination of N₂O and midazolam increased from 20 hospitals (6.6%) in 2007 to 51 hospitals (8.3%) in 2019. Conclusion: While there is a critical limitation to the investigation of dental hospitals performing sedation using insurance claims data, namely exclusion of dental clinics providing non-insured treatments, we found that in 2019, approximately 3.31% of the dental clinics were practicing sedation and that N₂O was the most commonly prescribed sedative.

• Tuberculosis and Respiratory Diseases
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• 제78권4호
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• pp.349-355
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• 2015

Background: The tuberculin skin test (TST) is the standard tool to diagnose latent tuberculosis infection (LTBI) in mass screening. The aim of this study is to find an optimal cut-off point of the TST+ rate within tuberculosis (TB) contacts to predict the active TB development among adolescents in school TB outbreaks. Methods: The Korean National Health Insurance Review and Assessment database was used to identify active TB development in relation to the initial TST (cut-off, 10 mm). The 7,475 contacts in 89 schools were divided into two groups: Incident TB group (43 schools) and no incident TB group (46 schools). LTBI treatment was initiated in 607 of the 1,761 TST+ contacts. The association with active TB progression was examined at different cut-off points of the TST+ rate. Results: The mean duration of follow-up was $3.9{\pm}0.9years$. Thirty-three contacts developed active TB during the 4,504 person-years among the TST+ contacts without LTBI treatment (n=1,154). The average TST+ rate for the incident TB group (n=43) and no incident TB group (n=46) were 31.0% and 15.5%, respectively. The TST+ rate per group was related with TB progression (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.001-1.050; p=0.037). Based on the TST+ rate per group, active TB was best predicted at TST+ ${\geq}$ 16% (OR, 3.11; 95% CI, 1.29-7.51; area under curve, 0.64). Conclusion: Sixteen percent of the TST+ rate per group within the same grade students can be suggested as an optimal cut-off to predict active TB development in middle and high schools TB outbreaks.