• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3463-3471
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• 2015

Background: The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the womans perspective. Materials and Methods: In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Programme (CASP) tool was used. Results: From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. Conclusions: Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening.

• Journal of Information Technology Services
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• v.13 no.3
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• pp.343-357
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• 2014

As science and technology infiltrates every aspects of modern society in terms of economic and social growth and development, funding for research and development (R&D) is growing rapidly. Republic of Korea is not an exception in this trend and the R&D funding in Korea has been grown about 10% every year, recently. However, as the scope and size of funding grows exponentially, need for monitoring and managing these R&D projects becoming more and more imminent. Though different types of project management systems were developed by a variety of agencies and departments and used in monitoring and managing, these systems were developed as standalone silo type systems. These systems are not connected to each other while the same researchers may involved in different projects across agencies and department. Also, these management systems are not linked to the banking systems in which real transactions of funding occurs, such as cost reimbursement and financial audit of each R&D accounts. Historically, a few fraud and malappropriation cases were found and indicted. However, as the number of these incidents grows along with the growth of R&D funding, a large scale integration/linking of project management systems and banking systems. Realizing the importance of systems integration among agencies as well as with the banking systems, situational requirements analyses were conducted concerning the current state of R&D management system. As a results, a Real-time Case Management System (RCMS) was proposed as a solution to current problems. In this paper, the collected systems requirements were documents with analyses of the situation, the architecture of the integrated systems with more user-friendly technological alternatives. This large scale linkage requires interface standardization as well as modularization of interfaces. Proposed systems architecture is introduced here with technical details of Jex Framework used,, followed by resulting technical and economic performance of the Realtime Cashflow Management System (RCMS).

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Fire Science and Engineering
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• v.31 no.6
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• pp.99-106
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• 2017

This research investigated the improvement plan for Korean Volunteer Fire Department through comparative consideration of overall operation system of Japanese and U.S. Volunteer Fire Department. For this, the researcher utilized descriptive approach according to documentary survey method including relevant academic essay, advanced research report, national institution publication, fire fighting-related books, textbook for new comers of Japanese fire department, and overseas training report, etc., and suggested an improvement plan for efficient operation of Korean Volunteer Fire Department. Research results are, first, enhance the community spirit of local community and establish of the status of Volunteer Fire Department. second, enlarge the scope of the work of Volunteer Fire Department to rescue, emergency medical services. third, organize task force team which is in charge of professional field education and training for Volunteer Fire Department. fourth, improve individual reward system and establishment of Volunteer Fire Department's identity and reinforce financial support. The researcher expects the research results can be utilized as the basic materials for the development of Korean Volunteer Fire Department, henceforth.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.73-87
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• 1992

The level of copayment increased in order to stabilize the financial condition of the health insurance on 1986. An important question regarding the policy was whether the increase in the level of copayments reduced the utilization of medical services in the poor selectively. In spite of the importance of the research question, no study has been reported. This study was designed to find out changes in numbers of physician visits, to explain characteristics influencing the difference of utilization before and after the program. Finally the interaction effect between the program and the level of income was examined for the abover question. A total of 10,421 persons from eight institutions was selected as the study sample. Research findings are as follows. 1. The number of physician visits decreased by ten percent as a result of increasing the level of copayment. 2. The decrease was remarkable in some groups such as children, rural area and large family. 3. The most important factor which explained the difference was the number of physician visits before the introduction of the new program. The more numbers of physian visits during the last year were, the more numbers of physian visits decreased after the program. 4. The interaction term between the program and the level of income was statistically significant in the multiple regression model which explained physician visits and its coefficient was negative. It means that an increase in copayment did not reduced the number of physician visits in the poor, selectively. 5. It can be concluded that imposing adequate copayment reduces the use of medical services as well as medical costs without serious damage in access especially for the poor people.

• Health Policy and Management
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• v.24 no.3
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• Journal of Information Technology Services
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• v.16 no.3
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• pp.17-45
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• 2017

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

• Journal of Korea Society of Digital Industry and Information Management
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• v.7 no.2
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• pp.173-183
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• 2011

The business is faced with the situation must improve a power in an increasingly competitive environment due to the recent rapid advance in information technology and the opening and expansion of global market, fast technological change, and various customer demand. The rapid change in information technology is having an effect on not only all the processes to develop products, but information contents that is provided for the purpose of customer value, and the appearance of products. In other words, the information technology is being recognized as a very important factor among other factors for companies to enhance their competitiveness. In addition, it is more efficient to focus on key factor to maintain the competitive advantage on the using of information technology by outsourcing information systems, rather than by operating the systems under their own. Since the global financial crisis, the long-term recession has been increasing companies who is ready to adopt outsourcing or adopted already. This study is to understand the environment and unique characteristics of outsourcing services and related industries focusing on information system operation and management in information outsourcing services, and is to set the concept needed through my theory that is connected to the service quality and customer satisfaction. A lot of business wiew the improvement of service quality and ensuring customer satisfaction as the major factors of business growth, and lots of ongoing studies have focused on service management in the Information outsourcing service industry. Yet few studies have ever concentrated on the quality of information system operation management service. This study, moreover, is to define the quality of service related with customer satisfaction from customer's viewpoint, measuring effects on customer satisfaction. The quality of outsourcing service on information system in this study is a great help to companies who are offering information outsourcing service, and company's managers and staffs who outsourcedto specialized company.

• Korea Journal of Hospital Management
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• v.9 no.2
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Korean Journal of Health Education and Promotion
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• v.24 no.2
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• pp.123-134
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• 2007

Since 1996, the Health Promotion Programme spearheaded by the Korean Central Government has been actively developing and recently, the Healthy City Project led by the local autonomous entities have also been actively promoted. Healthy City is one in which the health and well-being of the citizens are given the utmost importance in the decision-making of the city. While the Health Promotion Programme focuses on changing the "health behavior" of the people, the Healthy City Project, a policy to improve the existing inequality of public health services, deals with more essential health factors and requires political support as well as a new organization. The Healthy City paradigm based on the New Public Health started in England and ever since the Healthy City Model Project spearheaded by the EURO WHO began in 1986, the Alliance for Healthy Cities centered in the West Pacific region supported by the WHO in Oct 2003 was inaugurated. 19 Korean cities are full members of the Alliance for Healthy Cities and 2 laboratories are associate members. The Ministry of Health and Welfare has held the Healthy City Forum consisting of related officials, experts and representatives of civic bodies on 6 occasions since Dec 2005. The need for adequate administrative and financial support from the Central Government to the local autonomous entities governing the Healthy Cities was raised. It is hoped that this Healthy City Project will bring about the improved health conditions of the people as well as promote the equality of the public health services.