• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.341-351
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• 2010

The purpose of this study was to estimate the socioeconomic costs resulting from alcohol drinking among adolescents as of 2006 from a societal perspective. Methods: The costs were classified into direct costs, indirect costs, and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by future income losses from premature death, productivity losses from using medical services and reduction of productivity from drinking and hangover. The other costs consisted of property damage, public administrative expenses, and traffic accident compensation. Results: The socioeconomic costs of alcohol drinking among adolescents as of 2006 were estimated to be 387.5 billion won (0.05% of GDP). In the case of the former, the amount included 48.25% for reduction of productivity from drinking and hangover, 39.38% for future income losses from premature death, and 6.71% for hangover costs. Conclusions: The results showed that the socioeconomic costs of alcohol drinking among adolescents in Korea were a serious as compared with that of the United States. Therefore, the active interventions such as a surveillance system and a prevention program to control adolescents drinking by government and preventive medicine specialist are needed.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.2
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• pp.147-158
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• 2006

The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

• 한국노년학
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• v.32 no.2
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• pp.467-485
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• 2012

National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.434-434
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• 2005

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.433-433
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• 2005

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.121-136
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• 2002

The main purpose of this study is to examine the overall procedure of hospital's internal review of health insurance reimbursement, to present the case of protest against reimbursement cut, and hence to provide some information on hospital's management of medical revenue. The object of the case study is 'P' university medical center, possessing 5 different hospitals under its system. Presentation of the case of protest against reimbursement cut has following meanings: Firstly, to the hospitals that already have internal review departments, information on the details of the protest process and results can be exchanged. Secondly, to the Government and National Health Insurance Corporation, useful data are provided for the improvement of the rules and procedures of health insurance reimbursement. Thirdly, to the hospitals without internal review departments, fundamental materials on the internal review process are provided for the effective management of medical revenue.

• Health Policy and Management
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• v.23 no.1
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• pp.35-43
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• 2013

Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.31-34
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• 2009

Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.285-291
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• 2009

Objective : This study examined the change of range of motion (ROM) at the segments within the dynamic posterior stabilization, segments above and below the system, the clinical course and analyzed the factors influencing them. Methods : This study included a consecutive 27 patients who underwent one-level to three-level dynamic stabilization with Bioflex system at our institute. All of these patients with degenerative disc disease underwent decompressive laminectomy with/without discectomy and dynamic stabilization with Bioflex system at the laminectomy level without fusion. Visual analogue scale (VAS) scores for back and leg pain, whole lumbar lordosis (from L1 to S1), ROMs from preoperative, immediate postoperative, 1.5, 3, 6, 12 months at whole lumbar (from L1 to S1), each instrumented levels, and one segment above and below this instrumentation were evaluated. Results : VAS scores for leg and back pain decreased significantly throughout the whole study period. Whole lumbar lordosis remained within preoperative range, ROM of whole lumbar and instrumented levels showed a significant decrease. ROM of one level upper and lower to the instrumentation increased, but statistically invalid. There were also 5 cases of complications related with the fixation system. Conclusion : Bioflex posterior dynamic stabilization system supports operation-induced unstable, destroyed segments and assists in physiological motion and stabilization at the instrumented level, decrease back and leg pain, maintain preoperative lumbar lordotic angle and reduce ROM of whole lumbar and instrumented segments. Prevention of adjacent segment degeneration and complication rates are something to be reconsidered through longer follow up period.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.169-173
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• 2008

Purpose：This is a retrospective study to evaluate the results of concurrent chemoradiotherapy in nasopharyngeal carcinoma. Material and Methods：From Mar 2000 to June 2005, 18 patients with nasopharyngeal carcinoma completed planned concurrent chemoradiotherapy. Stages were I in 1 patients, II in 2 patients, III in 7 patients and IV in 8 patients. Pathologic type was squamous cell carcinoma(WHO type 1) in 2 patients, non-keratinizing type(WHO type 2) in 8 patients and undifferetiated carcinoma(WHO type 3) in 8 patients. The follow up period ranged from 30 months to 95 months with a median of 56 months. Follow up was possible in all patients. Results：Response to concurrent chemoradiation therapy was a complete response in all patients. Patterns of failure were as follows：local recurrence in only one patient(5.6%) and distant metastases in three patients with N3 diseases(16.7%). The overall 5 year survival rates were 88.5%, the 5 year disease free survival rate was 77% and these were very good results. There were no significant differences in the local control and survival rates between the clinical stages and pathologic types. Conclusion：The outcome of the nasopharyngeal carcinoma treated with concurrent chemoradiotherapy was very good, even though most of the patients(15/18=83.3%) were in stage III and IV diseases. We concluded that concurrrent chemoradiotherapy in nasopharyngeal carcinoma showed the good local control and survival rates without significant complications. In the patients with N3 disease, we have to consider the more effective and strong chemotherapeutic regimens to prevent distant metastases.