• Journal of Dental Anesthesia and Pain Medicine
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• v.24 no.1
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• pp.67-73
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• 2024

Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m³ (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO₂ equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.617-626
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• 2015

This study examined the relationship between the physical activity levels and health care utilization in Korean elderly based on the data from The fifth Korean National Health and Nutrition Examination Survey (K-NHANES V). As a result, physically active participants were 0.54 times (OR;95% CI, p<0.001) less likely to use inpatient health care and 0.73 times (OR;95% CI, p=0.040) less likely to use outpatient health care and 0.75 times (OR;95% CI, p<0.007) less likely to use drugstores than physically inactive participants, and the frequency of health care use was lower. In addition, physically minimal active participants were 0.64 times (OR;95% CI, p<0.001) less likely to use inpatient health care than physically inactive participants; the frequency of other health care facilities was lower. In conclusion, the relationship between being physically active and lower health care utilization among Korean elderly identified in this study. This suggests that being physically active is helpful to the elderly, not only in health promotion and improving quality of life, but also in reduced medical expenditure.

• Journal of the Korean Home Economics Association
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• v.35 no.4
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• pp.229-242
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• 1997

the purpose of this study is to investigate the effect of household type on human capital enhancement expenditures and to compare the difference in these expenditures between female-hemale-headed and married-couple households. Data for this study were from the 1990-91 Consumer Expenditure Survey(CES) and consisted of a sample of 7,225 married-couple and 1,391 female-headed households with children under age 18. The dependent variable to measure human capital expenditures was the sum of four sub-components-education reading leisure and health care expenditures. Tobit analysis with a dummy variable for household type was used to identify the effect of household type on the dollars spent on human capital expenditures. The effect of household type was significant in human capital expenditures indicating that female-headed households spent significantly less for this category than did married-couple household holding other factors constant. the findings of this study suggested that income from a public assistance program was associated with lesser expenditures on human capital while social security income source was associated with greater human capital expenditures, It was also found that the addition of family members between ages of 6 and 17 positively affected human capital expenditures. Understanding these factors is useful for family resource management professionals who work with female-headed households.

• Asian-Australasian Journal of Animal Sciences
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• v.23 no.1
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• pp.131-148
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• 2010

Piglet health at weaning is compromised due to several stress factors. Following the ban of antibiotic growth promoters new alternatives are required to control these problems. This paper reviews the evidence available for the use of spray dried animal plasma (SDAP) as an alternative to antibiotics in weaning pigs. Data from 75 trials in 43 publications involving over 12,000 piglets (mean values) have been used to calculate the performance responses of piglets according to several factors including SDAP origin, protein source from the control diet being replaced, dose of inclusion, age and weight of the piglets at weaning, sanitary conditions and simultaneous use or not of medication. Although the use of SDAP of all origins results in positive responses, it appears that plasma from porcine origin has the highest efficacy. This could be explained by the specificity of its IgG against porcine pathogens. During the first week post-weaning the response to plasma appears to increase with the inclusion dose, although over the two-week pre-starter period an optimal inclusion level of 4-8% is suggested. SDAP improves feed efficiency more markedly when the piglets are challenged with an experimental infection or when feed does not contain medication, which could be indicative of a lower expenditure of energy and nutrients to build an immune response against the challenge. There is evidence supporting that SDAP IgG and other bioactive substances therein prevent the binding of pathogens to the gut wall and reduce the incidence of diarrhoea in the post-weaning phase. Overall, plasma can be postulated as an excellent alternative to in-feed antimicrobials for piglets in the post-weaning phase.

• Journal of Nutrition and Health
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• v.29 no.8
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• pp.899-907
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• 1996

This study was conducted to examine how Korean women mange energy metabolism during lactation. Eighteen women recruited were healthy, had normal pregnancies and were required to breast-feed their babies exclusively for at least 12wks. During the study period, all subjects were visited and interviewed five times : 3d, 9d, 4wk, 8wk, and 12wk lactation. Body composition variables were analyzed by a bioelectrical impedance method, energy intakes were assessed by using the inventory-weighing method, energy expenditure were determined by recording daily activities, and milk energy output was investigated from the amount of milk production and the gross energy content of milk. The subjects consumed less energy than current recommended allowance all over the study period, but compatible with fairly adequate lactational performance. They responded the additional energy stress of lactation by enhancing metabolic efficiency, increasing energy intakes, reduction physical activities and mobilizing body reserves. Another finding in this study was that the reduction in body fat-free mass may be the one way that women meet the energy demands of lactation like the reduction in body fat mass. The results from this study suggest that current recommended additional energy need during lactation, 2.09MJ/d(500kcal/d), is too high for healthy Korean women. Our data also indicate that the changes of body composition and energy balance at earlier postpartum are extremely different from those at later periods.

• Journal of Nutrition and Health
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• v.25 no.7
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• pp.617-627
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• 1992

This study was attempted to observe the possibility of body fat distribution and fasting serum insulin as potential predictive factors for obesity and energy intake. Subjects participated in this study were seventeen pairs of upper body type women and lower body type women whose age weight BMI daily energy expenditure per body weight were equally matched, Waist to hip girth ratio(WHR) was measured as a criteria of body fat distribution. Comparison of eating behavior between upper body type and lower body type women did not show any significant differences in meal size meal duration and energy intake per minute While serum free fatty acid level was lower in upper body type women percentage of body fat and fasting serum insulin triglycerde level of upper body type women were statistically higher than those of lower body type women(p<0.05) Our data may indicate the possibility that sympathetic nervous system activity was suppressed in upper body type women which needs ti be examined in future studies. In addition since the upper body type women were dieting over the period of survey with the intention of weigh loss we can conclude that upper body type women had larger variabilities than lower body type women in terms of daily energy intake level.

• The Korean Journal of Pain
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• v.30 no.2
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• pp.142-150
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• 2017

Background: There have been few studies about pain using a big data. The purpose of this study was to identify the prevalence of pain, and trends of pain associated with chronic diseases and personal out-of-pocket medical expenditures over time. Methods: Subjects were 58,151 individuals, using the Korea Health Panel from 2009 to 2013. Chi-square and multinomial logistic regression were conducted to identify the prevalence and odds ratios (ORs) of pain. Repeated measures ANOVA was used to find the trend over these 5 years. Results: Prevalence of mild and severe pain was 28.1% and 1.7% respectively. The ORs of mild and severe pain were 1.6 and 1.4 in females compared with males. From 2009 to 2013, numbers of chronic diseases producing mild pain were 2.1, 2.4, 2.8, 2.9, and 3.1 and those producing severe pain were 3.0, 3.4, 3.9, 4.2, and 4.4, respectively. After applying the average South Korean inflation rate by year over 5 years, the annual, personal out-of-pocket medical expenditures (unit: ￦1,000) for mild pain were 322, 349, 379, 420, and 461, and those for severe pain were 331, 399, 504, 546, and 569, respectively (P < 0.0001). Conclusions: The pain prevalence was 29.8%. The numbers of chronic diseases and the personal out-of-pocket medical expenditures revealed increasing trends annually, especially in those with pain. Therefore, to eliminate and alleviate the pain, there needs to be further study for developing a systemic approach.

• Communications for Statistical Applications and Methods
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• v.28 no.4
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• pp.393-410
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• 2021

The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

• The Korean Journal of Food And Nutrition
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• v.36 no.4
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• pp.222-235
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• 2023

In this research, we examined the shifts in determinants influencing the frequency of eco-friendly food purchases pre- and post-COVID-19. Our analysis utilized filtered 2019-2021 Consumption Behavior Survey data from the Korea Rural Economic Institute Food, excluding any irrational responses. Given the nature of the dependent variable, a multinomial logistic regression model was employed with demographic factors, variables pertaining to food consumption behavior, and variables concerning food consumption awareness as predictors. Following the onset of the COVID-19 pandemic, an individual's level of education was observed to positively influence the frequency of eco-friendly food purchases. In contrast, income level and fluctuations in food consumption expenditure did not appear to have a discernible impact on the purchasing frequency of such eco-friendly products. Irrespective of the advent of COVID-19, variables such as the frequency of online food purchases, the utilization of early morning delivery services, dining out frequency, and the intake of health-functional foods consistently demonstrated a positive correlation with the propensity to purchase eco-friendly foods. Overall, consumers prioritizing safety, quality, and nutrition over price, taste, and convenience in their procurement decisions for rice, vegetables, meat, and processed foods exhibit an increased inclination toward the acquisition of eco-friendly food products.