• 제목/요약/키워드: Index Insurance

검색결과 314건 처리시간 0.026초

방글라데시 해안 지역 농업에서 기후에 대응한 스마트 농업 적용에 대한 농업인의 장애 영향요인 (Factors Influencing Farmers' Barriers to Adopting Climate Smart Agriculture Practices in the Coastal Area of Bangladesh)

  • 아비짓 비스와스;쁘로미 데브나스;강대구
    • 농촌지도와개발
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    • 제31권3호
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    • pp.153-175
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    • 2024
  • 이 연구는 방글라데시 해안 지역에서 기후에 대응한 스마트 농업 (CSA) 방법의 채택에 대한 장애요인을 도출하고자 하였다. 반구조화된 설문지를 사용하여 최소 10년 이상의 농사경험이 있는 160명의 연안 농부들로부터 정량적 및 정성적 데이터를 수집하였다. 농업 취약성, 채택된 CSA 관행, 그리고 CSA 관행 채택에 대한 인식된 장벽 항목의 내적 일관성(Cronbach's alpha)은 각각 0.72, 0.74, 0.79로 나타났다. 농업 취약성 지수 (AGVI)는 토양 염분 증가, 담수 자원의 감소, 불량한 씨앗발아, 해충과 질병의 증가를 농업의 취약점으로 확인하였다. 채택 지수(ADI)는 다수성 채소 재배, 단기간 다수성 쌀 재배, 퇴비나 바이오가스 사용, 적절한 비료 관리, 그리고 소르존 재배 방법 등을 공통 CSA 방법으로 파악하였다. 그러나 장벽 지수(BI)는 높은 초기 투자 비용, 열악한 제방 인프라, 낮은 작물 가격, 태양광 관개 시스템의 부족, 기술 지원의 부족이 CSA 채택을 저해하는 것으로 파악되었다. 또한 농부의 나이, 직무 만족도, 교육 수준, 훈련 경험, 정보원 사용이 CSA 방법 채택장벽에 영향을 미치는 것으로 나타났다. 연구는 CSA 관행을 장려하기 위해 해안 농부 역량 개발, 농작물 보험, 무이자 대출정책, 그리고 공정한 농작물 가격 체계를 제안하였다.

국가 구강검진이 어린이의 치아우식 경험, 치료 및 비용에 미치는 영향 (Effects of National Dental Screening on Dental Caries Experience, Treatment, and Cost in Children)

  • 이종형;이한길;손동현;김지훈
    • 대한소아치과학회지
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    • 제47권3호
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    • pp.248-256
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    • 2020
  • 이 연구의 목적은 영유아구강검진의 효과를 치아우식 예방, 우식 치료행위, 치과진료비용이라는 다각적 관점에서 분석, 평가하는 것이다. 국민건강보험공단에서 제공하는 영유아검진코호트 데이터베이스를 활용하였고, 2008 - 2015년에 시행된 구강검진 1차 32,937건, 2차 22,608건, 3차 13,708건 및 2008년생과 2009년생 27,944명의 치과 진료 241,043건을 분석하였다. 2차와 3차 구강검진 결과를 통해 산출한 우식경험유치지수와 유치우식경험자율은 각각의 선행 구강검진 수검 횟수가 증가함에 따라 감소하였다. 유치의 급여 수복치료 및 치수치료, 유견치와 유구치의 조기 발치 시행 횟수는 구강검진 수검 횟수가 증가함에 따라 감소하였고, 전체 급여 치과진료비용 또한 수검 횟수가 증가함에 따라 감소하였다. 영유아구강검진은 치아우식을 예방하여 치아우식 관련 치료의 가능성을 줄이고, 따라서 치과진료비를 절감하는 효율적이고 경제적인 구강 건강 관리 방법이다.

입원환자 질병유형의 구성에 의한 지역별 진료기능에 관한 연구 (A Study on the Regional Function of Health Care by the Disease Pattern of the Inpatients)

  • 최현림;이상일;신영수;김용익
    • Journal of Preventive Medicine and Public Health
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    • 제21권2호
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    • pp.390-403
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    • 1988
  • The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.

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코로나19에서 고혈압 치료율의 지역 간 변이요인 분석 (Interregional Variant Factor Analysis of Hypertension Treatment Rate in COVID-19)

  • 박종호;김지혜
    • 디지털융복합연구
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    • 제20권4호
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    • pp.469-482
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    • 2022
  • 본 연구의 목적은 코로나19에서 고혈압 치료율의 지역 간 변이요인을 분석하는 것이다. 이를 위해 생태학적 분석에 적합한 데이터를 2020년 질병관리청 지역건강통계, 각 지자체 코로나19 확진자 현황 자료, 국민건강보험공단, 건강보험심사평가원의 건강보험통계, 한국사회보장정보원의 복지통계, 한국교통연구원의 교통접근성 지표 자료를 수집하였다. 고혈압 치료율의 지역 간 변이와 관련 요인을 SPSS Statistics 23을 활용하여 기술통계, 상관분석을 실시하였으며, 지역 간 변이 요인을 Arc GIS를 이용하여 지리적 가중회귀분석을 실시하였다. 연구결과로 지리적 가중회귀모형의 전반적인 설명력은 27.6%였으며, 지역별로는 23.1%에서 33.4%까지 분포하는 것으로 나타났고, 고혈압 치료율에 영향을 미치는 요인으로 기초생활보장 의료급여 수급자 비율, 당뇨병 치료율, 인구10만 명당 보건기관 수가 높을수록 고혈압 치료율이 높았으며, 코로나19 확진자수, 코로나19 유행으로 감소된 신체활동 비율, 코로나19 유행으로 감소된 음주 비율이 낮을수록 고혈압 치료율이 높은 것으로 분석되었다. 이러한 결과를 기반으로 코로나19에서 고혈압 치료율의 지역 간 변이요인 분석은 효과적인 고혈압 치료율 관리 사업을 기대할 수 있을 것이며, 더 나아가 지역사회 중심의 건강증진 정책 수립에 활용될 것으로 기대된다.

건강한 중년 남성에서 커피 음용 습관이 혈중 총 콜레스테롤 값에 미치는 영향 (The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men)

  • 신명희;김동현;배종면;이형기;이무송;노준양;안윤옥
    • Journal of Preventive Medicine and Public Health
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    • 제27권2호
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    • pp.200-216
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    • 1994
  • In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.

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정유 및 석유화학플랜트 중대사고 전조신호 평가지표 개발에 관한 연구 (A Study on the Development of Assessment Index for Catastrophic Incident Warning Sign at Refinery and Pertrochemical Plants)

  • 윤용진;박달재
    • Korean Chemical Engineering Research
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    • 제57권5호
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    • pp.637-651
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    • 2019
  • 정유 또는 석유화학플랜트에서 폭발 등과 중대사고가 발생할 때 심각한 인명 및 재산피해를 야기시켜 보험시장에 큰 영향을 끼쳐왔다. 일반적으로 정유, 석유화학공장 등 장치산업에서 이러한 사고 발생시 국립과학수사연구원, 사고원인 조사자, 손해보험사 손해사정사 등이 조사하여 손해 및 사고와 가장 인접한 근인 위주로 사고원인을 도출하고 있다. 반면 실제 중대사고로 이어지기까지 문제 및 결함으로 작용한 여러 중대사고 전조신호에 대한 근본원인분석을 실시하여 예방대책을 수립하는 것이 중요하나 그 동안이에 대한 것이 미흡하였다. 이에 본 연구에서는 전 세계에서 발생된 중대사고 사례에 대하여 근본원인분석 방법과 스위스치즈모델 원리를 활용한 기여요소분석법 등을 통하여 도출하였던 미국 화학공정안전센터의 중대사고 전조신호 자체평가 도구의 전조신호 판단기준 항목을 우선적으로 고찰하였다. 여기에 실제 정유 및 석유화학플랜트 내 중대사고 전조신호가 해외재보험사 Loss control engineer 등 Auditor 들에게 어떠한 식으로 권고되어 왔는지 확인하고자 지난 17년간 Loss Control Engineer가 Risk Survey 이후 도출하였던 안전권고사항 약 614개를 분석하였다. 최종적으로 이를 중대사고 전조신호 평가지표로 개발이 용이하도록 정유 및 석유화학플랜트에서의 중대사고 전조신호 판단기준을 유형별로 그룹화한 후 상위 및 하위 항목으로 구분하였다. 또한, 정유 및 석유화학공장 관련 전문가(40명)에게 설문 실시 및 AHP기법을 적용하여 각 항목별 가중치(중요도)를 도출하여 최종 전조신호 판단기준과 항목별 가중치가 적용된 '정유 및 석유화학플랜트에서의 중대사고 전조신호 평가지표'를 개발하였다. 그리고 개발한 지표를 8개의 정유 및 석유화학플랜트에 적용하여 분석하였다. 본 연구에서 개발된 평가지표는 정유 및 석유화학공장 등 장치산업에서의 중대사고 예방을 위하여 추적관리 되어야 할 전조신호 항목 및 요소가 무엇인지 인식하고 취약수준을 평가하는데 도움이 될 수 있고, 관련 사업장 자체 관계자뿐만 아니라 외부 auditor들에게 유용하게 활용되리라 판단된다.

한의 외래환자분류체계 개선 및 평가 (Revision and Evaluation of Korean Outpatient Groups-Korean Medicine)

  • 류지선;임병묵;이병욱;김창훈;한창호
    • 대한한의학회지
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    • 제35권3호
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    • pp.93-102
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    • 2014
  • Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the $R^2$ coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The $R^2$ values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.

Measuring Out-of-pocket Payment, Catastrophic Health Expenditure and the Related Socioeconomic Inequality in Peru: A Comparison Between 2008 and 2017

  • Hernandez-Vasquez, Akram;Rojas-Roque, Carlos;Vargas-Fernandez, Rodrigo;Rosselli, Diego
    • Journal of Preventive Medicine and Public Health
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    • 제53권4호
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    • pp.266-274
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    • 2020
  • Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.

A prediction model of low back pain risk: a population based cohort study in Korea

  • Mukasa, David;Sung, Joohon
    • The Korean Journal of Pain
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    • 제33권2호
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    • pp.153-165
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    • 2020
  • Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

병원근무자의 직무만족 요인 분석 (Job Satisfaction of Hospital Employees)

  • 장미경;최윤경;황지인;김은경;박노현;이지영;황정해
    • 간호행정학회지
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    • 제10권1호
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    • pp.63-81
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    • 2004
  • Purpose: To identify job satisfaction of hospital employees and the relating factors Methods: The study sample was a total of 1,031 healthcare workers(doctors, nurses, pharmacists, medical engineers, office workers, etc) at a tertiary teaching hospital. The data were collected using a questionnaire developed by a expert group. The questionnaire consisted of 21 items including job characteristics, organizational culture, and personal characteristics on the five Likert scale. Results: The overall satisfaction on job characteristics was 3.24 on the five Likert scale. The satisfaction of each item was 4.14 in role clarity, 3.26 in communication participating rate, 3.10 in work variety, 3.06 in autonomy, and 2.64 in workload. The overall satisfaction on organizational culture was 3.00. Particularly, the satisfaction on collaboration was 3.83, co-worker's support. 3.73, identity, 3.62, education/training opportunity, 3.12, pay, 2.62, welfare, 2.35, promotion, 2.34, and organizational conflict, 2.00. The level of satisfaction on personal characteristics was 3.00. In the satisfaction of each item, the score of disposition was 3.83, contribution to the hospital, 3.75, pride as a member of hospital, 3.70, and attitude on job performance, 3.68. The correlation between satisfaction and other variables was statistically significant with the exception of work variety. The satisfaction related significantly to loyalty index(r=.486, p=.000), autonomy(r=.415, p=.000), pride as a member of hospital(r=.411, p=.000), supervisor support(r=.364, p=.000). Conclusions: The results showed developing organizational strategy to promote job satisfaction can decrease the turnover rate and increase loyalty to the organization. It will contribute to enhance productivity in hospital.

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