• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• Journal of Navigation and Port Research
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• v.46 no.4
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• pp.359-366
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• 2022

While the Forward Freight Agreement (FFA) has emerged as an effective hedging tool since early 1990, the basis risk and cash flow distortions have been addressed as obstacles to the active use of FFAs. This research analyses the basis risk of FFAs and provides a feasible suggestion to reduce it. Basis risk is divided into timing basis, route basis, size basis, and low liquidity basis. The timing basis is defined as the difference between the physical hire, fixed on the specific contract date and the FFA settlement price, calculated by averaging spot rates for a certain period. Timing basis is considered the worst in eroding the effectiveness of FFAs. This paper suggests a change of hire payment criterion from contract date to 15-day moving average, as a means of mitigating the basis risk, and analyzed the effectiveness through historical simulation. The result revealed that the change is effective in mitigating the timing basis. This study delivers a meaningful implication to shipping practice in that the change of hire payment criterion mitigates the basis risk and eventually activates the use of FFAs in the future.

• Health Policy and Management
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• v.10 no.4
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• pp.20-56
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• 2000

The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.

• Journal of Preventive Medicine and Public Health
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• v.36 no.1
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• pp.33-38
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• 2003

Objectives : To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance(the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. Methods : 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February 18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. Results : A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder)were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. Conclusions : More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.

• Journal of Fashion Business
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• v.5 no.3
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• pp.19-34
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• 2001

The purpose of this study was to investigate the differences of the general characteristics of subjects, the utilizing realities and the degree of satisfaction in the shopping mall and purchasing intention between group I that specializes in fashion design and group II that doesn't specialize in it. The results are summarized as the following six aspects. First, as a result of the general characteristics of subjects and the utilizing realities, the most different variables were the visiting frequency and the goods purchasing frequency. The result indicated that group II took more interests than group I. Second, as a result of the degree of satisfaction according to the factors of the general characteristics of subjects and the utilizing realities in the shopping mall, both group I and group II showed high degree of satisfaction in factor 1 (variety of event) whereas both groups showed relatively low degree of satisfaction in factor 3 (variety of goods). Third, as a result of the degree of satisfaction according to the general characteristics of subjects and the utilizing realities, group I showed significant differences in the degree of satisfaction according to a monthly allowance of pocket money and goods purchasing frequency and group II showed significant differences in the degree of satisfaction according to grade, the utilizing reason, goods purchasing frequency. Fourth, as a result of purchasing intention of fashion goods according to the general characteristics of subjects and the utilizing realities, group I showed the higher purchasing intention of fashion goods in group that the terms of payment was on-line payment than group that they was credit card. On the other hand, group II showed a significant difference in grade, which showed that group that was above third grade had the higher purchasing intention of fashion goods than group that was under third grade. Fifth, as a result of purchasing intention of fashion goods according to the degree of satisfaction, group I showed significant differences in factor 1 and factor 3 among the degree of satisfaction. In other words, group that had high degree of satisfaction in factor 1 showed the higher purchasing intention of fashion goods than other groups and group that had medium degree of satisfaction in factor 3 showed the higher purchasing intention of fashion goods than other groups. In group II, on the other hands, group that had high total degree of satisfaction showed the higher purchasing intention of fashion goods than other groups. Sixth, as a result of relative influencing power of independent variable with respect to purchasing intention of fashion goods in group I, the higher degree of satisfaction in factor 1 and the lower degree of satisfaction in factor 3 showed, the higher purchasing intention of fashion goods showed. As a result of relative influencing power of independent variable in group II, however, the higher grade and the higher degree of satisfaction in factor 1 showed, the higher purchasing intention of fashion goods showed.

• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.413-425
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• 2000

The purpose of this study was to compare the health services information need between urban area and rural area in Sooncheon City. For accomplishing this purpose, we selected 1,060 adults randomly, 744 urban residents and 314 rural residents were surveyed from 1st, December to 31st, December in 1999. Compared the difference between two areas by cross tabulation, and chi-square test were used. The results of this study are as follows: 1. There were statistically difference in sociodemographic characteristics between urban residents and rural residents, such as age, education, job, income, and insurance payment(p<0.001). 2. According to the health utilization behavior, types of health facility, satisfaction of medical cost, and satisfaction of medical results were statistically different between the two areas(p<0.001). Also utilization of the health service center, and accessibility were statistically different between urban and rural areas(p<0.001). 3. Experiencing the health service information, type of health service information, methods of information, effectiveness, and satisfaction were statistically different between the two areas(p<0.001). 4. And experience of using computer, and internet and preference of method of health service information were statistically different between urban and rural areas. Therefore, the construction of health information system should be carefully reviewed by community health service centers and they should consider the different residents information needs, and accessibility and convenience of community residents.

• Journal of Technologic Dentistry
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• v.43 no.3
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• pp.124-131
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• 2021

Purpose: This study aimed to investigate the perception of dental implant insurance supply and demand for the elderly living in Hongseong-gun and Chungcheongnam-do, as well as the selection criteria regarding dental clinics for dental implant treatment to collect basic data for improving the oral health of the elderly population. Methods: Participants living in Hongseong-gun, Chungcheongnam-do who were at least 55 years old from November 2020 to March 2021 were included in this study. The chi-square test was performed to examine the age-specific perception of insurance-covered dental implants (p<0.05). Results: The age group that was the most interested in implants was the 70s age group, and the difference between this age group and the other age groups was statistically significant. Those in their 70's, 80's, and 90's or older paid about 600,000 won including dental implants covered by insurance, and there was a significant difference (p<0.05). Those in their 60s, 70s, and 80s estimated the highest value of implants covered by insurance as two and showed a significant difference (p<0.05). The awareness of the dental implant insurance by age showed that all age groups, except for the ≥90 years age group, considered the insurance to be mediocre mostly due to the large co-payment (p<0.05). Conclusion: There were differences by age in the awareness of dental implant insurance, co-payments, number of applications, and insurance coverage. The perceptions on dental implant insurance by age showed that all age groups except for those over 90 years and older, they considered the insurance was just mediocre the most.

• The Journal of Korean Society for School & Community Health Education
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• v.1 no.2
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• pp.105-125
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• 2000

The purpose of this study was to examine the influence of school safety accident on teacher's normal educational activities and to seek some desirable ways to cope with it. The subjects in this study were 351 class teachers randomly selected from Seoul and Kyonggi Province and surveyed from April through July, 2000. The conclusions were as follows; 1. Actual Condition of School Safety Accident 1) Approximately many teachers investigated had had an experience to suffer safety accident. Safety accident occurred most during break or class, but there was a significant difference according to service area. 2) Safety accident took place most in playground, and the most common cause was student's own carelessness, and the most widely occurred accident type was an injury. But there was no significant difference caused by the general characteristics of the teachers. 2. Influence of Safety Accident On Teacher's Educational Activities. 1) The largest reason they offered safety education was to ensure student safety. The greatest number of them had an opinion they would consider changing or giving up a planned normal educational activity if they recognized any possibilities of safety accident. There was a significant difference in this point according to gender and career. 2) They worried about possible safety accident most during field study, but there was a significant difference according to gender or presence or absence of safety accident experience. 3) The general characteristics of teacher produced a significant difference to an experience of avoiding educational activity due to psychological withdrawal, but safety accident experience didn't make any difference. 3. Minimization of Teacher Damage or Loss from Safety Accident. 1) The dominant opinion about teacher's small mistake for any occurrence of safety accident was that the responsibility should be escaped to maintain teacher's authority. For severe mistake, however, there were two different opinions at the same percentage: one was being exempted and the other was taking civil liability. 2) Establishing teacher insurance was preferred as a way to minimize teacher's economic loss from safety accident, but there was a significant difference according to gender. 3) The dominant opinion about the payment of insurance premium for safety accident was that it should be paid from school operating expenses.

• Health Policy and Management
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• v.33 no.1
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• pp.3-18
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• 2023

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.