• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8993-9004
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• 2014

Background: The incidence rate and the treatment costs of hepatocellular carcinoma (HCC) are high, especially in Thailand. Previous studies indicated that early detection by a surveillance program could help by down-staging. This study aimed to compare the costs and health outcomes associated with the introduction of a HCC surveillance program with no program and to estimate the budget impact if the HCC surveillance program were implemented. Materials and Methods: A cost utility analysis using a decision tree and Markov models was used to compare costs and outcomes during the lifetime period based on a societal perspective between alternative HCC surveillance strategies with no program. Costs included direct medical, direct non-medical, and indirect costs. Health outcomes were measured as life years (LYs), and quality adjusted life years (QALYs). The results were presented in terms of the incremental cost-effectiveness ratio (ICER) in Thai THB per QALY gained. One-way and probabilistic sensitivity analyses were applied to investigate parameter uncertainties. Budget impact analysis (BIA) was performed based on the governmental perspective. Results: Semi-annual ultrasonography (US) and semi-annual ultrasonography plus alpha-fetoprotein (US plus AFP) as the first screening for HCC surveillance would be cost-effective options at the willingness to pay (WTP) threshold of 160,000 THB per QALY gained compared with no surveillance program (ICER=118,796 and ICER=123,451 THB/QALY), respectively. The semi-annual US plus AFP yielded more net monetary benefit, but caused a substantially higher budget (237 to 502 million THB) than semi-annual US (81 to 201 million THB) during the next ten fiscal years. Conclusions: Our results suggested that a semi-annual US program should be used as the first screening for HCC surveillance and included in the benefit package of Thai health insurance schemes for both chronic hepatitis B males and females aged between 40-50 years. In addition, policy makers considered the program could be feasible, but additional evidence is needed to support the whole prevention system before the implementation of a strategic plan.

• The Journal of the Korea Contents Association
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• v.19 no.9
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• pp.308-320
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• 2019

This study aims at investigating the major symptoms that help family carers detect mental illness in elderly patients. Another purpose of this study is to empirically verify the major factors determining the utilization of mental health services with a focus on family carers. The results of this study are as follows. First, the most commonly detected symptoms that caused the family carers to suspect mental illness in the elderly patients were memory decline and other forms of cognitive function decline. Second, the determinants of the elderly's utilization of mental health services included the patient's long-term care insurance level, the age of the family carer, the period of care, the level stress associated with the provision of care felt by the carer, his understanding of geriatric mental illness, and the level of perception about community mental health services. Based on these findings, this study suggests policies and practical implications for the early detection of and response to elderly mental health problems and the utilization of related services from the viewpoint of the family carers of the elderly.

• Journal of Agricultural Extension & Community Development
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• v.12 no.2
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• pp.137-150
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• 2005

Although the rate of women farmer's participation in agricultural activities have been increased upto 52.7 % as of year 2003, Korean society has not fully recognized their roles in rural society. According to the agricultural basic law, most of rural women were engaged in agriculture as full time job, however, only about 11% of them could have supporting evidence of themselves as farmer having legal right. If women farmers faced some unexpected things such as a traffic accident, insurance company would not reward them as farmers unless they provide written proof of their job as farm worker or farm owner. Based on lawyer's legal advice, the authors developed a diary called "Saenghwalilji", a daily diary based on their time use and bookkeeping to prove the fact of their contribution to income generation of the farm. After examination of the diary, 18 persons out of 29 volunteers kept two types of dairy for the period of two weeks, and they reported it was very useful. Finally the better one of two was selected after reflecting the suggestions from the respondents. The "Saenghwalilji", will be very useful proof of women farmer's contribution to income, at the same time improving their farm management through better use of daily life time.

• The Journal of the Korea Contents Association
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• v.22 no.2
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• pp.782-793
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• 2022

The rise in chronic disease not only has a negative effect on people's lives, but it also increases the cost of medical care owing to the increased usage of medical care as health and medical technology improves, life expectancy rises, and rapid population ageing. In such context, this study examined the difference in the disease cost of hypertension according to demographic information and the effect of the initial diagnosis age and treatment period on the cost. This study used the Korean Health Panel Survey from 2010 to 2017, and selected subjects based on health insurance beneficiaries between the ages of 30 and under 80. With the selected data, the direct and indirect costs of disease loss were calculated according to the cost of illness approach, and we constructed a disease-loss ratio cohort considering the age of diagnosis and time of treatment for hypertension. From the results of the study, the annual cost of disease loss for hypertensive patients differed by gender by 110,107 won, and it was found that the cost increased by 1.8 times as the treatment time increased. In addition, when comparing disease loss ratios between the same age groups, it was found that the disease loss ratios between those in their 60s and 70s were affected by treatment time. This study confirmed that hypertension significantly affects the cost of the disease, and not only requires early diagnosis and management, but also preventive efforts to lower the incidence of hypertensive disease must be strengthened.

• The Korean Society of Law and Medicine
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• v.23 no.2
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• pp.3-36
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• 2022

In order to solve the pharmaceutical kickback problem, it is needed to establish legal system that allow ways to enable pharmaceutical promotion of medicines without kickbacks as well as provide sanction those who commit illegal act. Before the National Assembly and the government focused on strengthening sanctions. As a result, in 2014, a system of suspending medical care benefits was introduced, which could inflict heavy losses on pharmaceutical companies by withdrawing target medicines from the market. However, three years after the introduction, the system was abolished in 2018, recognizing the problem that the disposition could infringe on the patients' right to access to and choice of medicines. In 2021, the National Assembly made it possible for dispositions suspending medical care benefits regarding the third violation, which remained symbolic until then, replaced with administrative fines. Although the legislator's reflective stance on the system is more than clear, the Ministry of Health and Welfare still interprets that the old law should be applied to kickbacks for the period of the law. Moreover, regarding the substitution of fines at the discretion of the Minister of Health and Welfare under the old law, the narrow standards taken under the old law seems to be maintained. In this paper, firstly pharmaceutical kickback issue, the main reason for the introduction of the system, will be explained, after that the history of introduction and abolition of the system examined and last but not least the unconstitutionality of the system and the illegality of the disposition are to be examined.

• The Journal of the Convergence on Culture Technology
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• v.6 no.4
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• pp.1-8
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• 2020

Existing studies have used a variety of terms related to North Korea's income guarantees, causing some confusion. It can be said that it is a problem that appears only when dealing with the contents of a specific statute in an existing study. To this end, we will look at the laws and regulations related to income security by period and analyze the contents of dictionaries that are also the explanations of the laws and the status of orders and rules. As a result of the analysis, living subsidies are classified into subsidies under the national social insurance system and pension and subsidy under the national social security system. Among them, the pension under the national social security system, which is an income security system for non-workers, includes old age pensions, labor capacity loss pension(general work ability loss pension, accidental work ability loss pension, honored soldiers' work ability loss pension), and survivor pension(general survivor pension, war deads' survivor pension, victims' survivor pension). In particular, it was confirmed that the terminology for social security pension, which has been confusing in previous studies, is a collective jargon for all pensions under the national social security system. This study is significant in that it synthesized the historical transition process of the terminology of income security from the 10th Platform for the National Liberation Society in 1936 to the Socialist Constitution of the Democratic People's Republic of Korea in 2013.

• Korean Journal of Social Welfare
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• v.69 no.3
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• pp.193-212
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• 2017

This study is purposed to explain the characteristics of injured workers' labor market situation and to analyze the factors influencing labor market transition of those workers. Using the Worker's Compensation Insurance Panel Data ver.1~3 which was surveyed by the Korean Workers' Compensation & Welfare Service in 2013-2015, this study analyzed 1,668 injured worker cases. The study shows that workers who have experience job retention at least once are 36.8% of all, 51.5% of them have experienced re-employment, and 36.9% have done unemployment. One result of the longitudinal analysis is that socio-demographic factors including gender, age, education years, convalescence period, ability on job performance, company size, term of service, temporary employment, daily-workers status before job accident and job training were associated with return to pre-injury job. The other result is that statistically significant factors affecting the probability to be the unemployed are gender, age, levels of disability, convalescence, ability on job performance, term of service before job accident, job rehabilitation service utilization. These findings indicate that we need to develop efficient intervention programs for supporting return-to-work and labor market transition of injured workers.

• The Journal of the Korea Contents Association
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• v.22 no.9
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• pp.561-569
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• 2022

A study was conducted to determine whether there is a difference in the incidence of kidney cancer according to income level and the difference in delayed diagnosis. To this end, the incidence of kidney cancer in Korea was analyzed by income level and by stage. From 2015 to 2017, a national kidney cancer cohort was established by linking the KCCR(Korea Central Cancer Registry), NHISS(National health insurance sharing service), and the HIRA(Health insirance review and assessment service) database to calculate the kidney cancer incidence by stage and income level. During the study period, the incidence of kidney cancer in Korea increased in all income deciles, but decreased only in the medical aid population. The incidence of kidney cancer in Korea was 7.35 per 100,000 people, and 83.54% of them were locoregional kidney cancer. In the top 20% of the income decile, there was a high incidence of 21.46 cases per 100,000 people, among which 18.37 cases were locoregional kidney cancer. On the other hand, even after adjusting for risk factors related to kidney cancer, it was confirmed that the lower the income level, the higher the risk of being diagnosed with kidney cancer with distant metastasis (lowest income 20% adj.OR 1.807, 95% CI 1.411-2.222). In the insured population, the risk ratio of being diagnosed with unknown stage was 1.926 (95% CI 1.317, 2.816). The higher the income level, the higher the frequency of early cancer diagnosis, but the lower the income level, the higher the risk of being diagnosed with metastatic kidney cancer or an unknown stage, so health inequality according to income level was observed.

• Korean Journal of Social Welfare
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• v.57 no.2
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• pp.143-164
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• 2005

The study is to analyze support-related issues, particularly associated with elderly and children care, which have been a fundamental agenda of family welfare policy. We are expected for societal-level controversy on the relationship of family support and social security in the near future because of rapid increase in ageing and divorce rate. Accordingly, we need to establish social consensus on the extent to which both family support system and social support system are responsible for the life maintenance of the elderly and the children from divorced family. We also clarify the various characteristics(including scope, degree, period of time, and need/manageability) of support provided by family members. Considering the changes of family structure and population composition, the policy of supporting the old and children should go for social responsibility. Findings show that civil law and social welfare law have unclear application on the relationship between family support and social security, and contents in family support. In particular, public assistance law strongly emphasizes the principle of family support while social insurance laws provide only limited and insufficient family maintenance. The suggestions of further study on support-related issues are given in the rapidly changing society and the increasing economic instability.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.3
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• pp.215-223
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• 2024

The patient in this case presented with a desire to have new dentures due to discomfort with existing ones. At the initial visit, all of teeth were missing except for the mandibular left second molar. As the patient was 65 years old, treatment with dentures and implant-supported prostheses was possible under the national health insurance system, and the patient opted for the mandibular denture using implant. Temporary prostheses were initially provided for patient adaptation, and following successful adaptation period, the treatment progressed. A maxillary complete denture and a mandibular implant-supported denture using two implants in the canines were fabricated. The mandibular denture is a Kennedy Class II removable partial denture which consists of a six-unit porcelain fused to metal fixed dental prostheses supported by the implant in the canines on both sides and left second molar serving as the abutments. Despite severe bone resorption and insufficient abutment teeth, the patient expressed satisfaction with the treatment results. In cases with economic and anatomical constraints affecting the feasibility of complete denture, implant-supported overdenture, and implant-supported fixed dental prostheses, an implant-assisted removable partial denture using implant surveyed crowns proves to be a viable and effective alternative treatment option. Nevertheless, the current dearth of scientifically rigorous studies underscores the necessity for meticulous regular check-up and occlusal assessment.