• 보건행정학회지
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• 제30권1호
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• 보건행정학회지
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• 제22권3호
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• 한국병원경영학회지
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• 제29권2호
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• pp.37-47
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• 2024

Purpose: This study aimed to determine the effect of adjusted out-of-pocket maximum rules in the 'differential co-payment ceiling', which means having a higher burden of co-payment, that expanded to the entire ceiling level in long-stay admission patients in long-term care hospitals(LTCH). Methodology: We used health insurance claim data between January 1, 2022, and December 31, 2022 received from the National Health Insurance Service. The study populations were inpatients in long-term care hospitals more than 1 days during the study period. We performed the difference in characteristics of the LTCH patient of the differential and general ceiling by the chi-square test. We estimated the change of the population, cost, and co-payments per person under the assumption of restructuring. Finding: Based on adjusted out-of-pocket maximum rules in 2023, it was expected that the number of benefits decreases at the high-income level while increasing at the low-income level. The burden of health expenditure after reimbursement of co-payment ceiling, is expected to increase by 65.1% in the highest medical necessity, whereas the low medical necessity would decreases compared to 2022. Practical Implications: The results demonstrate that the current out-of-pocket maximum rules do not reflect the needs of medical necessity. This study suggested the need to reflect the medical necessity in LTCH on the out-of-pocket maximum rules in the future.

• 복식
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• 제66권6호
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• pp.32-45
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• 2016

The purpose of this study is to propose changes that can be made to improve nurse uniforms in terms of outfit and functionality based on actual wearing conditions and nurse's preference. The proposed nurse uniform was composed of a blouse and pants. The design was as follows: the blouse had short set-in sleeve with China collar, a princess line, and it came down to middle hip. Armhole action pleats and back inverted pleats were embedded for convenient arm movements. The pants waist had a rubber band at the back waist, and the crotch length and the knee width were increased for activity. To make the pocket more accommodative, separate pocket slots treated with silicone were added to prevent belongings from coming out of the pocket. The pink tone of the uniforms, as well as the stripes on the blouses and spandex incorporated pants were based on nurses' preference. the nurse uniforms were produced after measuring the size of women in the age of 25 to 29, and the uniform patterns were corrected after two wearing experiments. Wearing test was examined in terms of appearance and functionality. For appearance, experts gave the uniforms a mean rating of 4.30, and nurses gave a mean rating of 4.00. Functionality was evaluated in terms of ease of activity and storage aspects. The total mean of ease of activity in nursing service was 4.30, whereas the evaluation of storage in terms of pocket position and convenience was 3.80.

• 전기전자학회논문지
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• 제26권2호
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• pp.196-204
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• 2022

Electrostatic discharge (ESD) protection devices of P-type embedded silicon-controlled rectifier (PESCR) structure were analyzed for high-voltage operating input/output (I/O) applications. Conventional PESCR standard device exhibits typical SCR characteristics with very low-snapback holding voltages, resulting in latch-up problems during normal operation. However, the modified device with the counter pocket source (CPS) surrounding N⁺ source region and partially formed P-well (PPW) structures proposed in this study could improve latch-up immunity by indicating high on-resistance and snapback holding voltage.

• 한국의료질향상학회지
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• 제7권2호
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• pp.190-202
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• 2000

Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

• 디자인학연구
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• 제5권1호
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• pp.7-20
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• 1992

Since 80th, in the monetary markets due to the escalation of creditable promptness dealing of financial goods, Korea monetary business has been confronted with structual contradictions. The first like a men power reduction, inorder to meet and satisfying with cost reduction policy of the holding firms and secondly, escalation and expention of business networks or facilities inorder to meet and satis~'ing with customers continuously seeking for prompt, acurate, and helpfulness service nearly like one similar to a door to door service. Accordingly, the firms eventually poured mere sweaty money into procuring such devices for upgrading. On the contrary, however, regardless the escalation monetary expenditure may be, inorder to promote quality of the same devices are keen necessary because present days customer groups were tended to receives ample service almost like door to door service without moving too$$\mu$h apart from the immediate spot where they belongs tl or veryspot of where actually they spend instead of deep consideration of natures, quality or sttractiveness of service medias what they can received from. Under the present circumstance, the financial business firms, however, would highly suffering and recei\ulcornerves pressures from imblalance natures ofincoming and out go of the business budget due to excessive inc1ease of managerial expences. For these reasons, therefor, in order to solves, compensates, improves, and developes most effective fina\ulcornerncial service for customers can use under most pleasant environment, the establishment of adequate standardization of such service devices based on the foregoing environmental circumstances. This analytical study, therefor, mainly aimed and emphasized based on pre- estimatimation of proper de\ulcornervlopment and use of the unattended servicing devices such as Cash Dispenser and Auto Teller Machine bygeneralization, automating. and innovation of design to meet compactness and door to door like convenient service for customers which can be achieved by performing constant comparative analysis and continual study toward development of such devices those of which produced by Five (5) major domestic producers aro~nd the country.

• 한국보건간호학회지
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• 제21권2호
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• pp.182-192
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• 2007

Purpose: The objectives of this study were to define basic data for developing silver services related to goods, medical care, finance, leisure and residence. Method: In this cross-sectional study, the subjects were 792 pre-elderly and 382 elderly. The data were collected 2005 by using a structured questionnaire from Aug. 19 to Sep. 5. Data were analyzed using descriptive statistics on the SPSS version 12.0 for windows. Result: The pre-elderly had the intention to use massage chair(36.6%), homecare service(29.8%), national pension(35.9%), sports(48.5%) and personal house(59.5%) in the ares of silver goods, medical care, finance, leisure and residence, respectively. The elderly wanted sphygmomanometer(38.7%), homecare service(27.7%), pocket money from their offspring (40.5%), sports(33.5%), and personal house(74.8%). They wanted manpower in the area of reforming of living place, leisure time and education, counseling of silver goods, and management of finance. Conclusion: Based on this study findings, the pre-elderly are thoroughly established for their future than the elderly. It is important to upgrade the silver services and to prepare the manpower for the pre-elderly and the elderly in the future of the aging society.

• 인터넷정보학회논문지
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• 제7권2호
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• pp.93-102
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• 2006

상호작용적 성격을 갖는 통신서비스의 수요확산패턴은 네트워크 효과에 기인한 임계 가입자 규모에 상당한 의존을 보이고 있으며, 이로 인한 통신서비스의 지연 확산 시기 현상이 발생하고 있다. 그러나 통신망이 회선교환망에서 패킷교환망으로 빠르게 진화하고 또한 다양한 패킷기반 서비스들이 개발, 제공됨에 따라 이러한 통신서비스의 확산 패턴 상의 특성은 변화하고 있다. 내구재를 대상으로 수요 확산 패턴을 분석한 기존 연구들과 국내 6개 회선기반서비스 그리고 역시 6개 패킷기반서비스의 확산 패턴을 비교 분석한 결과, 기존 회선기반서비스들에서 보인 지연 확산 시기 현상은 존재하지 않았으며. 뿐만 아니라 다른 내구재들의 초기 확산보다 더 빠른 확산 속도를 보임으로서 오히려 빠른 확산 시기 현상이 발생하고 있음을 발견하였다. 이러한 결과를 바탕으로 향후 신규 통신서비스 확산 전략은 기존의 통신서비스 보급 및 확산을 위한 초기 단계에서의 촉진전략에서 성장 단계의 확산 유지 및 확대 전략이 보다 유용한 전략임을 제시하였다.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 2006년도 한국컴퓨터종합학술대회 논문집 Vol.33 No.1 (B)
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• pp.136-138
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• 2006

최근 이동통신 기술의 급격한 발전과 PPC(Pocket PC), 노트북 등의 휴대단말기의 보급 확산에 따라 위치기반 서비스(Location Based Service: LBS)가 주요한 응용분야고 부상하고 있다. 위치 정보에 대한 정확한 위치 추적 및 활용 방안에 대한 활발한 연구가 진행되고 있지만, 대부분 제공되는 서비스는 현재 사용자의 위치에 기반한 정적인 서비스를 제공하는 초보적인 단계에 있다. 이동경로는 사용자의 성향이나 상태를 반영하기 때문에 사용자의 이동패턴을 예측하거나, 사용자의 현재 상태를 추론하는데 도움을 줄 수 있다. 본 논문에서는 이동패턴에 따른 사용자의 의도를 예측하여 개별화 된 서비스 제공을 위해, RSOM(Recurrent Self Organizing Map)과 마르코프 모델을 단계적으로 구성하여 사용자의 이동패턴을 모델링하는 방법을 제안한다. 실제 연세대학교 캠퍼스 내에서 실제 대학원생의 생활을 모델로 GPS(Global Positioning System) 데이터를 수집하여. 이동패턴을 모델링하고 개별화된 서비스를 제공함으로써 제안하는 방법의 유용성을 검증하였다.