• Title/Summary/Keyword: Risk Adjustment Model

Search Result 101, Processing Time 0.023 seconds

Characteristics of Healthcare REITs' Performance and Operation, and their Use for Activating the Silver Industries in Korea (헬스케어 REITs의 성과 및 운영 특성과 국내 실버산업에의 활용 방안)

  • Park, Won-Seok
    • Journal of the Economic Geographical Society of Korea
    • /
    • v.14 no.2
    • /
    • pp.157-175
    • /
    • 2011
  • This paper aims to analyze the characteristics of healthcare REITs' performance and operation, and to examine their use for activating the silver industries in Korea. The results of this study are as follows. First, according to the results of analyzing healthcare REITs' performance, healthcare REITs outperformed average REITs and extended investment proportion compared to total REITs after 2007. This outperforming came from not only rapid growth of silver industries, but also REITs strategy using the structure of sale-and-leaseback and triple-net lease. Second, healthcare REITs use selection and concentration strategy in terms of asset sector, but use portfolio diversification strategy in terms of investment region. Third, according to the analysis results, healthcare REITs are to be useful for activating the silver industries in Korea. In this context, major implications are presented to use healthcare REITs effectively.

  • PDF

A Study on the design of the outpatient and inpatient conversion factors based on the medical expenditure budget system (진료비 예산에 기초한 외래 및 입원 환산지수 설계에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.21 no.2
    • /
    • pp.470-478
    • /
    • 2020
  • In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.

Associations of Blood Lead and Cadmium Levels with Hypertension using the Korea National Health and Nutrition Examination Survey III-VI (국민건강영양조사 자료를 활용한 혈 중 납과 카드뮴의 고혈압과의 관련성)

  • Seo, Jeong-Wook;Kim, Byoung-Gwon;Kim, Yu-Mi;Choe, Byeong-Moo;Seo, Sang-Min;Hong, Young-Seoub
    • Journal of Environmental Health Sciences
    • /
    • v.44 no.4
    • /
    • pp.380-390
    • /
    • 2018
  • Objective: A significant association between blood lead levels and hypertension has been reported in many studies. The relationship between cadmium and hypertension has been debated as well. We aimed to study the association of lead, cadmium, and both with hypertension in the Korean general population. Methods: We examined 5,967 adult men and 6,074 women who participated in the Korea National Health and Nutrition Examination Survey III-VI (2005, 2008-2013 years). Logistic regression models were used to examine the relationship between blood lead concentration and blood cadmium concentration and hypertension using logtransformed blood lead and cadmium concentrations as independent variables after covariate adjustment. Results: Adjusted for general characteristics, the odds ratio of log-lead to hypertension was 2.71 (1.82-4.03), and log-cadmium to hypertension was 2.52 (1.83-3.47). Estimates were found to be statistically significant (p<0.001). When a multiple logistic model was applied, the odds ratio of log-lead and log-cadmium for hypertension were 2.24 (1.50-3.36) and 2.24 (1.62-3.10), respectively. The standardized estimate coefficients of log-lead and logcadmium for hypertension were 4.77 and 6.65, respectively. Conclusion: We observed the association of blood lead concentration, blood cadmium concentration, and both with hypertension. This study suggests that exposure to lead and exposure to cadmium are both risk factors for hypertension.

A FRAM-based Systemic Investigation of a Rail Accident Involving Human Errors (인적오류가 관여된 철도 사고의 체계적 분석을 위한 FRAM의 활용)

  • Choi, Eun-Bi;Ham, Dong-Han
    • Journal of the Korea Safety Management & Science
    • /
    • v.22 no.1
    • /
    • pp.23-32
    • /
    • 2020
  • There has been a significant decline in the number of rail accidents in Korea since system safety management activities were introduced. Nonetheless, analyzing and preventing human error-related accidents is still an important issue in railway industry. As a railway system is increasingly automated and intelligent, the mechanism and process of an accident occurrence are more and more complicated. It is now essential to consider a variety of factors and their intricate interactions in the analysis of rail accidents. However, it has proved that traditional accident models and methods based on a linear cause-effect relationship are inadequate to analyze and to assess accidents in complex systems such as railway systems. In order to supplement the limitations of traditional safety methods, recently some systemic safety models and methods have been developed. Of those, FRAM(Functional Resonance Analysis Method) has been recognized as one of the most useful methods for analyzing accidents in complex systems. It reflects the concepts of performance adjustment and performance variability in a system, which are fundamental to understanding the processes of an accident in complex systems. This study aims to apply FRAM to the analysis of a rail accident involving human errors, which occurred recently in South Korea. Through the application of FRAM, we found that it can be a useful alternative to traditional methods in the analysis and assessment of accidents in complex systems. In addition, it was also found that FRAM can help analysts understand the interactions between functional elements of a system in a systematic manner.

Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients

  • Kang, Kwan Woo;Choi, Byoung Geol;Rha, Seung-Woon
    • Yonsei Medical Journal
    • /
    • v.59 no.9
    • /
    • pp.1057-1063
    • /
    • 2018
  • Purpose: Coronary artery spasm (CAS) and diabetes mellitus (DM) are implicated in endothelial dysfunction, and insulin resistance (IR) is a major etiological cause of type 2 DM. However, the association between CAS and IR in non-diabetic individuals has not been elucidated. The aim of the present study was to evaluate the impact of IR on CAS in patients without DM. Materials and Methods: A total of 330 eligible patients without DM and coronary artery disease who underwent acetylcholine (Ach) provocation test were enrolled in this study. Inclusion criteria included both hemoglobin A1c <6.0% and fasting glucose level <110 mg/dL without type 2 DM. Patients were divided into quartile groups according the level of homeostasis model assessment of insulin resistance (HOMA-IR): 1Q (n=82; HOMA-IR<1.35), 2Q (n=82; $1.35{\leq}HOMA-IR<1.93$), 3Q (n=83; $1.93{\leq}HOMA-IR<2.73$), and 4Q (n=83; $HOMA-IR{\geq}2.73$). Results: In the present study, the higher HOMA-IR group (3Q and 4Q) was older and had higher body mass index, fasting blood glucose, serum insulin, hemoglobin A1c, total cholesterol, and triglyceride levels than the lower HOMA-IR group (1Q). Also, poor IR (3Q and 4Q) was considerably associated with frequent CAS. Compared with Q1, the hazard ratios for Q3 and Q4 were 3.55 (95% CI: 1.79-7.03, p<0.001) and 2.12 (95% CI: 1.07-4.21, p=0.031), respectively, after adjustment of baseline risk confounders. Also, diffuse spasm and accompanying chest pain during Ach test were more strongly associated with IR patients with CAS. Conclusion: HOMA-IR was significantly negatively correlated with reference diameter measured after nitroglycerin and significantly positively correlated with diffuse spasm and chest pain.

Factors Influencing the Adoption of Location-Based Smartphone Applications: An Application of the Privacy Calculus Model (스마트폰 위치기반 어플리케이션의 이용의도에 영향을 미치는 요인: 프라이버시 계산 모형의 적용)

  • Cha, Hoon S.
    • Asia pacific journal of information systems
    • /
    • v.22 no.4
    • /
    • pp.7-29
    • /
    • 2012
  • Smartphone and its applications (i.e. apps) are increasingly penetrating consumer markets. According to a recent report from Korea Communications Commission, nearly 50% of mobile subscribers in South Korea are smartphone users that accounts for over 25 million people. In particular, the importance of smartphone has risen as a geospatially-aware device that provides various location-based services (LBS) equipped with GPS capability. The popular LBS include map and navigation, traffic and transportation updates, shopping and coupon services, and location-sensitive social network services. Overall, the emerging location-based smartphone apps (LBA) offer significant value by providing greater connectivity, personalization, and information and entertainment in a location-specific context. Conversely, the rapid growth of LBA and their benefits have been accompanied by concerns over the collection and dissemination of individual users' personal information through ongoing tracking of their location, identity, preferences, and social behaviors. The majority of LBA users tend to agree and consent to the LBA provider's terms and privacy policy on use of location data to get the immediate services. This tendency further increases the potential risks of unprotected exposure of personal information and serious invasion and breaches of individual privacy. To address the complex issues surrounding LBA particularly from the user's behavioral perspective, this study applied the privacy calculus model (PCM) to explore the factors that influence the adoption of LBA. According to PCM, consumers are engaged in a dynamic adjustment process in which privacy risks are weighted against benefits of information disclosure. Consistent with the principal notion of PCM, we investigated how individual users make a risk-benefit assessment under which personalized service and locatability act as benefit-side factors and information privacy risks act as a risk-side factor accompanying LBA adoption. In addition, we consider the moderating role of trust on the service providers in the prohibiting effects of privacy risks on user intention to adopt LBA. Further we include perceived ease of use and usefulness as additional constructs to examine whether the technology acceptance model (TAM) can be applied in the context of LBA adoption. The research model with ten (10) hypotheses was tested using data gathered from 98 respondents through a quasi-experimental survey method. During the survey, each participant was asked to navigate the website where the experimental simulation of a LBA allows the participant to purchase time-and-location sensitive discounted tickets for nearby stores. Structural equations modeling using partial least square validated the instrument and the proposed model. The results showed that six (6) out of ten (10) hypotheses were supported. On the subject of the core PCM, H2 (locatability ${\rightarrow}$ intention to use LBA) and H3 (privacy risks ${\rightarrow}$ intention to use LBA) were supported, while H1 (personalization ${\rightarrow}$ intention to use LBA) was not supported. Further, we could not any interaction effects (personalization X privacy risks, H4 & locatability X privacy risks, H5) on the intention to use LBA. In terms of privacy risks and trust, as mentioned above we found the significant negative influence from privacy risks on intention to use (H3), but positive influence from trust, which supported H6 (trust ${\rightarrow}$ intention to use LBA). The moderating effect of trust on the negative relationship between privacy risks and intention to use LBA was tested and confirmed by supporting H7 (privacy risks X trust ${\rightarrow}$ intention to use LBA). The two hypotheses regarding to the TAM, including H8 (perceived ease of use ${\rightarrow}$ perceived usefulness) and H9 (perceived ease of use ${\rightarrow}$ intention to use LBA) were supported; however, H10 (perceived effectiveness ${\rightarrow}$ intention to use LBA) was not supported. Results of this study offer the following key findings and implications. First the application of PCM was found to be a good analysis framework in the context of LBA adoption. Many of the hypotheses in the model were confirmed and the high value of $R^2$ (i.,e., 51%) indicated a good fit of the model. In particular, locatability and privacy risks are found to be the appropriate PCM-based antecedent variables. Second, the existence of moderating effect of trust on service provider suggests that the same marginal change in the level of privacy risks may differentially influence the intention to use LBA. That is, while the privacy risks increasingly become important social issues and will negatively influence the intention to use LBA, it is critical for LBA providers to build consumer trust and confidence to successfully mitigate this negative impact. Lastly, we could not find sufficient evidence that the intention to use LBA is influenced by perceived usefulness, which has been very well supported in most previous TAM research. This may suggest that more future research should examine the validity of applying TAM and further extend or modify it in the context of LBA or other similar smartphone apps.

  • PDF

A Study on Cause-and-Effect Hierarchy of Profit Factors for the Feasibility Evaluation of Overseas Construction Projects (해외건설공사의 타당성 평가를 위한 수익성 영향인자의 인과관계 계층구조 구축에 관한 연구)

  • Sun Seung-Min;Kim Han-Him;Han Seung-Heon
    • Proceedings of the Korean Institute Of Construction Engineering and Management
    • /
    • autumn
    • /
    • pp.373-378
    • /
    • 2003
  • Korea's overseas construction industry has been rather depressed by the weakened profitability as well as the sharp decrease of the market shares due to the lack of international competitiveness and the declined international market following the outbreak of Iraq war. There exist a lot of various risks in performing the overseas construction, and especially EPC projects, which entail complicated process from different parts, also require a sophisticated procurement and management skill. Subsequently, to survive in the competitive international market, we need to establish strategies to select potentially profitable projects at the initial stage of bidding process and to mitigate the high degree of risk exposures through contract negotiation and its adjustment. This research provides the profitability evaluation bases, with which overseas construction participants can forecast and analyze the risk more systematically, by eliciting profit-influencing factors from real overseas construction projects and structuring their cause-and-effect relationships. The profitability causal hierarchy structure describes the profitability factors' hierarchy in details and their interrelationships. It also enables us to find out critical factors directly related to profitability aggravation through a qualitative analysis. Ultimately, with this hierarchy structure as the base, the research will suggest how to develop the quantitative profitability forecasting model.

  • PDF

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

  • Song, SuJin;Kim, Eun-Kyung;Hong, Soyoung;Shin, Sangah;Song, YoonJu;Baik, Hyun Wook;Joung, Hyojee;Paik, Hee Young
    • Nutrition Research and Practice
    • /
    • v.9 no.5
    • /
    • pp.554-562
    • /
    • 2015
  • BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged ${\geq}30y$ were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Famine exposure in early life and type 2 diabetes in adulthood: findings from prospective studies in China

  • Feng Ning ;Jing Zhao ;Lei Zhang ;Weijing Wang ;Xiaohui Sun ;Xin Song ;Yanlei Zhang ;Hualei Xin ;Weiguo Gao;Ruqin Gao ;Dongfeng Zhang ;Zengchang Pang
    • Nutrition Research and Practice
    • /
    • v.17 no.4
    • /
    • pp.780-788
    • /
    • 2023
  • BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

A Building of Investment Decision Model for Improving Profitabilty of Tramper Shipping Business (해운산업 수익성 제고 투자의사결정 모델구축에 관한 연구 - 부정기선 영업을 중심으로 -)

  • Kim, Weon-Jae
    • Journal of Korea Port Economic Association
    • /
    • v.27 no.2
    • /
    • pp.297-311
    • /
    • 2011
  • This paper deals with a strategic investment decision model for improving investment profit in shipping industry. Despite the quantitative expansion of Korean shipping business, many shipping firms have suffered financial difficulties due to financial and operating risks that result from the characteristics of capital-intensive business as well as of volatility of shipping markets. As a result, managers in charge of making an investment decision, particularly in tramper business sector, are required to take both financial and operating risk factors into consideration. Put it differently, managers are strongly recommended to avoid these risks by ship asset play; buy-low and sell-high, which results in considerable capital gain and cost reduction. In addition, managers in shipping industry are also recommended to consider the ship chartering investment alternative when the freight markets show extreme volatility as the case of 2008 triggered by sub-prime mortgage financial crisis in USA. For example, the BDI suffered plunging down from 1000 in 2008 to 100 in 2010. Consequently, the 4th largest shipping company in Korea, DAEHAN Shipping Co., has collapsed primarily due to excessive tonnage expansion during the peak time of bulk market. In sum, the strategic investment decision model, suggested in this paper, is designed to include such factors as capital gain by asset play, timely chartering for alternative shipping service, and optimization of operating profit by tonnage adjustment in accordance with change in the shipping markets concerned.