• Title/Summary/Keyword: Social Insurance Costs

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Admissibility of Subrogation Arbitration in the view of Firm Offer Hypothesis (확정오퍼가설 관점에서 바라 본 대위중재의 허용여부)

  • Cho, Chung-Kon
    • International Commerce and Information Review
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    • v.15 no.4
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    • pp.287-311
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    • 2013
  • The arbitration parties may disagree with the arbitrator's award about whether they are eligible for the dispute case. While lots of disputes cases relating to subrogation are arising, it is not easy to find subrogation arbitration system to handle them clearly. The main issue is an availability of subrogation arbitration in case of the dispute which the insurer requests the arbitration against the carrier according to the arbitration clause of Bill of Lading. The direct parties of arbitration clause of the B/L are the carrier and the holder of the B/L. Could the insurer get the position of the arbitration party in stead of the holder of the B/L after compensation if there was an accident of insurance on the way of carriage? Even though there are a few arbitral awards of subrogation, the reason of the eligibility of subrogation arbitration is not enough. This paper scrutinized precedent research papers, arbitration awards, judicial precedents, and the Automobile Subrogation Arbitration System. Vague dispute resolution system which burden corporations with so many costs must be not good for business. In the view of economic efficiency, blank of contract, reciprocality, and Coase Theorem, it is recommended that subrogation arbitration system for the international trade would be better focus on the hypothesis of "Firm Offer Character of Arbitration Clause."

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Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea (성인 고지혈증 선별 검사의 비용-효과 분석)

  • Cha, Yeon-Soon;Khang, Young-Ho;Lee, Moo-Song;Kang, Wee-Chang;Jeon, Sung-Hoon;Kim, Kee-Lak;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.99-106
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    • 2002
  • Objective : Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults, Method : Seven alternative strategies for hyperlipidemia screening were formulated and compared ir terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. Results : Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol, high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. Conclusions : Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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