• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.125-133
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• 2022

Objectives: No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC. Methods: A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables. Results: Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported. Conclusions: This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.447-453
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• 2005

The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.

• Research in Community and Public Health Nursing
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• v.12 no.2
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• pp.513-531
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• 2001

Television news programs are becoming significant source of health information. This study aims at investigating the current state of health coverage of the prime time news program in Korea. Data were collected from KBS 9 0'clock news in the period of thirteen months. from December 1. 1998. to November 1. 1999. The data were analyzed using content analysis method. and the reliability degree was 99.7% according to the Holsti's inter-coder reliability test. The current research classified 489 health related news items into 49 sub-categories and five health categories through content analysis. Some of the basic results of this study are as follows. 1. The frequency according to health category, health maintenance promotion(57.3%) topped followed by disease prevention(23.2%), disease treatment(14.9%), life ethics(4.0%), and growth development(0.6%). 2. According to human developmental age. for the most part(80.1 %) is applicable to the entire range of human developmental age. 3. Health maintennance promotion category take top of health category by the rate of 57.3% and contain 20 sub-categories. 4. News items in the life ethics category, which had six sub-categories. occupied only four percent of the total health related news. News in the growth development category included two sub categories and occupied 0.6% of the total news items. 5. In disease prevention and disease treatment category, infectious disease(33.2%) showed the highest percentage according to the WHO's international disease classification system. Disease prevention occupied 23.2% and contained eleven sub-categories while disease treatment occupied 14.9% and included ten sub-categories. Television news coverage on health showed a wide variety of selection in terms that they are reporting various issues. This study, however, found that some news items were confusing and failing in presenting scientific evidences. It is suggested that the television coverage on health could be beneficial to most of viewers in receiving important health information and guidelines, only if they are utilizing their own sound discretion in consuming those news.

• Health Policy and Management
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• v.31 no.3
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• pp.344-354
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• 2021

Background: The purpose of this study was to analyze the effect of national health insurance coverage of Chuna therapy in April 2019 on the costs and service uses in automobile insurance. Methods: This study used the claim data from Health Insurance Review and Assessment Service. A total of 189,912 inpatients and 1,550,497 outpatients who received Chuna therapy covered by automobile insurance in oriental medical institutions were included. The analysis period was from July 2018 to December 2019, and a total of 18 months before and after April 2019, when Chuna therapy was covered by national health insurance. Interrupted time series analysis was applied to analyze the impact on the costs and service uses of Chuna therapy in automobile insurance before and after April 2019. Results: From July 2018 to December 2019, for 189,912 inpatients the cost and the number of times for Chuna therapy per capita were increased by 22.0% and decreased by 7.3% respectively right after the implementation of the policy. In the case of 1,550,497 outpatients, the cost of Chuna therapy per capita tends to be increased by 0.4% in overall study periods and increased 28.4% immediately after the implementation of the policy. Meanwhile, the number of times and visits for Chuna therapy per capita tends to be increased by 0.4% in overall study periods but decreased by 0.4% after the implementation of the policy. Conclusion: Results suggest that if the national health insurance coverage of oriental medicine services increases according to the policy stance for benefit expansion in national health insurance, the criteria for providing national health insurance benefits should be considered with the comprehensive impacts on the costs and service uses of automobile insurance.

• Health Policy and Management
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• v.30 no.3
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• Investigative Magnetic Resonance Imaging
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• v.16 no.2
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• pp.159-168
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• 2012

The proximity of thoracic aortic aneurysm to the left subclavian artery (LSA) has made the coverage of LSA during thoracic endovascular aortic repair (TEVAR) be essential. Despite controversy concerning the safety of LSA coverage and the indications for LSA revascularizations, the cerebral hemodynamic change after LSA coverage has not been demonstrated. We prospectively examined two patients who would undergo TEVAR with LSA coverage by using 2D cine phase contrast MR imaging. After LSA coverage, the left subclavian steal was properly compensated by the increased flow volumes of both carotid arteries and right vertebral artery, which is the major collateral supply. The total brain supply after TEVAR did not lessen, which showed good correlation with uneventful clinical outcome. Therefore, 2D phase contrast MR imaging can be recommended as a useful technique to evaluate the hemodynamic change of the LSA coverage during TEVAR and to triage the candidate for LSA revascularization.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.8
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• pp.15-22
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• 2019

Awireless sensor network utilizes small sensors with a low cost and low power being deployed over a wide area. They monitor the surrounding environment and gather the associated information to transmit it to a base station via multi-hop transmission. Most of the research has mainly focused on static sensors that are located in a fixed position. Unlike a wireless sensor network based on static sensors, we can exploit drone-based technologies for more efficient wireless networks in terms of coverage and energy. In this paper, we introduce a transmission power model and a video encoding power model to design the network environment. We also explain a priority mapping scheme, and deploy drones oriented for network coverage and energy consumption. Through our simulations, this research shows coverage and energy improvements in adrone-based wireless sensor network with fewer sensors, compared to astatic sensor-based wireless sensor network. Concretely, coverage increases by 30% for thedrone-based wireless sensor network with the same number of sensors. Moreover, we save an average of 25% with respect to the total energy consumption of the network while maintaining the coverage required.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.44-48
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• 2001

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wounds. However, in case of complete extremity amputation in eletrical burn patient, the transfer of pedicled flaps from the amputated part is not possible. In such instances, we have designed total arm musculocutaneous free-fillet flaps from the amputated limb to provide wound coverage, when replantation of the amputated part was contraindicated. now we present such a case. This technique allows immediate wound coverage without the morbidity of an additional donor site. The flap provides the ideal combination of large surface area, muscle bulk, and long vascular pedicle. It can be dissected rapidly to minimize ischemic time and could therefore be applicable to traumatic forequarter amputations.

• Korean Journal of Childcare and Education
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• v.13 no.2
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• pp.115-131
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• 2017

Objective: This study aimed to examine the status of South Korean unification education for young children by reviewing Nuri curriculum developed by the Korean government. Method: Literature review was adopted in order to analyze the contents of the Nuri curriculum teachers'manuals under the areas and elements of unification education. Results: Unification education has been designed to accelerate unification, to promote the values and attitudes toward the unification of the two Koreas, and to prepare for the post-unification period. This education can be categorized into specific areas: democratic community, democratic citizenship, peacekeeping and multiculturalism. These areas account for 24.24% of the total contents in the Teachers'Manual of the Nuri curriculum. The percentage of the contents helpful to understand North Korea and unification, however, is merely 0.25% of the total contents, and the elements are not fairly balanced. Such content coverage of the teacher's manuals for kindergartens is 2.83% higher than that for preschools. Conclusion/Implications: The implications of this analysis include that the elements of unification education should take a more balanced approach with more integrated and broader coverage. The elements also need to be revised so that both kindergarteners and preschoolers can get access to unification education of the same quality.