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The Conflict over the Separation of Prescribing and Dispensing Practice (SPDP) in Korea: A Bargaining Perspective (의약분업을 둘러싼 갈등 : 협상론의 관점에서)

  • Lee, Kyung-Won;Kim, Joung-Hwa;T. K. Ahn
    • Health Policy and Management
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    • v.12 no.4
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    • pp.91-113
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    • 2002
  • We report and analyze the Korean physicians' recent general strike over the implementation of the Separation of Prescribing and Dispensing Practice (SPDP) in which more than 18,000 private clinics and 280 hospitals participated. Utilizing game-theoretic models of bargaining we explain why the Korean physicians were so successful in organizing intense collective action against the government and securing very favorable policy outcomes. In particular, we highlight the role of distributional conflict among social actors in shaping the details of institutional reform. The introduction of the SPDP was a necessary first step in the overall reform of health care system in Korea. However, the SPDP was perceived to be a serious threat to the economic viability of their profession by the vast majority of Korean physicians who had long been relied on the profits from selling medicines to compensate for the loss of income due to the low service fee under the previous health care system. The strong political coalition among heterogeneous physicians enabled them to organize an intense form of collective action, the general strike. Thus, physicians were successful not only in dragging the government to a bargaining table, but also winning in the bargaining and securing an outcome vastly favorable to them. On the other hand, the lack of an overall reform plan in the health care policy area, especially the finance of the National Health Insurance and the need for maintaining an image as a successful reform initiator, motivated the government to reach a quick resolution with the striking physicians.

Factors Influencing the Intention of Admission into a Charged Nursing Home for the Elderly (유료노인전문요양원 입주의사 결정요인에 관한 연구)

  • Yoo, Young-Soon;Cho, Eun-Hi;Yu, Byung-Chul;Jeong, Ki-Won;Urm, Sang-Hwa;Kim, Sung-Jun;Chun, Jin-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.1-8
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    • 2001
  • Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.

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A Study on Numerical Calculations of Hybrid Air Pollution Control System Coupled with SDR and Bag Filter(II) -Structural Improvement (반건식 반응기와 백필터를 결합한 하이브리드 대기오염제어 시스템의 수치해석적 연구(II) -구조개선을 중심으로)

  • Kim, Jin-Uk;Jung, Yu-Jin;Yoo, Jeong-Kun;Shon, Byung-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.985-992
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    • 2011
  • The 3D computational fluid dynamics (CFD) was performed in relation to the internal fluid characteristics and flow distribution for the development of the most optimal model in the complex post-disposal device. As it is expected that a channeling (drift) would be made by the semi-dry reactor due to the large difference in the flow distribution by the compartment in the bag filter, a structural improvement should be urgently made for more uniformed flow distribution in the bag filter. Three types of modifications such as i) changing the plenum shape, ii) orifice install in the exit part of cleaned gas, iii) increasing the plenum number were established. From the results of computational fluid dynamics, it was revealed that the changing of plenum shape and orifice install in the exit part of cleaned gas was more reasonable than the increasing the plenum number because of the difficulties of retrofit. The complex post-disposal device, modified and supplemented with this analysis, integrated the semi-dry reactor and the bag filter in a single body, so it follows that the improvement can make the device compact, save the installation area, save the operation fee, and management more convenient.

A Study on the Method of Rural Rental Housing Management by Analysis of Rural-Fishing New Town Rental Housing (농어촌 뉴타운 공공임대주택 관리 분석을 통한 농촌형 임대주택 관리방안에 관한 연구)

  • Park, Mi-Lan;Park, Heon-Choon;Kim, Jin-Wook;Ryoo, Yeon-Su
    • Journal of the Korean Institute of Rural Architecture
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    • v.17 no.3
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    • pp.55-62
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    • 2015
  • Recently as return farmers has been increased rapidly, the introduction of a system of rental housing is being considerated in order to induce regional fixation. It was examined organizational management, business scope of rural type rental housing, management role, through the analysis about the management realities of the business of similar form Rural-Fishing New Town project. Jangseonggun and Hwasungun have maneged rental housing 280ho in Rural-Fishing New Town project. It is large village among Rural Rental Housing. And these counties have organized the complex on a large scale among the rental housing. Local governments have managed and operated directly, also these governments have two different methods for the co-management, and the way of making payment. Rental housing management services are divided into rental management, housing management, tenant management. Rental management services such as residents of recruitment, tenants and retreat, rent collection and the storage, management and leasing promotion of the cantilever, surveys of residents. Housing management services such as check of various facilities, maintenance and maintenance work, security and cleaning and daily facility management. Tenant management is life management in connection with housing welfare. In the rural type of rental housing, there are few cases to operate a management office. It is often supplied by rental housing to buy a house or vacant land within the existing village. In this case, by utilizing community facilities within the existing village instead of establishment of extra facilities,It doesn't need to make payment for maintenance fee. In the smaller complex than No. 20, it is self-managed by the tenants in order to reduce the administrative costs and specify the necessary municipal manager. Organization form can be maneged directly from local governments and part of for the management of the building can be employed a mixed management system to delegate management to private organizations such as non-profit organizations or neighborhood association. Tenant management helps people who move in a rental house live on stable circumstance in there area by connection with the program of life support.

A Study on Numerical Calculations of Hybrid Air Pollution Control System Coupled with SDR and Bag Filter (반건식 반응기와 백필터를 결합한 하이브리드 대기오염제어 시스템의 수치해석적 연구(I))

  • Kwon, Young-Hyun;Kim, Jin-Uk;Jung, Yu-Jin;Kim, Min-Choul;Lee, Jae-Jeong;Lee, Gang-Woo;Shon, Byung-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.11
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    • pp.4656-4663
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    • 2010
  • In this study, the 3D computational fluid dynamics (CFD) was performed in relation to the internal fluid characteristics, flow distribution, air mean ages, and residence time for the development of the most optimal model in the complex post-disposal device. As it is expected that a channeling (drift) would be made by the semi-dry reactor due to the large difference in the flow distribution by the compartment in the bag filter, a structural improvement should be urgently made for more uniformed flow distribution in the bag filter. In addition, it showed the possibility that the velocity field and distribution characteristics of the residence time could be improved through a modification to inlet structure of the spray dryer reactor. The complex post-disposal device, modified and supplemented with this analysis, integrated the semi-dry reactor and the bag filter in a single body, so it follows that the improvement can make the device compact, the installation area, the operation fee, and management more convenient.

The Effect of Corporate Social Responsibility on Audit Efficiency: Analyses of the effects of KEJI Index on Audit Fees and Audit Hours (감사대상기업의 사회적 책임활동과 감사의 효율성 : 경제정의지수와 감사보수 및 감사시간의 관련성 분석)

  • Li, Jia-Hui;Choe, Kuk-Hyun
    • International Area Studies Review
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    • v.21 no.4
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    • pp.247-268
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    • 2017
  • This paper analyzes for companies of 2011~2014 the effects of corporate social responsibility on audit efficiency. Using KEJI Index and its individual components which is published by Citizens' Coalition for Economic Justice Institute, this paper analyzes their effects on audit efficiency of audit fees and audit hours. The results of analyses are as followings. First, corporate social responsibility(CSR) composite index did not show any significant relationship between audit fees and audit hours. However, for analyses of the effects of CSR individual components on audit efficiency, variable such as CSR fairness(CSR2), CSR social contribution(CSR3), CSR environmental protection activity(CSR5) have the negative effects on the audit fees and audit time. and CSR customer protection(CSR4), CSR employee satisfaction(CSR6) have the positive effects on the audit fees and audit time. Results suggest that independent auditors may reduce audit risks associated with possible misrepresentation of financial statements for companies with high scores of CSR fairness (CSR2), CSR social contribution(CSR3), and CSR environmental protection activity(CSR5). Also, financial statement auditors may perceive surge of discretionary expenses, and set audit risk high for companies with CSR customer protection(CSR4), and CSR employee satisfaction(CSR6). Together, KEJI Index and its individual components appear to have differential effects on audit efficiency.

A Study on the Use Smartphone of Radiological Technologist (방사선사의 스마트폰 이용에 관한 연구)

  • Jeong, Bong-Jae
    • Journal of the Korean Society of Radiology
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    • v.14 no.7
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    • pp.915-922
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    • 2020
  • This study analyzed the content of use Tendency and addiction according to smartphone use of targeting radiological Technologist working in Gyeongnam area. The tool used as the data for the study is a survey. From April 21 to May 31, 2019, a total of 330 questionnaires were distributed to radiological Technologist working at medical institutions in Gyeongnam, and 300 copies suitable for the study were SPSS/PC Ver 18.0 program for Analysis was performed using. The factors of the study subject's tendency to use smartphone were communication, information, leisure, and convenience. As for the addiction factors, a total of 37 questions were analyzed, including daily living disorder, virtual world orientation, tolerance, and withdrawal. Smartphone-related characteristics were set as monthly average fee, usage time, and SNS usage time, and technical statistics, t-test, ANOVA, correlation and regression analysis were performed. The radiological Technologist tendency to use smartphones was 3.10±.55 points, which was average, and smartphone addiction was 2.34±.62 points, which was lower than the average. It was found that there was a significant correlation between the radiological Technologist Tendency to use smartphone and addiction. The effect of radiological Technologist tendency to use smartphone on addiction it was found to account for 10.8%. Through this study, it can be said that it is important to analyze the addiction factors according to the tendency use smartphone of radiological Technologist and to prepare a desirable plan for smartphone use.

Evaluation of the Behavior and Satisfaction of College Students for Family Restaurants in Seoul.Kyunggi Area (수도권 대학생들의 패밀리 레스토랑에 대한 이용 성향과 만족도 평가)

  • Shin, Mee-Hye;Lee, Ki-Yup;Kang, Kun-Og
    • Journal of the East Asian Society of Dietary Life
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    • v.17 no.3
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    • pp.445-455
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    • 2007
  • This study surveyed university students in the Seoul area regarding their awareness of family restaurants and visiting experiences. Frequency analysis was used to study the data. Most of the repliers (92.0%) had visiting experiences and visited on weekends (72.4%), paying \$10,000{\sim}15,000$ for meals. In correlation analysis of the general characteristics and reasons for visiting, there were significant differences according to gender (p<0.01) and major study area (p<0.005). During visits the factor considered most important relative to the surroundings was food styling. The factors valued most highly when selecting a family restaurant were "good taste" (43.5%) and "good discounts" (26.3%) respectively. The favorite family restaurant was Outback Steakhouse (34.7%), and 86.4% of repliers had used a membership card, with 46.9% being satisfied with using the membership card. The conditions for using a family restaurant and satisfaction differences in each category, included: the amount of food (p<0.1) for the number of visits, taste (p<0.01), food shape and styling (p<0.05), surroundings (p<0.1), and interior (p<0.05): and for the meal fee per person, price (p<0.05) and sanitation (p<0.05), all showing significant differences as reasons for using the restaurants. In the factor analysis of nine categories, three factors: service, food, and economics were acquired, and their Cronbach's ${\alpha}$ values were 0.778, 0.671, and 0.587. Satisfaction toward food and service had a positive correlation of 0.457. Satisfaction toward food and economics increased a family restaurant's overall satisfaction score, and satisfaction toward service did not have a significant influence.

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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Corporate Bond Rating Using Various Multiclass Support Vector Machines (다양한 다분류 SVM을 적용한 기업채권평가)

  • Ahn, Hyun-Chul;Kim, Kyoung-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.157-178
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    • 2009
  • Corporate credit rating is a very important factor in the market for corporate debt. Information concerning corporate operations is often disseminated to market participants through the changes in credit ratings that are published by professional rating agencies, such as Standard and Poor's (S&P) and Moody's Investor Service. Since these agencies generally require a large fee for the service, and the periodically provided ratings sometimes do not reflect the default risk of the company at the time, it may be advantageous for bond-market participants to be able to classify credit ratings before the agencies actually publish them. As a result, it is very important for companies (especially, financial companies) to develop a proper model of credit rating. From a technical perspective, the credit rating constitutes a typical, multiclass, classification problem because rating agencies generally have ten or more categories of ratings. For example, S&P's ratings range from AAA for the highest-quality bonds to D for the lowest-quality bonds. The professional rating agencies emphasize the importance of analysts' subjective judgments in the determination of credit ratings. However, in practice, a mathematical model that uses the financial variables of companies plays an important role in determining credit ratings, since it is convenient to apply and cost efficient. These financial variables include the ratios that represent a company's leverage status, liquidity status, and profitability status. Several statistical and artificial intelligence (AI) techniques have been applied as tools for predicting credit ratings. Among them, artificial neural networks are most prevalent in the area of finance because of their broad applicability to many business problems and their preeminent ability to adapt. However, artificial neural networks also have many defects, including the difficulty in determining the values of the control parameters and the number of processing elements in the layer as well as the risk of over-fitting. Of late, because of their robustness and high accuracy, support vector machines (SVMs) have become popular as a solution for problems with generating accurate prediction. An SVM's solution may be globally optimal because SVMs seek to minimize structural risk. On the other hand, artificial neural network models may tend to find locally optimal solutions because they seek to minimize empirical risk. In addition, no parameters need to be tuned in SVMs, barring the upper bound for non-separable cases in linear SVMs. Since SVMs were originally devised for binary classification, however they are not intrinsically geared for multiclass classifications as in credit ratings. Thus, researchers have tried to extend the original SVM to multiclass classification. Hitherto, a variety of techniques to extend standard SVMs to multiclass SVMs (MSVMs) has been proposed in the literature Only a few types of MSVM are, however, tested using prior studies that apply MSVMs to credit ratings studies. In this study, we examined six different techniques of MSVMs: (1) One-Against-One, (2) One-Against-AIL (3) DAGSVM, (4) ECOC, (5) Method of Weston and Watkins, and (6) Method of Crammer and Singer. In addition, we examined the prediction accuracy of some modified version of conventional MSVM techniques. To find the most appropriate technique of MSVMs for corporate bond rating, we applied all the techniques of MSVMs to a real-world case of credit rating in Korea. The best application is in corporate bond rating, which is the most frequently studied area of credit rating for specific debt issues or other financial obligations. For our study the research data were collected from National Information and Credit Evaluation, Inc., a major bond-rating company in Korea. The data set is comprised of the bond-ratings for the year 2002 and various financial variables for 1,295 companies from the manufacturing industry in Korea. We compared the results of these techniques with one another, and with those of traditional methods for credit ratings, such as multiple discriminant analysis (MDA), multinomial logistic regression (MLOGIT), and artificial neural networks (ANNs). As a result, we found that DAGSVM with an ordered list was the best approach for the prediction of bond rating. In addition, we found that the modified version of ECOC approach can yield higher prediction accuracy for the cases showing clear patterns.