• Health Policy and Management
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• v.34 no.3
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• pp.319-333
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• 2024

Background: This study aims to identify the factors that influence the incidence of catastrophic health expenditure (CHE) for the elderly living alone and to discuss how to manage CHE for the elderly living alone. Methods: This study utilizes 6th (2016), 7th (2018), and 8th (2020) data from the Korean Longitudinal Study of Aging to identify the incidence rate of CHE among the elderly living alone and conducts a panel logit analysis. The dependent variable is the incidence of CHE (thresholds: 10%, 20%, 30%), and the independent variables include demographic factors (gender, age group, region), socioeconomic factors (education level, economic activity status, income quintile, financial support rate from children), health-related factors (subjective health status, regular exercise, smoking, drinking, number of chronic diseases), and healthcare coverage factors (type of health insurance, private health insurance). Results: Descriptive statistics classified by gender show that female elderly living alone are more vulnerable than male elderly living alone in terms of disease prevalence and socioeconomic status. In addition, the incidence of CHE is higher for elderly women living alone than for elderly men living alone across all thresholds. The main results of the panel logit analysis show that higher education, income quintile, and financial support rate from children are associated with lower odds of CHE, while poorer subjective health and a higher number of chronic diseases are associated with higher odds of CHE. Medical aid recipients are less likely to incur CHE than those covered by national health insurance. Conclusion: The implications of this study are as follows. First, vulnerable elderly living alone with multiple chronic diseases and low income and education levels are more likely to incur CHE. Second, it is necessary to review policies such as a CHE support program and chronic disease management programs focused on vulnerable elderly individuals living alone. Third, the CHE support program should be operated in a patient-centered manner, with consideration given to a customized system for selecting and supporting elderly individuals living alone who are in need.

• Journal of Global Scholars of Marketing Science
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• v.20 no.2
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• pp.199-207
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• 2010

For us, there is virtually no distinction between being a responsible citizen and a successful business... they are one and the same for Wal-Mart today." ~ Lee Scott, al-Mart CEO after the 2005 Katrina disaster; cited in Green to Gold (Esty and Winston 2006). Lee Scott's statement signaled a new era in sustainability as manufacturers and retailers around the globe watched the world's largest mass merchandiser confirm its intentions with respect to sustainability. For decades, the environmental movement has grown, slowly bleeding over into the corporate world. Companies have been born, products have been created, academic journals have been launched, and government initiatives have been undertaken - all in the pursuit of sustainability (Peattie and Crane 2005). While progress has been admittedly slower than some may desire, the emergence and entrance of environmentally concerned mass merchandisers has done much to help with sustainable efforts. To better understand this movement, we incorporate the perspectives of both executives and consumers involved in the consumer packaged goods (CPG) industry. This research relies on three underlying themes: (1) Conceptual and anecdotal evidence suggests that companies undertake sustainability initiatives for a plethora of reasons, (2) The number of sustainability initiatives continues to increase in the consumer packaged goods industries, and (3) That it is, therefore, necessary to explore the role that sustainability plays in the minds of consumers. In light of these themes, surveys were administered to and completed by 143 college students and 101 business executives to assess a number of variables in regards to sustainability including willingness-to-pay, behavioral intentions, attitudes, willingness-to-pay, and preferences. Survey results indicate that the top three reasons why executives believe sustainability to be important include (1) the opportunity for profitability, (2) the fulfillment of an obligation to the environment, and (3) a responsibility to customers and shareholders. College students identified the top three reasons as (1) a responsibility to the environment, (2) an indebtedness to future generations, and (3) an effective management of resources. While the rationale for supporting sustainability efforts differed between college students and executives, the executives and consumers reported similar responses for the majority of the remaining sustainability issues. Furthermore, when we asked consumers to assess the importance of six key issues (healthcare, economy, education, crime, government spending, and environment) previously identified as important to consumers by Gallup Poll, protecting the environment only ranked fourth out of the six (Carlson 2005). While all six of these issues were identified as important, the top three that emerged as most important were (1) improvements in education, (2) the economy, and (3) health care. As the pursuit and incorporation of sustainability continues to evolve, so too will the expected outcomes. New definitions of performance that reflect the social/business benefits as well as the lengthened implementation period are relevant and warranted (Ehrenfeld 2005; Hitchcock and Willard 2006). We identified three primary categories of outcomes based on a literature review of both anecdotal and conceptual expectations of sustainability: (1) improvements in constituent satisfaction, (2) differentiation opportunities, and (3) financial rewards. Within each of these categories, several specific outcomes were identified resulting in eleven different outcomes arising from sustainability initiatives. Our survey results indicate that the top five most likely outcomes for companies that pursue sustainability are: (1) green consumers will be more satisfied, (2) company image will be better, (3) corporate responsibility will be enhanced, (4) energy costs will be reduced, and (5) products will be more innovative. Additionally, to better understand the interesting intersection between the environmental "identity" of a consumer and the willingness to manifest that identity with marketplace purchases, we extended prior research developed by Experian Research (2008). Accordingly, respondents were categorized as one of four types of green consumers (Behavioral Greens, Think Greens, Potential Greens, or True Browns) to garner a better understanding of the green consumer in addition to assisting with a more effective interpretation of results. We assessed these consumers' willingness to engage in eco-friendly behavior by evaluating three options: (1) shopping at retailers that support environmental initiatives, (2) paying more for products that protect the environment, and (3) paying higher taxes so the government can support environmental initiatives. Think Greens expressed the greatest willingness to change, followed by Behavioral Greens, Potential Greens, and True Browns. These differences were all significant at p<.01. Further Conclusions and Implications We have undertaken a descriptive study which seeks to enhance our understanding of the strategic domain of sustainability. Specifically, this research fills a gap in the literature by comparing and contrasting the sustainability views of business executives and consumers with specific regard to preferences, intentions, willingness-to-pay, behavior, and attitudes. For practitioners, much can be gained from a strategic standpoint. In addition to the many results already reported, respondents also reported than willing to pay more for products that protect the environment. Other specific results indicate that female respondents consistently communicate a stronger willingness than males to pay more for these products and to shop at eco-friendly retailers. Knowing this additional information, practitioners can now have a more specific market in which to target and communicate their sustainability efforts. While this research is only an initial step towards understanding similarities and differences among practitioners and consumers regarding sustainability, it presents original findings that contribute to both practice and research. Future research should be directed toward examining other variables affecting this relationship, as well as other specific industries.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.77-81
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• 2009

Purpose: The PET of the PET/CT (Positron Emission Tomography/Computed Tomography) quantitatively shows the biological and chemical information of the body, but has limitation of presenting the clear anatomic structure. Thus combining the PET with CT, it is not only possible to offer the higher resolution but also effectively shorten the scanning time and reduce the noises by using CT data in attenuation correction. And because, at the CT scanning, the contrast media makes it easy to determine a exact range of the lesion and distinguish the normal organs, there is a certain increase in the use of it. However, in the case of using the contrast media, it affects semi-quantitative measures of the PET/CT images. In this study, therefore, we will be to establish the reliability of the SUV (Standardized Uptake Value) with CT data correction so that it can help more accurate diagnosis. Materials and Methods: In this experiment, a total of 30 people are targeted - age range: from 27 to 72, average age : 49.6 - and DSTe (General Electric Healthcare, Milwaukee, MI, USA) is used for equipment. $^{18}F$- FDG 370~555 MBq is injected into the subjects depending on their weight and, after about 60 minutes of their stable position, a whole-body scan is taken. The CT scan is set to 140 kV and 210 mA, and the injected amount of the contrast media is 2 cc per 1 kg of the patients' weight. With the raw data from the scan, we obtain a image showing the effect of the contrast media through the attenuation correction by both of the corrected and uncorrected CT data. Then we mark out ROI (Region of Interest) in each area to measure SUV and analyze the difference. Results: According to the analysis, the SUV is decreased in the liver and heart which have more bloodstream than the others, because of the contrast media correction. On the other hand, there is no difference in the lungs. Conclusions: Whereas the CT scan images with the contrast media from the PET/CT increase the contrast of the targeted region for the test so that it can improve efficiency of diagnosis, there occurred an increase of SUV, a semi-quantitative analytical method. In this research, we measure the variation of SUV through the correction of the influence of contrast media and compare the differences. As we revise the SUV which is increasing in the image with attenuation correction by using contrast media, we can expect anatomical images of high-resolution. Furthermore, it is considered that through this trusted semi-quantitative method, it will definitely enhance the diagnostic value.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• Progress in Medical Physics
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• v.24 no.1
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• pp.1-24
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• 2013

As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.52-58
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• 2014

Purpose : To establish a pH measurement system for a mouse tumor study using a clinical scanner, to develop the $^1H$ and 31P radio frequency (RF) coil system and to test pH accuracy with phantoms. Materials and Methods: The $^1H$ and the $^{31}P$ surface coils were designed to acquire signals from mouse tumors. Two coils were positioned orthogonally for geometric decoupling. The pH values of various pH phantoms were calculated using the $^1H$ decoupled $^{31}P$ MR spectrum with the Henderson-Hasselbalch equation. The calculated pH value was compared to that of a pH meter. Results: The mutual coil coupling was shown in a standard $S_{12}$. Coil coupling ($S_{12}$) were -73.0 and -62.3 dB respectively. The signal-to-noise ratio (SNR) obtained from the homogeneous phantom $^1H$ image was greater than 300. The high resolution in vivo mice images were acquired using a $^{31}P$-decoupled $^1H$ coil. The pH values calculated from the $^1H$-decoupled $^{31}P$ spectrum correlated well with the values measured by pH meter ($R^2$=0.97). Conclusion: Accurate pH values can be acquired using a $^1H$-decoupled $^{31}P$ RF coil with a clinical scanner. This two-surface coil system could be applied to other nuclear MRS or MRI.

• Asia pacific journal of information systems
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• v.19 no.4
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• pp.77-100
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• 2009

Information Systems (IS) is an essential tool for any organizations. The last decade has seen an increasing body of knowledge on IS usage. Yet, IS often fails because of its misuse or non-use. In general, decisions regarding the selection of a system, which involve the evaluation of many IS vendors and an enormous initial investment, are made not through the consensus of employees but through the top-down decision making by top managers. In situations where the selected system does not satisfy the needs of the employees, the forced use of the selected IS will only result in their resistance to it. Many organizations have been either integrating dispersed legacy systems such as archipelago or adopting a new ERP (Enterprise Resource Planning) system to enhance employee efficiency. This study examines user resistance prior to the adoption of the selected IS or ERP system. As such, this study identifies the importance of managing organizational resistance that may appear in the pre-adoption context of an integrated IS or ERP system, explores key factors influencing user resistance, and investigates how prior experience with other integrated IS or ERP systems may change the relationship between the affecting factors and user resistance. This study focuses on organizational members' resistance and the affecting factors in the pre-adoption context of an integrated IS or ERP system rather than in the context of an ERP adoption itself or ERP post-adoption. Based on prior literature, this study proposes a research model that considers six key variables, including perceived benefit, system complexity, fitness with existing tasks, attitude toward change, the psychological reactance trait, and perceived IT competence. They are considered as independent variables affecting user resistance toward an integrated IS or ERP system. This study also introduces the concept of prior experience (i.e., whether a user has prior experience with an integrated IS or ERP system) as a moderating variable to examine the impact of perceived benefit and attitude toward change in user resistance. As such, we propose eight hypotheses with respect to the model. For the empirical validation of the hypotheses, we developed relevant instruments for each research variable based on prior literature and surveyed 95 professional researchers and the administrative staff of the Korea Photonics Technology Institute (KOPTI). We examined the organizational characteristics of KOPTI, the reasons behind their adoption of an ERP system, process changes caused by the introduction of the system, and employees' resistance/attitude toward the system at the time of the introduction. The results of the multiple regression analysis suggest that, among the six variables, perceived benefit, complexity, attitude toward change, and the psychological reactance trait significantly influence user resistance. These results further suggest that top management should manage the psychological states of their employees in order to minimize their resistance to the forced IS, even in the new system pre-adoption context. In addition, the moderating variable-prior experience was found to change the strength of the relationship between attitude toward change and system resistance. That is, the effect of attitude toward change in user resistance was significantly stronger in those with prior experience than those with no prior experience. This result implies that those with prior experience should be identified and provided with some type of attitude training or change management programs to minimize their resistance to the adoption of a system. This study contributes to the IS field by providing practical implications for IS practitioners. This study identifies system resistance stimuli of users, focusing on the pre-adoption context in a forced ERP system environment. We have empirically validated the proposed research model by examining several significant factors affecting user resistance against the adoption of an ERP system. In particular, we find a clear and significant role of the moderating variable, prior ERP usage experience, in the relationship between the affecting factors and user resistance. The results of the study suggest the importance of appropriately managing the factors that affect user resistance in organizations that plan to introduce a new ERP system or integrate legacy systems. Moreover, this study offers to practitioners several specific strategies (in particular, the categorization of users by their prior usage experience) for alleviating the resistant behaviors of users in the process of the ERP adoption before a system becomes available to them. Despite the valuable contributions of this study, there are also some limitations which will be discussed in this paper to make the study more complete and consistent.

• Korea Science and Art Forum
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• v.37 no.1
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• pp.249-260
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• 2019

Recently, the proportion of single-person households is on the increase in Korea, expected to reach 34.6% in 2035. Among the single-person households, Young single family households are facing greater difficulties due to high house prices in Korea. The government is expanding its support to Young single family, executing various policies such as public lease housings, private lease housings for youth, youth dormitory, etc. The purpose of this study is to understand the exact housing requirement of Young single family households who have different lifestyles with other age groups and provide base line data for youth house planning which will be in use later on. Study methods are shown below. First, this research studied the status and characteristics of Young single family households by looking into literature. Second, by studying previous studies concerned with life style and housing preferences of youth, the tool for investigating preferences and needs of housing environment by Young single family households was composed. Third, survey on characterstics of space usage, preferences and needs on flat composition, and preferences of interior design were conducted based on lifestyle of Young single family-households. The survey was conducted as an online survey using SNS for 150 Young single family holds from the age of 20 and 39, including students and office workers from December 2018 to January 2019. The results are as following. (1) Looking into the space usage characteristics, considering that various activities other than basic functions take place in bedroom and living room of small-sized Young single family households, we need to consider this additionally when planning the housing. (2) Looking into the preferences and composite needs of flat composition, the subjects demand separate bed room and more living room space, and also demand expansion of living room space where various activities take place and additional storage such as dress room in bed room (3) The preferences toward interior design show preferences toward modern style and achromatic color, a representative color. The subjects also prefer floor finishing materials normally used for living spaces, and indirect, soft lighting that uses wall. Also, there are differences between interior design preferences between students (20's) and office workers(30's) due to their different lifestyles. Research is needed to propose practical residential environment requirements and plans through a case study of actual public rental housing and a wider range of users.

• The Journal of Bigdata
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• v.8 no.1
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• pp.111-129
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• 2023

With the diffusion of digital innovation, the adoption of innovative medical technologies based on artificial intelligence is increasing in the medical field. This is driving the launch and adoption of AI-based SaMD(Software as a Medical Device), but there is a lack of research on the factors that influence the adoption of SaMD by medical institutions. The purpose of this study is to identify key factors that influence medical institutions' decisions to adopt AI-based SaMDs, and to analyze the weights and priorities of these factors. For this purpose, we conducted Delphi surveys based on the results of literature studies on technology acceptance models in healthcare industry, medical AI and SaMD, and developed a research model by combining HOTE(Human, Organization, Technology and Environment) framework and HABIO(Holistic Approach {Business, Information, Organizational}) framework. Based on the research model with 5 main criteria and 22 sub-criteria, we conducted an AHP(Analytical Hierarchy Process) analysis among the experts from domestic medical institutions and SaMD providers to empirically analyze SaMD adoption factors. The results of this study showed that the priority of the main criteria for determining the adoption of AI-based SaMD was in the order of technical factors, economic factors, human factors, organizational factors, and environmental factors. The priority of sub-criteria was in the order of reliability, cost reduction, medical staff's acceptance, safety, top management's support, security, and licensing & regulatory levels. Specifically, technical factors such as reliability, safety, and security were found to be the most important factors for SaMD adoption. In addition, the comparisons and analyses of the weights and priorities of each group showed that the weights and priorities of SaMD adoption factors varied by type of institution, type of medical institution, and type of job in the medical institution.

• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.254-264
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• 2022

The Korean Society of Radiology and Medical Guidelines Committee amended the existing 2016 guidelines to publish the "Korean Clinical Practice Guidelines for Adverse Reactions to Iodide Contrast for Injection and Gadolinium Contrast for MRI: The Revised Clinical Consensus and Recommendations (2022 Third Edition)." Expert members recommended and approved by the Korean Society of Radiology, the Korean Academy of Asthma, Allergy and Clinical Immunology, and the Korean Nephrology Society participated together. According to the expert consensus or systematic literature review, the description of the autoinjector and connection line for the infection control while using contrast medium, the acute adverse reaction, and renal toxicity to iodized contrast medium were modified and added. We would like to introduce the revised contents.