• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.145-155
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• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of agricultural medicine and community health
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• v.40 no.3
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• pp.126-136
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• 2015

Objectives: This study was performed to investigate the effects of a health education program for the aged on knowledge about the warning signs and symptoms of acute myocardial infarction and stroke. Methods: Data from 337 elderly people (159 participated and 178 non-participated) at senior centers in Jeju-si were collected by 1 to 1 interview from January to March 2012, one year after the education program provided. Two stages of study were performed: Cross-sectional, case-control study on the level of knowledge about the warning signs and symptoms; and multivariate logistic regression to fine out predictors of optimal awareness. Results: No significant discrepancy of knowledge level between case and control group was found. The knowledge level as high as a surge was shown in both groups one year later. A surge of knowledge had been shown after the education provided in one month. The factors affecting the optimal level of knowledge were education (Odds ratio 3.01; Confidence Interval 1.72-5.26; P-value <0.001) and 7 days of watching TV news per week (2.97; 1.68-5.23; P<0.001). However, participation in the health education was not significant (1.60; 0.98-2.61; P=0.059). Conclusions: The effects of a targeted program in high-risk groups for cardio-cerebrovascular disease are only guaranteed in the enhancement by a population-based mass-media education campaign.

• Journal of agricultural medicine and community health
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• v.49 no.1
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• pp.37-49
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• 2024

Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

• Health Policy and Management
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• v.34 no.2
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• pp.211-221
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• 2024

Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

• Journal of Distribution Science
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• v.8 no.3
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• pp.17-26
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• 2010

Recently concerns have been raised due to the unbalanced supply of crops: the price of crops has been unstable and at one point the price went up so high that the word Agflation(agriculture+ inflation) was coined. Korea, in particular, is a small-sized country and needs to secure the stable supply of crops by investing in the produce importation at a national level. Investment in foreign produce importation is becoming more important as a measure for sufficient supply of crops, limited supply of domestic crops, weakened farming conditions worldwide, as well as recent changes in the use of crops due to the development of bio-fuels, influence of carbon emission on crops, the price increase in crops, and influx of foreign hot money. However, there are many problems with investing in foreign produce importation: lack of support from the government; lack of farming information and technology; difficulty in securing the capital; no immediate pay-off from the investment and insufficient management. Although foreign produce is originally more price-competitive than domestic produce, it loses its competiveness in the process of importation (due to high tariffs) and poor distribution system, which makes it difficult to sell in Korea. Therefore, investment in foreign produce importation is being questioned for feasibility; to make it possible, foreign produce must maintain the price-competitiveness. Especially, harvest of agricultural products depends on natural and geographical conditions of each country and those products have indigenous properties, so distribution system according to import and export of agricultural products should be treated more carefully than that of other industries. Distribution costs are differentiated into each item and include cost of sorting and wrapping, cost of wrapping materials, cost of domestic transport, cost of international transport and cost of clearing customs for import and export. So transporting and storing agricultural products generates considerable costs compared with other products. Also, due to upgrade of dietary life, needs for stability, taste and visible quality toward food including agricultural products are being raised and wrong way of storage causes decomposition of food and loss of freshness, making the storage more difficult than that in room temperature, so storage and transport in distribution of agricultural products needs specialty. In addition, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. However, existing distribution system of agricultural products is exposed to various problems including problems in distribution channel, making distribution and strategy for distribution and those problems are as follows. First, in case of investment in overseas agricultural industry, stable supply of the products is difficult because areas of production are dispersed widely and influenced by outer factors due to including overseas distribution channels. Also, at the aspect of quality, standardization of products is difficult, distribution system is quite complicated and unreasonable due to long distribution channels according to international trade and financial and institutional support is not enough. Especially, there are quite a lot of ineffective factors including multi level distribution process, dramatic gap between production cost and customer's cost, lack of physical distribution facilities and difficulties in storage and transport due to lack of wrapping containers. Besides, because import and export of agricultural products has been manages under the company's own distribution according to transaction contract between manufacturers and exporting company, efficiency is low due to excessive investment in fixed costs and lack of specialty in dealing with agricultural products causes fall of value of products, showing the limit to lose price-competitiveness. Especially, because lack of specialty in distribution and circulation such as storage and wrapping does not solve limit factors in distance, the distribution and circulation has been limited to a form of import and export within short-distant region. Therefore, need for distribution out-sourcing which can satisfy specialty in managing distribution and circulation and it is needed to establish more effective distribution system. Second, among tangible and intangible services which promote the efficiency of the whole distribution, a function building distribution environment which includes distribution information, system for standard and inspection, distribution finance, system for diversification of risks, education and training, distribution administration and tax system is wanted. In general, such a function building distribution environment is difficult to be changed and supplement innovatively because its effect compared with investment does not appear immediately despite of its necessity. Especially, in case of distribution of agricultural products, as a function of collecting and distributing is performed individually through various channels, the importance of distribution information and standardization is getting more focus due to the problem of repetition of work and lack of specialty. Also, efficient management of distribution is quite difficult due to lack of professionals in distribution, so support to professional education is needed. Third, though effort to keep self-sufficiency ratio of staple food, rice is regarded as important at the government level, level of dependency on overseas of others crops is high. Therefore, plan for stable securing food resources aside from staple food is also necessary. Especially, governmental organizations of agricultural products distribution in Korea are production-centered and have unreasonable structure whose function at the aspect of distribution and consumption is quite insufficient. And development of new distribution channels which can deal with changes in distribution environment and they do not achieve actual results of strategy for distribution due to non-positive strategy for price distribution. That is, it implies the possibility that base for supply will become vulnerable because it does not mediate appropriate interests on total distribution channels such as manufacturers, wholesale dealers and vendors by emphasizing consumer protection excessively in the distribution of agricultural products. Therefore, this study examined fundamental concept and actual situation for our investment to overseas agriculture, drew necessities, considerations, problems, etc. of overseas agricultural investment and suggested improvements at the level of distribution for price competitiveness of agricultural products cultivated in overseas under five aspects; government's indirect support, distribution's modernization and distribution information function's strengthening, government's political support for distribution facility, transportation route, load and unloading works' improvement, price competitiveness' securing, professional manpower's cultivation by education and training, etc. Here are some suggestions for foreign produce importation. First, the government should conduct a survey on the current distribution channels and analyze the situation to establish a measure for long-term development plans. By providing each agricultural area with a guideline for planning appropriate production of crops, the government can help farmers be ready for importation, and prevent them from producing same crops all at the same time. Government can sign an MOU with the foreign government and promote the importation so that the development of agricultural resources can be stable and steady. Second, the government can establish a strategy for an effective distribution system by providing farmers and agriculture-related workers with the distribution information such as price, production, demand, market structure and location, feature of each crop, and etc. In order for such distribution system to become feasible, the government needs to reconstruct the current distribution system, designate a public organization for providing distribution information and set the criteria for level of produce quality, trade units, and package units. Third, the government should provide financial support and a policy to seek an efficient distribution channel for foreign produce to be delivered fresh: the government should expand distribution facilities (for selecting, packaging, storing, and processing) and transportation vehicles while modernizing old facilities. There should be another policy to improve the efficiency of unloading, and to lower the cost of distribution. Fourth, it is necessary to enact a new law covering exceptional cases for importing produce in order to maintain the price competitiveness; currently the high tariffs is keeping the imported produce from being distributed domestically. However, the new adjustment should be made carefully within the WTO regulations since it can create a problem from giving preferential tariffs. The government can also simplify the distribution channels in order to reduce the cost in the distribution process. Fifth, the government should educate distributors to raise the efficiency and to modernize the distribution system. It is necessary to develop human resources by educating people regarding the foreign agricultural environment, the produce quality, management skills, and by introducing some successful cases in advanced countries.

• Korean small business review
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• v.31 no.2
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• pp.85-102
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• 2009

With the continued globalization of world markets, transfer pricing has become one of the dominant sources of controversy in international taxation. Transfer pricing is the process by which a multinational corporation calculates a price for goods and services that are transferred to affiliated entities. Consider a Korean electronic enterprise that buys supplies from its own subsidiary located in China. How much the Korean parent company pays its subsidiary will determine how much profit the Chinese unit reports in local taxes. If the parent company pays above normal market prices, it may appear to have a poor profit, even if the group as a whole shows a respectable profit margin. In this way, transfer prices impact the taxable income reported in each country in which the multinational enterprise operates. It's importance lies in that around 60% of international trade involves transactions between two related parts of multinationals, according to the OECD. Multinational enterprises (hereafter MEs) exert much effort into utilizing organizational advantages to make global investments. MEs wish to minimize their tax burden. So MEs spend a fortune on economists and accountants to justify transfer prices that suit their tax needs. On the contrary, local governments are not prepared to cope with MEs' powerful financial instruments. Tax authorities in each country wish to ensure that the tax base of any ME is divided fairly. Thus, both tax authorities and MEs have a vested interest in the way in which a transfer price is determined, and this is why MEs' international transfer prices are at the center of disputes concerned with taxation. Transfer pricing issues and practices are sometimes difficult to control for regulators because the tax administration does not have enough staffs with the knowledge and resources necessary to understand them. The authors examine transfer pricing practices to provide relevant resources useful in designing tax incentives and regulation schemes for policy makers. This study focuses on identifying the relevant business and environmental factors that could influence the international transfer pricing of MEs. In this perspective, we empirically investigate how the management perception of related variables influences their choice of international transfer pricing methods. We believe that this research is particularly useful in the design of tax policy. Because it can concentrate on a few selected factors in consideration of the limited budget of the tax administration with assistance of this research. Data is composed of questionnaire responses from foreign firms in Korea with investment balances exceeding one million dollars in the end of 2004. We mailed questionnaires to 861 managers in charge of the accounting departments of each company, resulting in 121 valid responses. Seventy six percent of the sample firms are classified as small and medium sized enterprises with assets below 100 billion Korean won. Reviewing transfer pricing methods, cost-based transfer pricing is most popular showing that 60 firms have adopted it. The market-based method is used by 31 firms, and 13 firms have reported the resale-pricing method. Regarding the nationalities of foreign investors, the Japanese and the Americans constitute most of the sample. Logistic regressions have been performed for statistical analysis. The dependent variable is binary in that whether the method of international transfer pricing is a market-based method or a cost-based method. This type of binary classification is founded on the belief that the market-based method is evaluated as the relatively objective way of pricing compared with the cost-based methods. Cost-based pricing is assumed to give mangers flexibility in transfer pricing decisions. Therefore, local regulatory agencies are thought to prefer market-based pricing over cost-based pricing. Independent variables are composed of eight factors such as corporate tax rate, tariffs, relations with local tax authorities, tax audit, equity ratios of local investors, volume of internal trade, sales volume, and product life cycle. The first four variables are included in the model because taxation lies in the center of transfer pricing disputes. So identifying the impact of these variables in Korean business environments is much needed. Equity ratio is included to represent the interest of local partners. Volume of internal trade was sometimes employed in previous research to check the pricing behavior of managers, so we have followed these footsteps in this paper. Product life cycle is used as a surrogate of competition in local markets. Control variables are firm size and nationality of foreign investors. Firm size is controlled using dummy variables in that whether or not the specific firm is small and medium sized. This is because some researchers report that big firms show different behaviors compared with small and medium sized firms in transfer pricing. The other control variable is also expressed in dummy variable showing if the entrepreneur is the American or not. That's because some prior studies conclude that the American management style is different in that they limit branch manger's freedom of decision. Reviewing the statistical results, we have found that managers prefer the cost-based method over the market-based method as the importance of corporate taxes and tariffs increase. This result means that managers need flexibility to lessen the tax burden when they feel taxes are important. They also prefer the cost-based method as the product life cycle matures, which means that they support subsidiaries in local market competition using cost-based transfer pricing. On the contrary, as the relationship with local tax authorities becomes more important, managers prefer the market-based method. That is because market-based pricing is a better way to maintain good relations with the tax officials. Other variables like tax audit, volume of internal transactions, sales volume, and local equity ratio have shown only insignificant influence. Additionally, we have replaced two tax variables(corporate taxes and tariffs) with the data showing top marginal tax rate and mean tariff rates of each country, and have performed another regression to find if we could get different results compared with the former one. As a consequence, we have found something different on the part of mean tariffs, that shows only an insignificant influence on the dependent variable. We guess that each company in the sample pays tariffs with a specific rate applied only for one's own company, which could be located far from mean tariff rates. Therefore we have concluded we need a more detailed data that shows the tariffs of each company if we want to check the role of this variable. Considering that the present paper has heavily relied on questionnaires, an effort to build a reliable data base is needed for enhancing the research reliability.