• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.12 no.6
• /
• pp.2668-2676
• /
• 2011

In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

• Journal of agricultural medicine and community health
• /
• v.16 no.2
• /
• pp.179-194
• /
• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• Environmental and Resource Economics Review
• /
• v.17 no.2
• /
• pp.419-455
• /
• 2008

This paper analyses the Night Thermal-storage Power Service(NTPS) from the perspective of sustainability. It investigates the economic, environmental and social aspects of NTPS, thereby reveals that NTPS triggers the inefficient use of fuel, the increase of carbon dioxide emission and the increase of cross subsidy between consumers. This paper also analyses NTPS from the perspective of energy security. It investigates how NTPS makes LNG demand volatile in winter, thus threatens our energy security. According to the analysis, NTPS directly violates two basic principles of national energy policy; Sustainability and Energy Security. To solve these problems, not only the harmonized adjustment of Heating Oil Tax and Electric Power Rates is needed to curb the rapier increase of NTPS, but also another separate policy is necessary for converting the electric heating system based on NTPS into the one based on Heating Oil.

• The Journal of the Korea Contents Association
• /
• v.15 no.12
• /
• pp.204-211
• /
• 2015

This study made fundamental approaches on the significance of social enterprises on minority protection policies. In particular, it offered discussions focused on the relationship between social enterprises and North Korean defectors which greatly affect minority policies. Study results can be summed up as follows. First, the greatest difficulties for North Korean defectors in their adjustment to Korean society are economic activities and a sense of social differences and social enterprises are a policy which can resolve these problems in the most effective way. Second, existing social enterprises were excessively run by the central government and they were support models which lacked creativity and development. To resolve such problems, a lesson was learned that these must change into policy models with local coproduction. Third, a lesson was learned that social enterprises offer more than simple economic activity, offering the proper functions of society, culture, living, and language, and thus the participation of North Korean defectors in social enterprises should be made mandatory in certain sectors. Such research results will contribute to theoretically explaining the relationship between North Korean defectors and social enterprises as minority policies.

• Journal of Preventive Medicine and Public Health
• /
• v.42 no.4
• /
• pp.267-273
• /
• 2009

Objectives : To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser s comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. Methods : This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. Results : Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: ${\pm}$10.2) and 64.8% of the population was male. Among them, 1,598 2.6%) had died in hospital. While the predictive ability of the Elixhauser's comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. Conclusions : In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.

• Health Policy and Management
• /
• v.15 no.2
• /
• pp.70-83
• /
• 2005

The purpose of this paper is to examine the relationship between socio-economic factors and self-rated health among older people living in the community. In addition, the study tries to determine whether risk differentials by these socio-economic factors can be explained by other demographic factors, chronic diseases, and functional status. We surveyed to investigate the self-rated health of 397 study samples which had been selected by stratified randomized sampling, $2.7\%$ by each Dong (district) of S-city in Gyeonggi-do. Our study found that the socioeconomic factors such as income, occupation, and insurance were significantly associated with self-rated health. The level of social economic status was positively associated with the level of self-rated health. Two-staged multivariate analysis demonstrated that this relationship was still significant even after adjustment for demographic factors, chronic diseases, and functional status. In conclusion, there are wide socio-economic disparities in self-rated health of older people in this community. It is important that government should know not only health status but also the health-associated factors in order to prepare for the aged society and improve the health status of the elderly. Further researches should uncover causality and mechanism by which SES affects changes in functional health among the elderly.

• Health Policy and Management
• /
• v.16 no.4
• /
• pp.24-47
• /
• 2006

Based on the findings of a study focused on medical institutions(Fama & French, 2002), this study determined possible causality between determinants of capital structure and liability level, while estimating targeted debt ratio. Moreover, it also examined hypotheses about the adjustment of targeted debt ratio and the of fundraising patterns, so that it verified the relative priority of trade-off theory and pecking order theory. First, profitability had positive(+) relationships with liability level, while investment opportunities had negative(-) relationships with liability level. This finding supported pecking order theory, and non-liability tax shield effects had negative(-) relationships with liability level as estimated in both trade-off theory and pecking order theory. Next, this study verified trade-off and pecking order theory at once by means of regression analysis about the variation of liability level in associations with disparity from targeted debt ratio and short-term fluctuation of profit and investment. As a result, it was noted that liability level became mean-reversed to targeted liability ratio but slowly, SO it was difficult to assert that such mean reverse may support trade-off theory. However, the finding that most of short-term fluctuations of profit and investment are absorbed into liabilities supported pecking order theory. On the other hand, it was found that the larger scale of medical institutions is more supportive of pecking order theory in the associations between liability level and profitability and the fundraising patterns than trade-off theory.

• Health Policy and Management
• /
• v.25 no.2
• /
• pp.107-117
• /
• 2015

Background: The purpose of this study is to analyze the cost for the denture treatment in accordance with the government's plan to expand the National Health Insurance coverage for dental prothesis from July 1, 2012. Methods: We developed the draft of classification of the treatment activities based on the existing researches and expert's review and finalized the standard procedures through confirming by Korean Dental Association. We also made the list of input at each stage of treatments. We conducted survey of 100 dental clinics via post from April 4 to May 20 in 2011 and 37 clinics took part in the survey. The unit of cost calculation is the process from the first visit for denture treatment to setting of denture and adjustment. The manufacturing process performed by dental technician was not included in the cost analysis. Results: The process for the complete denture treatment was classified with 10 stages. The partial denture treatment was classified with 8 stages. The treatment time per each denture is about 5.6 hours for complete dentures and about 6.6 hours for partial dentures. The treatment cost were from 591,108 won to 643,913 won for complete denture and from 670,219 won to 738,840 won for partial denture in 2011, depending on the location, type of the clinics and the types of physician's income. Conclusion: This study shows the example of cost analysis for the treatment to set the fee schedule. Measures to get representative and accurate information need to be made.

• Journal of Digital Contents Society
• /
• v.19 no.1
• /
• pp.35-41
• /
• 2018

The Q-learning algorithm based on reinforcement learning is useful for learning the goal for one behavior at a time, using a combination of discrete states and actions. In order to learn multiple actions, applying a behavior-based architecture and using an appropriate behavior adjustment method can make a robot perform fast and reliable actions. Q-learning is a popular reinforcement learning method, and is used much for robot learning for its characteristics which are simple, convergent and little affected by the training environment (off-policy). In this paper, Q-learning algorithm is applied to a lamp robot to learn multiple behaviors (human recognition, desk object recognition). As the learning rate of Q-learning may affect the performance of the robot at the learning stage of multiple behaviors, we present the optimal multiple behaviors learning model by changing learning rate.

• Journal of Korea Port Economic Association
• /
• v.23 no.2
• /
• pp.63-86
• /
• 2007

Historically, government has facilitated logistics by building the airports, the seaports, the rail and transit lines, subsidized their operations where necessary, and established the basic laws and regulations pursuant to which the industry serves the public. In the late 1990s and early 2000s, Korean government began to prepare the basic laws of logistics and nowadays it has tried to refine national logistics laws to reflect contemporary industry conditions and evolving ideological attitudes. The policy objectives governing logistics regulation have changed significantly since 2000. This article traces the current status of the Korean logistics laws which regulate one of the nation's most important industries and suggests certain amendment of current laws.