• Health Policy and Management
• /
• v.27 no.4
• /
• pp.273-275
• /
• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• Journal of Food Hygiene and Safety
• /
• v.16 no.4
• /
• pp.280-294
• /
• 2001

Despite to the reality that the outbreaks from flood poisoning in Korea have been continuously increasing in the last two decades, it was very much neglected even in the public health field in Korea. Food poisoning outbreaks resulted in many cases not only in the damage of health but also in the death of many lives. However, this problem can be effectively solved by effects through health education activities, but not solely by the legal measures. This study was carried out to provide information that can be used in planning health education programs and proposing new rules to prevent any possible outbreaks from flood poisoning. The main problems contributing to flood poisoning outbreaks in an institutional setting or school catering and at home were reviewed and analyzed through the epidemiological investigations and articles related to flood poisoning in the last a decade (1991 ∼ 2000). Accordingly, the data presented in this study are sufficient to show and prove the significant trends in food poisoning accidents in Korea. The major findings investigated in this study are as follows. The frequency of food poisoning accidents as well as the number of victims have continuously increased in Korea. The number of victims per food poisoning accident is also increased from 20 persons in 1990 to 69.8 persons in 2000. Therefore, we should realize that the group poisoning outbreaks occur more frequently and the size of group poisoning accidents is getting larger. Among four seasons, the food poisoning accidents occurred more frequently in the summer (May ∼September) until 1997, However, after 1997, the food poisoning accidents occurred evenly in three seasons except the winter. The most important bacteria that cause food poisoning in Korea were Salmonella spp., Vibrio spp. and Staphylococcus aureus. They occupied 85∼90% of the rates of accidents and the number of victims.

• Journal of Food Hygiene and Safety
• /
• v.33 no.1
• /
• pp.1-11
• /
• 2018

It is ten years since the Good Agricultural Practices (GAP) certification system was implemented in Korea, and the government aims to acquire GAP certification up to 25% of the total agricultural areas by 2022. As of the end of 2017, 6.3% of the total cultivated area and 8.1% of the total farm households were certified, which is slower than expected. The purpose of this study was to investigate the causes of the GAP accreditation through the surveys and on site inspections of the GAP certified farmers and to propose the development plans according to the problems analysis of the current system in order to expand the GAP certification. Certified farmers recognized the need for agricultural safety and hygiene, but there were a lot of nonconformities regarding practical practices. This is due to the ambiguity of the certification standards and the wrong ways in the training method for the producers. GAP certification is slow to expand to farmers and low consumer awareness is considered a structural problem of GAP certification system, and improvement measures are needed accordingly. It is necessary to convert the state-led GAP certification system into a state-led private certification system. It is necessary for the government to focus on policy, research and follow-up management. In addition, it is necessary to establish a separate organization in the form of a contribution organization for the certification, education, and public relations. In addition, long-term plan must be established and systematically carried out. It is necessary to integrate too many certification agencies compared to the farming scale of Korea, and it is necessary to realize the application fee for realizing the financial independence of the certification body and correct certification work. In addition, inspector qualification standards should be strengthened and training system should be improved to nurture high quality inspectors. Simplified certification standards based on statutes need to be subdivided into practical action plans. In order to improve the GAP certification system, it is necessary to have a discussion through a committee composed of specialists from industry and academia, and it will be possible to contribute to the safety of the food of the people through the production of safe by drawing concrete development plans.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.138-144
• /
• 2010

Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
• /
• v.24 no.4
• /
• pp.535-547
• /
• 2019

In this study, the heavy metal analysis in sediments (surface sediments, sediments cores and settling particles) from Shihwa Lake has been carried out to evaluate the changes of metal pollution levels in sediments after the operation of Tidal Power Plant (TPP). The average concentrations of metals in surface sediments sampled in 2015 were 8% (Cd)~31% (Zn, Hg) lower than in 2009 before TPP operation. Results of calculating the pollution load index (PLI) with 8 metals, the PLI value in 2015 showed a 18% decrease compared to 2009. However, Cu, Zn, Pb concentrations of surface sediments in 2015 at the upper region around industrial complex still exceeded the TEL (threshold effect level) values for sediment quality guideline in Korea. After the operation of TPP, the metal contaminated depths were increasing from 15 cm to 30 cm at S6 site and from 8 cm to 20 cm at S7 site, respectively. Our data showed that the mean concentration of heavy metals in core samples decreased but the contaminated depth increased. The average of the total sedimentation flux for particulate matter increased by 3.2 times from 32.5 g/㎡/d in 2009 to 103.5 g/㎡/d in 2015. This showed that the bottom sediments were resuspended by the operation of TPP, resulting in an increase of particulate matter in the water column. These results suggest that the sediments contaminated with heavy metals seem to be resuspended and relocated due to the water current caused by the operation of TPP. Cr, Cu, Zn, Pb and Cd were highly exceeding the TEL values in the upstream region and accumulated more than 40 cm of sediment depth, indicating that heavy metal contamination through industrial activity were still a serious environmental problem of Shihwa Lake. Although the metal pollution of Shihwa Lake has been slightly reduced, the contaminated sediments with heavy metals inside of Shihwa Lake might be discharged to outer sea after the resuspension by TPP operation. It is necessary for the advanced scientific approach and political decision to drastically reduce the heavy metal pollution of the study region.

• Journal of Science of Art and Design
• /
• v.3
• /
• pp.145-177
• /
• 2001

The artist's interest has been captivated by ecological phenomena in Nature. Her keen captivation has then been focused into plastic art depicting the image of primitive life. The wide sweep of her work encompasses the totality of nature which consists of the human's subconscious power and imagination which she then portrays by organic images. These organic images are in contrast to scientific, mathematical and logical inference and consciousness. This research examines the character of the organic images in modern art by her analysis of some representative works by others. The image is an essential concept in the art which appeared in very different ways and in different perspectives. The image in the artwork appears to be the realistic expression until the early part of the 20th Century. Well into the 20th Century, it began being expressed in various ways such as combined images by imagination which is combined or rejected in the story of artwork. It also began being expressed by transferred images by changed original conditions. It is the main purpose of this research is to study of various expressions of organic images in the artwork of the Post-Modernism era. The character and meaning of organic image painting helps people to approach the human instinct more easily to find out the natural essence. It is also an objective of the organic image to tenderise our human sensibilities, thus helping us to regain vitality and recover our poor humanity in the barren wilderness of modern society. 'Life communion with nature' is a meeting point and common ground for Oriental Philosophy and organic image painting. Through this research, organic image painting is characterised in the four following ways : 1st) Organic image painting seeks regularity and perfection of outer shapes, in contrast to disordered and deformed nature, resulting in organic and biotic formalistic mode of plastic art. 2nd) Organic image painting seeks the formative. 3rd) Organic image painting pursues the priceless dignity of life by researching the formatted arrangement and figure, which contains primitive power of life. 4th) Organic image painting makes crystal clear the power of human and nature, which is a historic and biological phenomenon. This, in turn, exposes the humanistic view of the world from modern society best characterised in lost self-understanding, isolation and materialism. The representative organic image painting artists are Elizabeth Murray, Kusama Yayoi, and Niki do Saint Phalle. Elizabeth Murray used shaped canvas and a round construction of relief works. Kusama Yayoi used Automatistic expressionism originating from the realms of unconsciousness and which is represented by the mass and shape of a water drop. Niki do Saint Phalle shows the transcendence of universal life and anti-life to respect the dignity of life and the eco-friendliness relationship of human and nature in the post-modernism in art history. This is accomplished by surrealistic, symbolic, fantastic and humoristic expression. These three artists' works express the spirit of the organic image in contemporary art. It contains the stream of nature and life to seek not only the state of materialism in the reality, but also the harmonized world of nature and human which has almost lost the important meaning in modern times. Finally, this organic image is the plastic language of the majestic life. It is the romantic idea that the intimacy of nature and the universe and Surrealism, which emphasizes the unconsciousness , is the source of truth and spirit. Also it is influenced by primitive art and abstract art. According to this research, the subject 'Research About Organic Images' is not only an important element in the plastic arts from primitive society to the present, but is also fundamental to an true understanding of Post-Modernism.

• Journal of Science of Art and Design
• /
• v.10
• /
• pp.161-181
• /
• 2006

The words which appeared in my theoretical study and work are image transformation to digital painting, simulation, heterologie and transfiguration, etc. Firstly, let's look into 'digital era' or 'new media era'. Nowadays, the image world including painting within the rapid social and cultural change, which is called as digital era, is having the dramatic change. Together with the development of scientific technology, large number of events which was deemed to be impossible is happening as real in image world Moreover, these changes in image world is greatly influencing to our life. The word which compresses this change of image world and shows is 'digital'. Digit, which means fingers in Latin, indicates separately changing signal, and to be more narrow, it indicates the continual signal of '0' and ' 1' in computer. The opposite word is 'analogue'. As analogue is the word meaning 'infer' or 'similarity', it indicates the signal or form which continuously changes along the series of time when it is compared to digital. Instead of analogue, digital is embossed as a major ruler along the whole area of our current culture. In whole culture and art area, and in whole generalscience, digital is appearing as it has the modernism and importance. The prefix, 'digital', e.g. digital media, digital culture, digital design, digital philosophy, etc, is treated as the synonym of modernism and something new. This advent of digital results the innovative change to the image world, creates the new beauty experience which we could not experience before, and forecasts the formation of advanced art and expansion of creative area. Various intellectual activities using computer is developing the whole world with making the infrastructure. Computer in painting work immediately accomplishes the idea of painters, takes part in simulation work, contingency such as abrupt reversal, extraction, twisting, shaking, obscureness, overlapping, etc, and timing to stimulate the creativity of painters, and provides digital formative language which enables new visual experience to the audience. When the change of digital era, the image appeared in my work is shown in 'transfiguration' like drawing. The word, 'transfiguration' does not indicate the completed and fixed real substance but indicate endlessly moving and floating shape. Thus, this concept is opposite to the substantial consideration, so that various concepts which is able to replace this in accordance with the similar cases are also exist such as change, deterioration, mutation, deformity of appearance and morphing which is frequently used in computer as a technical word. These concepts are not clearly classified, and variably and complicatedly related. Transfiguration basically means the denial of "objectivity' and '(continual) stagnation' or deviation from those. This phenomenon is appeared through the all art schools of art ever since the realism is denied in the 19th century. It is called as 'deformation' in case of expressionism, futurism, cubism, etc, in the beginning of the century, which its former indication is mostly preserved within the process of structural deviation and which has the realistic limit which should be preserved. On the contrary, dramatic transfiguration which has been showing in the modern era through surrealism is different in the point that dramatic transfiguration tends to show the deterioration and deviation rather than the preservation of indicated object. From this point, transfiguration coming out from morphing using computer deteriorates and hides the reality and furthermore, it replaces the 'reality'. Moreover, transfiguration is closely approached to the world of fake or 'imaginary' simulation world of Baudrillard. According to Baudrillard, the image hides and deteriorates the reality, and furthermore, expresses 'not existing' to 'imaginary' under the name of transfiguration. Certain reality, that is, image which is absent from the reality is created and overflowed, so that it finally replaces the reality. This is simulation as it is said by Baudrillard. In turn, Georges Bataille discusses about the image which is produced by digital technology in terms of heterologie. Image of heterologie is the visual signal which is established with the media. Image of media is to have the continuous characteristics of produce, extinction, and transformation, and its clear boundary between images becomes meaningless. The meaning of composition, excess, violation, etc of digital image is explained to heterological study or heteologie suggested as important meaning of Georges Bataille who is a heretic philosopher. As the form and image of mutation shows the shape in accordance with mechanical production, heterologie is introduced as very low materialism (or bas materialisme), in this theory. Heterologie as low materialism which is gradually changing is developing as a different concept and analysis because of the change of time in the late 20s century beside high or low meaning. Including my image, all images non-standardizes and transforms the code. However, reappearance and non-standardization of this code does not seem to be simple. The problem of transformation caused by transfiguration which appears in my digital drawing painting, simulation, heterologie, etc, are the continual problems. Moreover, the subject such as existence of human being, distance from the real life, politics and social problems are being extended to actual research and various expressing work. Especially, individual image world is established by digital painting transfiguration technique, and its change and review start to have the durability. The consciousness of observers who look at the image is changing the subject. Together with theoretical research, researchers are to establish the first step to approach to various image change of digital era painting through transfiguration technique using our realistic and historical image.

• Korean Journal of Soil Science and Fertilizer
• /
• v.8 no.3
• /
• pp.135-152
• /
• 1975

The following informations are known from physical and chemical characteristics of orchard soils and nutritional diagnosis of orange leaves in Jeju. 1. Most orange orchards are located on terrace and cindercone thus soil moisture and microclimate of an orchard will greatly be affected by its topography. 2. Excessive well drainage, shallow soil depth, high content of gravels, low solid phase ratio and strong wind will give severe problem of soil moisture and wind errosion, thus the exte- nsion of soil depth is necessary for maintain nutrients, water and sufficient root volume. 3. Available soil water was significantly and positively correlated with organic matter content and clay content also contributes to available soil water. Vinyl mulching was greatly helpful for soil water conservation, wind errosion prevention, soil temperature increases during winter. 4. Abundant amphoteric amorphous allophane take a key role to fix phosphorus and also rations and thus it is the major factor to determine fertilizer efficiency. Lime and phosphorus must be applied in deeper soil layer. Release of filed phosphorus must be reevluated for availability. 5. Organic matter such as see weeds will greatly increase fertilizer efficiency and low fertilizer efficiency during spring may be related to available soil water. 6. Nitrogen was in superoptimum and Mg was enough but P and Ca were somewhat deficient according to leaf analysies while K was deficient according to fruit analysis. Phosphorus application increased sugar/acid ratio and potassium decreases rind percentage. 7. Manganese deficiency and toxicity appeared in a few places. Iron and boron were enough. Most places showed tendency of copper excess but some places showed copper deficiency. 8. Soiling after elimination of rock base, application of slow release fertilizer and abundant organic matter, vinyl mulching and drip irrigation will increase fertilizer efficiency greatly and fruit yield drastically.

• Radiation Oncology Journal
• /
• v.24 no.4
• /
• pp.309-316
• /
• 2006

$\underline{Purpose}$: To analyze the recent citation trend and to find a way to improve impact factor (IF) of the Journal of Korean Therapeutic Radiology and Oncology (JKSTRO) by analysis of Korean Medical Citation Index (KoMCI) citation data of JKSTRO and comparison with that of mean citation data of all journals enlisted on KoMCI (KoMCI journals) during 2000-2005. $\underline{Materials\;and\;Methods}$: All citation data of entire journals enlisted on KoMCI and JKSTRO from 2000 to 2005 were obtained from KoMCI. The trend of total and annual number of published articles and reference citations, total citations and self-citations per paper, IF and impact factor excluding self-citations (ZIF) were described and compared on both KoMCI journals and JKSTRO. $\underline{Results}$: Annual number of published articles was decreased for 6 years on both KoMCI journals and JKSTRO (32% and 38% reduction rate). The number of Korean journal references per article is 1.6 papers on JKSTRO comparing to 2.0 papers on KoMCI journals. The percentage of Korean references/total references increased from 5.0% in 2000 to 7.7% in 2005 on JKSTRO and from 8.5% in 2000 to 10.1% on KoMCI journals. The number of total citations received/paper on JKSTRO (average 1.333) is smaller than that of KoMCI journals (average 1.694), there was an increased rate of 67% in 2005 comparing to 2000. The percentage of self-citations/total citations (average 72%) on JKSTRO is slightly higher than that of KoMCI journals (average 61%). IF of JKSTRO was gradually improved and 0.144, 0.125, 0.088, 0.107, 0.187, and 0.203 in 2000-2005 respectively. However, ZIF of JKSTRO is steadily decreased from 0.038 in 2000 to 0.013 in 2005 except 0.044 in 2004. $\underline{Conclusion}$: IF of JKSTRO was slightly improved but had some innate problem of smaller number of citations received. To make JKSTRO as a highly cited journal, the awareness of academic status of JKSTRO and active participation of every member of JKSTRO including encouraging self-citations of papers published recent 2 years and submission of English written papers, and active academic cooperation with related academic societies.

• Journal of Chest Surgery
• /
• v.38 no.4 s.249
• /
• pp.277-283
• /
• 2005

Arterial oxygen saturation $(SaO_2)$ instability frequently takes place after systemic-pulmonary shunt without shunt occlusion. We analyzed actual incidence and risk factors for $SaO_2$ instability after shunt operations, and possible mechanisms were speculated on. Material and Method: Ninety three patients, who underwent modified Blalock-Taussig shunt from January 1996 to December 2000, were enrolled in this study. Adequacy of shunt was verified in all patients, either by ensuing one ventricle or biventricular repair later on or by appropriate pulmonary artery growth on postoperative angiogram. Age, body weight, hemoglobin level at operation were 3 day to 36 years (median: 1.8 months), 2.5kg to 51kg (median: 4.1kg) and $10.7\~24.3$ gm/dL (median: 15.2 gm/dL) respectively. Preoperative diagnoses were functional single ventricle with pulmonary stenosis or atresia in 39, tetralogy of Fallot in 38 and pulmonary atresia with intact ventricular septum in 16. Pulmonary blood flow (PBF) was maintained pre-operatively by patent ductus or previous shunt in 64 and by forward flow through stenotic right ventricular outflow tract (RVOT) in 29. $SaO_2$ instability was defined as $SaO_2$ less than $50\%$ for more than 1 hour with neither anatomic obstruction of shunt nor respiratory problem. Result: 10 patients $(10.7\%)$ showed $SaO_2$ instability after shunt operation. After shunt occlusion was ruled out by echocardiogram, they received measures to lower pulmonary vascular resistance (PVR), which worked within a few hours in all patients. Risk factors for $SaO_2$ instability included older age at operation (p=0.039), lower preoperative $SaO_2$ (p=0.0001) and emergency operation (p=0.001). PBF through stenotic RVOT showed marginal statistical significance (p=0.065). Conclusion: $SaO_2$ instability occurs frequently after shunt operation, especially in patients with severe hypoxia pre-operatively or unstable clinical condition necessitating emergency operation. Temporary elevation of pulmonary vascular resistance is a possible mechanism in this specific clinical setting.