• Title/Summary/Keyword: public claim

검색결과 170건 처리시간 0.023초

Functional Movement Screen as a Predictor of Occupational Injury Among Denver Firefighters

  • Shore, Erin;Dally, Miranda;Brooks, Shawn;Ostendorf, Danielle;Newman, Madeline;Newman, Lee
    • Safety and Health at Work
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    • 제11권3호
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    • pp.301-306
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    • 2020
  • Background: The Functional Movement Screen (FMSTM) is a screening tool used to assess an individual's ability to perform fundamental movements that are necessary to do physically active tasks. The purpose of this study was to assess the ability of FMS to predict occupational injury among Denver Fire Department firefighters. Method: FMS tests were administered from 2012 to 2016. Claim status was defined as any claim occurrence vs. no claim and an overexertion vs. no claim/other claim within 1 year of the FMS. To assess associations between FMS score and claim status, FMS scores were dichotomized into ≤ 14 and > 14. Age-adjusted odds ratios were calculated using logistic regression. Sensitivities and specificities of FMS predicting claims at various FMS score cut points, ranging from 10 to 20 were tested. Results: Of 581 firefighters (mean ± SD, age 38 ± 9.8 y) who completed FMS between February 2015 and March 2018, 188 (32.4%) filed a WC claim in the study time frame. Seventy-two of those (38.3%) were categorized as overexertion claims. There was no association between FMS score and claim status [odds ratio (OR) = 1.27, 95% confidence interval (CI): 0.88 - 1.83] and overexertion claim vs. no claim/other claim (OR = 1.33, 95% CI: 0.81 - 2.21). There was no optimal cutoff for FMS in predicting a WC claim. Conclusions: Although the FMS has been predictive of injuries in other populations, among this sample of firefighters, it was not predictive of a future WC claim.

여성의 종사산업과 자연유산 (Industry of Employment and Spontaneous Abortion of Female Workers)

  • 박정순;나명채;백도명;문옥륜
    • Journal of Preventive Medicine and Public Health
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    • 제27권2호
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    • pp.242-257
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    • 1994
  • In Korea, female workforce has reached more than 40% of total working population, but the effects of work on spontaneous abortion are yet to be examined. This study as conducted to investigate the occupational effects on spontaneous abortion. Medical insurance claim data were used to examine the effects of the employment status and industry of employment on spontaneous abortion. The study population was composed of females, aged $15{\sim}44$, who were the beneficiary of medical insurance in the month of June, 1993. The working females covered by medical insurance for industrial workers, had the highest age-adjusted Spontaneous Abortion rate (SAB rate=claim frequency of spontaneous abortion/claim frequency of complication of pregnancy, childbirth and the puerperium), 6.65% whereas female dependants of medical insurance for industrial workers had the lowest age-adjusted SAB rate, 4.54%. Among industrial workers, the workers in manufacturing industry had the highest age-adjusted Spontaneous Abortion ratio(SAB ratio=claim frequency of spontaneous abortion/claim frequency of completly normal delivery), 43.2/100 whereas those in financing and service industry had age-adjusted SAB ratio, 16.2/100 and 20.5/100, respectively. The results of the study suggest the adverse effect of manufacturing Industry on reproduction. Work environments such as chemical exposures, overwork, awkard posture, and job stress should be further studied for their effects on reproductive functions of female.

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친환경 패션 광고의 친환경 주장 유형과 소비자 언어가 광고효과에 미치는 영향 (The Effects of Environmental Claim Types and Consumer Vocabulary on Eco Fashion Advertisement)

  • 김민영;전은하;고은주
    • 한국의류산업학회지
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    • 제19권2호
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    • pp.166-179
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    • 2017
  • Fashion industry have been emphasizing on eco-friendly business to enhance their public image. Due to the lack of consumers' awareness and experience of eco fashion advertising, this have resulted in adverse outcomes. Therefore, it is required to develop eco fashion advertisement that meets the public interest of Koreans. This study aims to obtain practical implications which can be applied to further eco fashion advertising. The study examines the public opinion towards eco fashion using Twitter as big data analysis and the protracted implication was provided to consumers as consumer vocabulary to see the advertising effect of consumer vocabulary. In addition, this study focuses on the environmental claim types to identify the most effective advertisement in eco fashion. The results are as follow. Associative claim types had a more positive influence on advertising attitude than substantive claim types. Substantive claim types had a more positive influence on brand cognition than associative claim types. In addition, the moderating effects of consumer vocabulary on advertising attitude and brand cognition were supported in substantive claim types. Advertisement attitude shows positive effects to both brand cognition and brand attitude. It has been proved that brand cognition leads to positive influence towards brand attitude and brand attitude eventually increases consumers' urge to buy products. This study has implication when providing a guideline for eco fashion advertisements.

공공공사의 분쟁사례 분석을 통한 클레임예방 체크리스트 개발 (Development of Checklist to Prevent Claim through Dispute Case Analysis of Public Construction Projects)

  • 신창준;김윤겸;조규만;현창택;홍태훈
    • 한국건설관리학회논문집
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    • 제12권1호
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    • pp.13-22
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    • 2011
  • 클레임의 발생원인과 예방에 대하여 많은 연구들이 수행되어 왔으나, 개선방안 혹은 제도개선, 대응방안 등에 대한 연구가 대부분이었다. 특히, 잠재되어 있는 클레임에 대한 구체적인 내용들을 정리하고, 예방을 위한 실무적인 연구는 미흡한 실정이다. 그러므로 향후 발생할 수 있는 클레임에 대해, 그 중 설계단계에서 잠재될 가능성이 큰 원인들을 사전에 검토 및 재확인하여 클레임을 예방할 수 있는 수단이 부족하다. 본 연구에서는, 클레임이 발생되는 시기가 대부분 시공단계이지만 클레임의 원인은 설계단계에서 발생하는 점에 착안하여, 설계단계에서 잠재된 클레임 예방을 위하여 설계단계의 설계서 등을 포함한 계약문서를 중심으로 연구를 수행하였다. 클레임의 근거서류를 준비하고, 관련법규의 적용규정을 확인하면서 클레임 발생원인을 짚어볼 수 있는 체크리스트를 개발하였다.

의료보험 진료비 지급 지연요인 - 병원요인과 보험자 요인을 중심으로 - (A Study of the Factors Causing Delayed Reimbursement of Medical Insurance Benefit)

  • 손명세;이영두;전기홍
    • Journal of Preventive Medicine and Public Health
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    • 제22권2호
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    • pp.259-267
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    • 1989
  • The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

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Public Policy Exception under Russian Law as a Ground for Refusing Recognition and Enforcement of Foreign Arbitral Awards

  • Andreevskikh, Liliia;Park, Eun-ok
    • 한국중재학회지:중재연구
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    • 제32권3호
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    • pp.47-70
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    • 2022
  • This paper studies legal regulation of the public policy exception in the Russian Federation and domestic judicial practice on the issue. It reviews current legislation and analyzes a number of recent court cases where an arbitral award rendered by a foreign arbitration body was refused recognition and enforcement based on public policy violation. By doing so, it contributes to the knowledge on the concept of public policy in the Russian legal system and how public policy can affect the process of recognition and enforcement of foreign arbitral awards on its territory. The review of court cases demonstrates different aspects of how the public policy exception can be applied by Russian arbitrazh courts. Such decisions can provide a clearer picture of the kinds of situation that can lead to invoking the public policy clause by the court. Also, it is of practical value as persons preparing to file a claim or to be a defendant in a Russian court can be required to present existing court decisions in support of their claim or defence.

IMF 경제위기 전.후 지역의료보험가입자들의 진료비 청구내용의 변화 (Change of Medical Utilization Claims in Self-employees before and aster the Economic Crisis in Korea)

  • 이신재;장원기;최순애;이상이;김남순;정백근;문옥륜
    • Journal of Preventive Medicine and Public Health
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    • 제34권1호
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    • pp.28-34
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    • 2001
  • Objectives : To investigate the changing pattern of medical utilization claims following the economic crisis in Korea. Methods : The original data consisted of the claims of the 'Medical insurance program of self-employees' between 1997 and 1998. The data was selected by medical treatment day ranging between 8 January and 30 June. Medical utilizations were calculated each year by the frequency of claims, visit days for outpatients, length of stay for inpatients, total days of medication, and the sum of expenses. Results : The length of stay as an inpatient in 1998 was decreased 4.7 percent in comparison to 1997. However, inpatient expenses in 1998 increased 10.8 percent as compared to 1997. Inpatient hospital claims in 1998 increased 6.2 percent over 1997, although general hospital inpatient claims in 1998 decreased 3.3 percent in comparison to 1997. The outpatient claim frequency decreased 7.3 in 1998 percent as compared to 1997 Outpatient visit days of in 1998 were decreased 8.5 percent in comparison to that recorded in 1997. Outpatient claim frequencies of 'gu region' in 1998 decreased 10.5 percent comparison to that in 1997, but 'city and gun region' decreased less than 'gu region'. Conclusions : Medical utilization in 1998 deceased in relation to 1997 Medical utilization by outpatients decreased more than that of inpatients. Medical utilization by 'gu region' decreased mere than the other regions.

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민원발생시 발파진동.소음의 처리사례에 관한 연구 (Case Study of Blasting Vibration and Noise in Public Resentment Area)

  • 안명석;최영천;박종남;목연수
    • 화약ㆍ발파
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    • 제17권3호
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    • pp.13-22
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    • 1999
  • It Is indispensible to cause vibration, noise and dust to blasting and breaker operations. Since the control of these factors is supposed to be extremely difficult, the claim of compensation for material and mental damages are getting increased. Economically feasible blasting operation with controlling vibration and noise can be achieved by establishment of science-based plan, accurate operation and responsible inspection, and the application of efficient management system. It must also be remarked that the relevant applied without prejudice by the operator, and the law and regulation should be applied without prejudice by the authority concerned. In addition, the public claim against operators should be investigated in detail and the prosecution should be made under the careful onside-ration of scientific and reasonable conception. Finally, it is strongly suggested that the operations, public and authorities should make great efforts to develop higher technology in order to expand our construction market, to overseas.

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영국 보험법의 개혁동향에 관한 연구 - 사기적인 보험금청구에 대한 구제수단을 중심으로 - (A Study on the Trends for Reforming Insurance Law in England - Focused on the Remedies for Fraudulent Claim -)

  • 신건훈
    • 무역상무연구
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    • 제67권
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    • pp.119-142
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    • 2015
  • Many insurers have traditionally incorporated "fraud clauses" into insurance policies, setting out the consequences of making a fraudulent claim. Even in the absence of an express terms, English courts provide insurers with a remedy for a fraudulent claim. However, the law in this area is complex, convoluted and confused. English Law Commission think that the law in this area needs to be reformed for three reasons; (1) the disjunctive between the common law rule and section 17 generates unnecessary disputes and litigation, (2) increasingly, UK commercial law must be justified to an international insurance society, and (3) the rules on fraudulent claims are functioned as a deterrent if they are clear and well-understood. In order for these purposes, English Law Commission recommends a statutory regime to the effect that, when an insured commits fraud in relation to a claim, the insurer should (1) have no liability to pay the fraudulent claim and be able to recover any sums already paid in respect to the claim, and (2) have the option to treat the contract as having been terminated with from the time of the fraudulent act and, if chosen the option, be entitled to refuse all claims arising after the fraud, but (3) remain liable for legitimate losses before the fraudulent act. LC is not recommending a complete restatement of the law on insurance fraud generally. For example, LC does not seek to define fraud, instead, recommends the introduction of targeted provisions to confirm the remedies available to an insurer who discovers a fraud by a policyholder.

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연구를 위한 건강보험 청구자료 요구 및 이용 요인분석 (Assessment of Needs and Accessibility Towards Health Insurance Claims Data)

  • 이정아;오주환;문상준;임준태;이진석;이진용;김윤
    • 보건행정학회지
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    • 제21권1호
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    • pp.77-92
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    • 2011
  • Objectives : This study examined the health policy researchers' needs and their accessibility towards health insurance claim datasets according to their academic capacity. Methods : An online questionnaire to capture relevant proxy variables for academic needs, accessibility, and research capacity was constructed based on previous studies. The survey was delivered to active health policy researchers through three major scholarly associations in South Korea. Seven-hundred and one scholars responded while the survey as open for 12 days (starting on December 20th, 2010). Descriptive statistics and logistic regression analysis were carried out. Results : Regardless of the definition for operational needs, the prevalent needs of survey respondents were not met with the current provision of claim data. Greater research capacity was shown to be correlated with increased demand for claim data along with a positive correlation between attempts to obtain claim datasets and research capacity. A greater research capacity, however, was not necessarily correlated with better accessibility to the claim data. Conclusions : The substantial unmet need for claim data among the healthcare policy research community calls for establishing proactive institutions which could systematically prepare and make available public datasets and provide call-in services to facilitate proper handling of data.