• Title/Summary/Keyword: public claim

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Investigating the Level of Competition between Public Health Centers and Private Clinics in Korea

  • Kim, Hyun Joo;Lee, Jin Yong;Jo, Min-Woo;Eun, Sang Jun
    • Korea Journal of Hospital Management
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    • v.21 no.2
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    • pp.37-49
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    • 2016
  • The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

A Study on the Reading Movement of Public Library (공공도서관에서의 독서운동에 관한 연구)

  • 이만수
    • Journal of Korean Library and Information Science Society
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    • v.34 no.4
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    • pp.105-125
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    • 2003
  • This study is on the reading movement of public library. The purpose of this study is to provide who and how to campaign reading for library users. In conclusion, I'd like to claim that the dean of public library have to make efforts first and the librarians also have to develop various programs for library users continually.

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A Study on the First Modern Public Library in Korea: - Focusing on Japanese Hongdohoe Library - (우리나라 최초의 근대 공공도서관 규명에 관한 연구 - 일본홍도회도서실을 중심으로 -)

  • Kim, Young-Seok;Lee, Yong-Jae
    • Journal of Korean Library and Information Science Society
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    • v.49 no.2
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    • pp.131-150
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    • 2018
  • Many researchers and librarians in library and information science area in Korea and Japan claim that Japanese Hongdohoe Library is the first modern public library in Korea. The results of analysis of the study reveal that the claim should be reconsidered because of the following reasons. Firstly, Hongdohoe Library was established in Korea but was established by Japanese. Secondly, the library was established for Japanese in Busan and operated for a long time for the use of Japanese people in Busan. Thirdly, most of the collection of the library were revealed as Japanese materials. Fourthly, the Japanese Hongdohoe which established the library was the organization that supported Japanese militarism before and during the Japanese occupation of Korea.

A Study on the Method of Blasting Demolition of Reinforced Concrete Structures (RC구조물 발파해체공법 연구)

  • 최영천
    • Explosives and Blasting
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    • v.20 no.3
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    • pp.83-96
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    • 2002
  • Reconstruction and redevelopment of old and dilapidated apartment and housing have been increasing to provide more housing accommodation and to secure the safety of building structures since the middle of 1990's. Since, however, little researches on the demolition technique have been made, conventional mechanical demolition method were applied to the most of works that resulted in flooding in small demolition companies. Problems associated with mechanical demolition method are increase not only in working days and costs, but also in public claims, particularly for high-rise building structures. This is to contribute the demolition industries bt providing the concept, standards, and technique of demolition engineering while maximizing working efficiency and minimizing public claims.

Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women (우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계)

  • Kang, Hye-Young;Kang, Dae-Ryong;Jang, Young-Hwa;Park, Sung-Eun;Choi, Won-Jung;Moon, Seong-Hwan;Yang, Kyu-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.287-294
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    • 2008
  • Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

Impact of public releasing of hospitals' performance on acute myocardial infarction outcomes (병원의 급성심근경색증 진료 결과 공개의 효과)

  • Eun, Sang Jun;Kim, Yoon;Lee, Eun Jung;Jang, Won Mo
    • Quality Improvement in Health Care
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    • v.17 no.1
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    • pp.69-78
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    • 2011
  • Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

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A Chinese Case of Coronavirus Disease 2019 (COVID-19) Did Not Show Infectivity During the Incubation Period: Based on an Epidemiological Survey

  • Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.67-69
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    • 2020
  • Controversy remains over whether the coronavirus disease 2019 (COVID-19) virus may have infectivity during the incubation period before the onset of symptoms. The author had the opportunity to examine the infectivity of COVID-19 during the incubation period by conducting an epidemiological survey on a confirmed patient who had visited Jeju Island during the incubation period. The epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period.

COVID-19 International Collaborative Research by the Health Insurance Review and Assessment Service Using Its Nationwide Real-world Data: Database, Outcomes, and Implications

  • Rho, Yeunsook;Cho, Do Yeon;Son, Yejin;Lee, Yu Jin;Kim, Ji Woo;Lee, Hye Jin;You, Seng Chan;Park, Rae Woong;Lee, Jin Yong
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.1
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    • pp.8-16
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    • 2021
  • This article aims to introduce the inception and operation of the COVID-19 International Collaborative Research Project, the world's first coronavirus disease 2019 (COVID-19) open data project for research, along with its dataset and research method, and to discuss relevant considerations for collaborative research using nationwide real-world data (RWD). COVID-19 has spread across the world since early 2020, becoming a serious global health threat to life, safety, and social and economic activities. However, insufficient RWD from patients was available to help clinicians efficiently diagnose and treat patients with COVID-19, or to provide necessary information to the government for policy-making. Countries that saw a rapid surge of infections had to focus on leveraging medical professionals to treat patients, and the circumstances made it even more difficult to promptly use COVID-19 RWD. Against this backdrop, the Health Insurance Review and Assessment Service (HIRA) of Korea decided to open its COVID-19 RWD collected through Korea's universal health insurance program, under the title of the COVID-19 International Collaborative Research Project. The dataset, consisting of 476 508 claim statements from 234 427 patients (7590 confirmed cases) and 18 691 318 claim statements of the same patients for the previous 3 years, was established and hosted on HIRA's in-house server. Researchers who applied to participate in the project uploaded analysis code on the platform prepared by HIRA, and HIRA conducted the analysis and provided outcome values. As of November 2020, analyses have been completed for 129 research projects, which have been published or are in the process of being published in prestigious journals.

Key Public Health Issue Priorities in Asian Countries (아시아지역 국가들의 보건문제 우선과제에 대한 조사연구)

  • Yu Myeong-Ae;Oh Won-Taek;Lee Cherl-Ho
    • Journal of Food Hygiene and Safety
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    • v.21 no.3
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    • pp.164-170
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    • 2006
  • Asian Branches of International Life Science Institute (ILSI), i.e. China, India, Japan, Korea and South East Asian Region, identified five key public health issue priorities of each region and compared the results. In case of China, India and South East Asian countries (Indonesia, Malaysia, Philippines, Thailand etc. ASEAN countries), communicable diseases were the first priority issue, while elderly issue and food safety were prime issues for Japan and Korea, respectively. Malnutrition was the second priority issue for India and ASEAN countries, whereas non-communicable disease like cancer and degenerative diseases was for Korea and China, and obesity far Japan. Typical issues were smoking for China, nutrition education for China and Japan, biotechnology aiming GMO for India, and functional food causing health claim problem for Korea and Japan. Although the priority varied with the socioeconomic situation of each county, food and water safety recorded the highest priority of all the countries. The key public health issues of Korea were discussed in detail.

The Status of Unilateral Arbitration Agreements Through the U.S. Case Laws (미국법원의 판례를 통한 선택적 중재합의의 지위)

  • Ha, Choong-Lyong;Park, Won-Hyung
    • Journal of Arbitration Studies
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    • v.17 no.1
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    • pp.77-95
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    • 2007
  • This article focuses on the history and evolution of the US court's attitude towards unilateral arbitration and dispute resolution clauses, but also considers the practical approach of national courts to theses clauses. It goes on to consider some potential pitfalls in the operation of unilateral clauses, which should be borne in mind when developing a strategy for bringing or defending a claim which falls within the scope of a unilateral clause. There can be few objections to the general validity of unilateral arbitration clauses. The principle of party autonomy is the driving force behind international arbitration and, provided it is tolerably clear that the parties intended the arbitration clause to operate unilaterally, courts should be reluctant to interfere with the parties' agreement. There are also no persuasive public policy reasons why such clauses should not be upheld in commercial agreements. In addition to the issue of whether such unilateral clauses are permissible under certain law, it is important to be aware of how they should properly operate in practice, that is, useful guidance on the subject of the proper operation and effect of such clauses where they are intended to be used to enable a party to decide whether, and in what circumstances, a claim should be referred to court or to arbitration.

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