• 보건행정학회지
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• 제28권2호
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• pp.178-185
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• 2018

Background: We investigated association between introduction of the diagnosis-related groups (DRG) system for anal operation and length of stay. Also, we investigated how it is different among hospitals with longer length of stay and among hospitals with shorter length of stay before introduction of the DRG system. Methods: We used data from Health Insurance Review and Assessment which were national health insurance claim data. Total 13,111 cases of anal surgery cases were included which were claimed by hospitals since July 2012 to June 2014. Two-level multivariable regression was conducted to analysis the association between length of stay and characteristics of hospital and patient. Results: Before introducing DRGs, the average length of stay was 5.41 days. After introducing DRGs, average length of stay was decreased to 3.92 days. After introducing DRGs, length of stay has decreased (${\beta}=-1.0450$, p<0.0001) and it was statistically significant. Among hospitals which had short length of stay (shorter than mean of length of stay) before introducing DRGs, effect of introducing DRGs was smaller (${\beta}=-0.4282$, p<0.0001). On contrary, among hospitals which had long length of stay (longer than mean of length of stay) before introducing DRGs, effect of introducing DRGs was bigger (${\beta}=-1.8280$, p<0.0001). Conclusion: Introducing DRGs was more effective to hospitals which had long length of stay before introducing DRGs.

• 보건행정학회지
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• 제24권3호
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• KDI Journal of Economic Policy
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• 제33권1호
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• pp.93-124
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• 2011

본고에서는 Tversky and Kahneman(1974)의 기준점 효과와 Kahneman and Tversky(1979)의 전망이론으로 해석이 가능한 현상이 우리나라 자산시장에 동시에 나타나는지를 주가 및 부동산 가격을 대상으로 검증하였다. 전망이론의 경우 위험 회피 성향 투자자가 가격 상승 시 매각을 선호하는 것으로 예측하는데, 본고는 이런 성향이 자산가격 수익의 변동성이 증가하는 경우 더 강화되는 것으로 보았다. 1990년대 이후 우리나라 자료를 바탕으로 실증분석한 결과, 과거 수익률이 양(+)인 경우, 주가수익률은 과거 20 또는 30 영업일 자료(window)를 이용하여 산출한 변동성에, 아파트를 제외한 주택가격 수익률은 과거 24~36개월의 자료를 이용하여 산출한 변동성에 각각 통계적으로 유의한 영향을 받는 것으로 나타났다.

• 보건행정학회지
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• 제9권1호
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• pp.72-109
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• 1999

This study is conducted to investigate the current status on the utilization of health care and plan for solving this problem. The claims data of the fiscal tear 1995 obtained from the regional health insurance society are used for the study. The main findings of the study are summarized as follows. Indexes(The Extremal Quotient(EQ), coefficients of variance(CV's))which represent the regional difference in the admission rate of the tertiary medical diagnosis group report that there is difference in quantity and quality of utilization of health care. The admission rate is lower in the big city areas, Kyoungkido, Kangwondo and Chunlapukdo. Even after age-sex adjustment, the admission rate is still low in Kangwondo, Chunlapukdo and Kyoungsangpukdo. The big city areas tend to have higher rates in the expenses per claim, hospital days per claim, and daily expenses but the rates are still low in some area in Kangwondo, Chunlanamdo and Kyoungsangpukdo. This result remains as same after age-sex adjustment. There is a large regional difference in average utilization rate for the tertiary hospital of the tertiary medical diagnosis group: 57.2%(SD 11.53). The utilization rates for the tertiary hospital in their large catchment area are 96.34%, 83.19% and 73.22% in each Kyoungin, Kyoungnam and Kyoungpuk areas whereas it is lower in a Chungpuk and Chungnam areas. The regional differences of health care utilization of the tertiary medical diagnosis group gave some relationships with their geographical characteristics such as socio-economic characteristics and supply factors of medical services. It is important that many medical policies should be developed in order to minimize and balance out the regional differences of health care utilization. The service allocation policy should include the reconstruction of manpower policy, developing the resource allocating formula, finding the self-sufficient catchment area and reforcing of public health services. Moreover, in order to achieve the balanced development by region, they should investigate and consider each county's microscopic properties under the consistent macrocopic policy. The further studies to find causes of regional difference are needed.

• Journal of Preventive Medicine and Public Health
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• 제56권4호
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• pp.312-318
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• 2023

Objectives: We reviewed the operational definitions of colorectal cancer (CRC) from studies using the Korean National Health Insurance Service (NHIS) and compared CRC incidence derived from the commonly used operational definitions in the literature with the statistics reported by the Korea Central Cancer Registry (KCCR). Methods: We searched the MEDLINE and KoreaMed databases to identify studies containing operational definitions of CRC, published until January 15, 2021. All pertinent data concerning the study period, the utilized database, and the outcome variable were extracted. Within the NHIS-National Sample Cohort, age-standardized incidence rates (ASRs) of CRC were calculated for each operational definition found in the literature between 2005 and 2019. These rates were then compared with ASRs from the KCCR. Results: From the 62 eligible studies, 9 operational definitions for CRC were identified. The most commonly used operational definition was "C18-C20" (n=20), followed by "C18-C20 with claim code for treatment" (n=3) and "C18-C20 with V193 (code for registered cancer patients' payment deduction)" (n=3). The ASRs reported using these operational definitions were lower than the ASRs from KCCR, except for "C18-C20 used as the main diagnosis." The smallest difference in ASRs was observed for "C18-C20," followed by "C18-C20 with V193," and "C18-C20 with claim code for hospitalization or code for treatment." Conclusions: In defining CRC patients utilizing the NHIS database, the ASR derived through the operational definition of "C18-C20 as the main diagnosis" was comparable to the ASR from the KCCR. Depending on the study hypothesis, operational definitions using treatment codes may be utilized.

• Safety and Health at Work
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• 제14권4호
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• pp.398-405
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• 2023

Background: Starting from March 2020 until December 2021, different phases of Covid-19 pandemic have been identified in Italy, with several containing/lifting measures progressively enforced by the National government. In the present study, we investigate the change in occupational risk during the subsequent pandemic phases and we propose an estimate of the incidence of the cases by economic sector, based on the analysis of insurance claims for compensation for Covid-19. Methods: Covid-19 epidemiological data available for the general population and injury claims of workers covered by the Italian public insurance system in 2020-2021 were analyzed. Monthly Incidence Rate of Covid-19 compensation claims per 100,000 workers (MIRw) was calculated by the economic sector and compared with the same indicator for general population in different pandemic periods. Results: The distribution of Covid-19 MIRw by sector significantly changed during the pandemic related to both the strength of different waves and the mitigation/lifting strategies enforced. The level of occupational fraction was very high at the beginning phase of the pandemic, decreasing to 5% at the end of 2021. Healthcare and related services were continuously hit but the incidence was significantly decreasing in 2021 in all sectors, except for postal and courier activities in transportation and storage enterprises. Conclusion: The analysis of compensation claim data allowed to identify time trends for infection risk in different working sectors. The claim rates were highest for human health and social work activities but the distribution of risk among sectors was clearly influenced by the different stages of the pandemic.

• 아동학회지
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• 제16권1호
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• pp.79-88
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• 1995

The purpose of this study was to investigate whether the experience of computer programming in Logo geometry advances the development of young children's concepts and/or representation of Euclidian spatial relations, particularly their concepts of the vertical-horizontal. Papert's claim of the positive effects of Logo programming experiences on young children's cognitive development was tested using the Piagetian Water Level Test (PWLT), the Free Hand Drawing Test (FHDT), and the Computer Drawing Test (CDT). Forty-four subjects were drawn from 2nd graders attending a public elementary school in Ithaca. The subjects were divided into 2 groups: a treatment group (TG) with Logo training for 10 weeks and a control group (CG) without Logo training. Our results showed that TG did not make any significant improvement on PWLT. In contrast, TG outperformed CG on FHDT. We suggested several possible explanations for this contradiction.

• 한국BIM학회 논문집
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• 제5권2호
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• pp.26-33
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• 2015

Design-build projects were devised to enhance the design technologies of the domestic construction industry and the efficiency of public works, contributing greatly to the development of construction technologies. However, as various stages of the process, such as formulation of basic plans and design documents, and deliberations proceed, claims, including changes in the requirements of clients, and design changes occur. These claims result in the delay in construction and an increase in construction costs. In this regard, this study attempted to identify main claims that delay construction and increase the costs of design-build projects, prevent claims in the future, and improve the efficiency of project implementation.

• 보험의학회지
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• 제27권1호
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• pp.6-8
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• 2008

Korean life insurance medical association's public periodical, the Journal of Korean Life Insurance Medical association (J Kor Lif Ins Med Assoc, JKLIMA) is now published $27^{th}$ issue. From this issue there are some changes of the journal than before. It is because general requirements for medical journals from the Korean association of medical journals editors. It can be remedy for the development of JKLIMA, in terms of academicism. First, the style of the manuscripts, medical opinion of insurance administration is added. This style of manuscript needs not keep the format of original research article such as background, materials, results, and discussion. Secondly, It is emphasized that submitted manuscripts must be reviewed by peer reviewers. Thirdly, we will make an effort to globalization of our journal. Lastly the publication period has been changed from annual to biannual. The publication date will be at March 31st and September 30th every year.

• Tuberculosis and Respiratory Diseases
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• 제52권6호
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• pp.579-589
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• 2002

Since the inception of the National Tuberculosis Control Program in 1962, the incidence of tuberculosis and its associated mortality has declined dramatically due to effective anti-tuberculosis drugs and a systematic control program. The prevalence of radiographically active tuberculosis has fallen from 5.1% in 1965 to 1.0% in 1995. However, tuberculosis is still a major problem, as the mortality rate is still higher compared to other developed countries. Furthermore, tuberculosis is currently re-emerging in HIV/AIDS epidemic countries. In order to lower the tuberculosis death rate to the levels of developed countries, the tuberculosis control efforts in private healthcare institutions and the national tuberculosis control program in the public sector, need to work together more effectively and efficiently. In this paper, the quthor reviewed the current situation regarding tuberculosis management in private healthcare institutions of Korea based on the literature and the National Health Insurance Claim data, and the future tasks of tuberculosis management are suggested.