• Health Policy and Management
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• v.17 no.3
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• Child Health Nursing Research
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• v.12 no.1
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• pp.15-24
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• 2006

Purpose: This study was done to define nursing behavior in neonatal intensive care units so as to estimate resource-based relative value-. Method: Participating in this study were 292 nurses in neonatal intensive care units. The study surveyed physical and mental labor, stress and time involved in nursing work. Tool used in this study was a nursing labor per relative value tool. For analyzes, the relative value of each nursing behavior was calculated, where the mean value of the three components, labor intensity and component-by-component explanatory power were in percentage terms. Results: 1. Nursing behaviors in neonatal intensive care unit were classified and defined at three levels: 5 main domains, 17 mid-domains, and 42 small domains. 2. The per component explanatory power of intensity involved in nursing labor showed physical effort to be 32.45%, mental 32.86%, and stress 34.69%. 3. The reliability of nursing labor factors was very strong, Cronbach's alpha value of 0.96. Conclusion: In this research, which is a first in defining nursing behavior in neonatal intensive care units, individual nursing behavior were broken down using resource-based relative value for nursing cost, and each nursing behavior was successfully translated to a numerical value.

• Journal of Korean Physical Therapy Science
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• v.3 no.2
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• pp.1065-1077
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• 1996

Fees for medical insurance services in Korea has not being been set based on service costing. Recently in the USA, fees for physican services are determined by developing and applying Resoure Based Relative Value Scales (RBRVS). This study attempts to develop relative value scales for personal factors of rehabilitative and physical therapeutic services. The personal factors were classified into four categories as having been done in the USA;service time, treatment technology and physical efforts, mental efforts and judgement, and stress. Input factors were measured using Magnitude Estimation Method (MEM), and relative value units were calculated for each of twenty eight rehabilitative and physical therapeutic services. Results show that service time surveyed differs from that provided in the public fee schedules in 24 services; the three personal factors but the service time are highly correlated; the physical therapists hold treatment technology and physical efforts to be the most important factor in setting the for services; and that relative values developed for noninsurance services such as Silver Spike Electrode (SSP) and Proprioceptive Neuromuscular Facilitation (PNF) are higher than those of similar insurance services. The policy implications and measures for improvement for the above findings were suggested respectively.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.283-293
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• 2002

Purpose: The purpose of this study was to define cost-countable perioperative nursing activities and to analyze the cost of each nursing activities based on the Resource-Based Relative Value Scale (RBRVS). Method: Researcher and 3 research assistants observed and documented the 83 operating patients in order to measure nursing time for each of the perioperative nursing activities. And then, 35 operating room nurses with at least one year of perioperative nursing experience were observed for the RBRVS of perioperative nursing activities. Finally, the direct and indirect nursing costs were estimated. Result: Nursing costs of 25 nursing activities were estimated using the RBRVS. Most expensive nursing activities were delivery of the instrument and implement for OP team (9,780 won per hour) and behavior of wash, pack, disinfect the instrument (6,770). Conclusion: Based on the relative values of each perioperative nursing activities estimated in this study, proper medical reimbursement system should be established in a near future.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.47-53
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• 2017

Objectives : The Korean Resource Based Relative Value Scale (K-RBRVS) was introduced in 2001 as an alternative of the previous medical fee schedule. Unfortunately, most neurosurgeons are unfamiliar with the details of the K-RBRVS and how it affects the reimbursement rates for the surgical procedures we perform. We summarize the K-RBRVS in brief, and discuss on how the relative value (RV) of the spinal neurosurgical procedures have changed since the introduction in 2001. Methods : We analyzed the change of spinal procedure RVs since 2001, and compared it with the change of values in the brain neurosurgical procedures. RVs of 88 neurospinal procedures on the list of K-RBRVS were analyzed, while 24 procedures added during annual revisions were excluded. Results : During the past 15 years, RVs for spinal procedures have increased 62.8%, which is not so different with the cumulative increase of consumer prices during this time period or the increase rate of 92.3% for brain surgeries. When comparing the change of RVs in more complex procedures between spinal and brain neurosurgery, the increase rate was 125.3% and 133%, respectively. Conclusion : More effort of the society of spinal surgeons seems to be needed to get adequate reimbursement, as there have been some discrimination compared to brain surgeons in the increase of RVs. And considering the relative underestimation of spinal neurosurgeons' labor, more objective measures of neurospinal surgeons' work and productivity should be developed for impartial reimbursement.

• Journal of Korean Institute of Industrial Engineers
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• v.15 no.2
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• pp.33-44
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• 1989

This paper presents stochastic-statistical dominance rules which eliminate dominated alternatives thereby reduce the number of satisficing alternatives to a manageable size so that the decision maker can choose the best alternative among them when neither the utility function nor the probability distribution of outcomes is exactly known. Specifically, it is assumed that only the characteristics of the utility function and the value function are known. Also, it is assumed that prior probabilities of the mutually exclusive states of nature are not known, but their relative bounds are known. First, the notion of relative risk aversion is used to describe the decision maker's attitude toward risk, which is defined with the acknowledgement that the utility function of the decision maker is a composite function of a cardinal value function and a utility function with-respect to the value function. Then, stochastic-statistical dominance rules are developed to screen out dominated alternatives according to the decision maker's attitude toward risk represented in the form of the measure of relative risk aversion.

• Korean Journal of Organic Agriculture
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• v.22 no.2
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• pp.229-240
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• 2014

The objective of this study is to estimate the relative importance of food labelling on organic and country-of-origin of tofu. The relative importance of three Tofu attributes shows that the country-of-origin is the most important and an organic labelling and price are followed in order. The result is that if two attributes, an organic labelling and the country-of-origin are taken into account, organic soybeans produced in Korea gets the highest value and non-organic soybeans produced in Korea, organic soybeans produced in USA, and others are followed in order. For respondents who have children under 6 years or under 18 years, the importance of an organic labelling increased compared to those whose children do not fall into that age. The results of this study show that the country of origin, especially domestically produced products, is more importantly recognized than the organic labeling to consumers.

• Journal of Environmental Science International
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• v.30 no.5
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• pp.379-389
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• 2021

Soil microorganism activity in an agricultural field is affected by various factors including climate conditions, soil chemical properties, and crop cultivation. In this study, we elucidate the correlation between microorganism activity and agricultural environment factors using the dehydrogenase activity (DHA) value, which is one of the indicators of soil microbial activity. As a result, the various factors noted above were related to the DHA value. Annual rainfall, soil Mg2+, bacterial and fungal diversities, types of crops, developmental stages, seasons, and cultivation status were highly correlated with the DHA value. Furthermore, next-generation sequencing (NGS) analysis was used to identify that the type of crop affected soil microbial compositions of both bacteria and fungi. Soil used for soybean cultivation showed the highest relative abundance for Verrucomicrobia, Planctomycetes, and Acidobacteria but Actinobacteria and Firmicutes had the lowest relative abundance. In the case of soil used for potato cultivation, Actinobacteria had the highest relative abundance but Proteobacteria had the lowest relative abundance. Armatimonadetes showed the highest relative abundance in soil used for cabbage cultivation. Among the fungal communities, Mortierellomycota had the highest relative abundance for soybean cultivation but the lowest relative abundance for cabbage cultivation; further, Rozellomycota, Chytridiomycota, and Cercozoa had the highest relative abundance for cabbage cultivation. Basidiomycota had the highest relative abundance for potato cultivation but the lowest relative abundance for soybean cultivation.

• East Asian Economic Review
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• v.21 no.2
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• pp.123-146
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• 2017

This paper examines the persistence of relative consumer price indices for 15 regions in Korea including 6 metropolitan cities and 9 provinces over the period of 1990-2016. In particular, we ask if relative regional price indices contain a common stochastic trend and find that they are not. We then investigate how quickly these relative prices converge to their long run value and find that a half-life of a deviation from the long run value is in the range of 13 to 22 months for the aggregate consumer price indices and in the range of 7 to 13 months for the tradable goods price indices, which is much quicker than the estimates of previous studies. These estimates suggest that existing monetary models with the realistic duration of price rigidities can generate the persistence in relative price indices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.334-347
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• 2006

The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.