Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database

Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. the total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. the per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. the total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. the indirect costs were identified as the largest component of the overall cost.ope

Interest groups' influence over drug pricing policy reform in South Korea

In 1999, the Korean government made a drug pricing policy reform to improve the efficiency and transparency of the drug distribution system. Yet, its policy formation process was far from being rational. Facing harsh resistance from various interest groups, the government changed its details into something different from what was initially investigated and planned. So far, little evidence supports any improvement in Korea's drug distribution system. Instead, the new drug pricing policy has deteriorated Korea's national health insurance budget, indicating a heavier economic burden for the general public. From Korea's experience, we may draw some lessons for the future development of a better health care system. As a society becomes more pluralistic, the government should come out of authoritarianism and thoroughly prepare in advance for resistance to reform, by making greater efforts to persuade strong interest groups while informing the general public of potential benefits of the reform. Additionally, facing developing civic groups, the government should listen but not rely too much on them at the final stage of the policy formation. Many of the civic groups lack expertise to evaluate the details of policy and tend to act in a somewhat emotional way.ope

Changes in Morbidity and Medical Care Utilization after the Recent Economic Crisis in the Republic of Korea

OBJECTIVE: To examine and quantify the impact of the recent economic crisis on morbidity and medical care utilization in the Republic of Korea. METHODS: 22 675 people from 6791 households and 43 682 people from 12 283 households were questioned for two nationwide surveys that took place in 1995 and 1998, respectively. A separate sample pretest-posttest design was used and we conducted c2 test and logistic regression analysis after controlling for the maturation effect of the morbidity and medical care utilization. FINDINGS: The morbidity rates of chronic disease and acute disease increased significantly by 27.1% and 9.5%, respectively, whereas the utilization rates of outpatient and inpatient services decreased by 15.1% and 5.2%, respectively. In particular, the pace of decline in the utilization rate of outpatient services varied depending on the type of disease: morbidity rates for mental and behavioural disorders were 13.7%; for cardiovascular disease, 7.1%; and for injury, 31.6%. CONCLUSION: After the Republic of Korean economic crisis, the morbidity and medical care utilization rates changed significantly but the degree of change depended on the type of disease or service. The time-dependent relationship between the national economy and the morbidity and medical care utilization rates needs to be further investigated.ope

Socioeconomic Costs of Alcohol Drinking in Korea

BACKGROUND: The purpose of this study was to estimate socioeconomic costs caused by alcohol drinking in Korea as of 2004 in an effort to raise the awareness of the gravity of problems associated with alcohol drinking and the necessity of active intervention by family physicians. METHODS: The costs were classified as direct costs, indirect costs and other costs. The direct costs consisted of direct medical costs and direct non-medical costs. The indirect costs were computed by the reduction and loss of productivity and the loss of workforce. Other costs consisted of property loss, administration costs and costs of alcohol beverage. RESULTS: The annual costs, which seemed to be attributable to alcohol drinking, were estimated to be 200,990 hundred million won (2.9% of GDP). In the case of the former, the amount included 38.83% for reduction of productivity, 26.92% for loss of the workforce, 22.24% for alcoholic beverage, 5.34% for direct medical costs, 2.29% for loss of productivity, 1.87% for direct non- medical costs, 1.54% for administration costs and 0.97% for loss of property. CONCLUSION: Our study confirms that compared with the cases of Japan (1.9% of GNP), Canada (1.09% of GDP), France (1.42% of GDP) and Scotland (1.19% of GDP), alcohol drinking incurs substantial socioeconomic costs to Koreans. An active intervention by family physicians is suggested.ope

A Comparative Study on the Phonetic Realizations of Korean stops by Generation and Age

학위논문(석사) -- 서울대학교대학원 : 인문대학 국어국문학과, 2023. 8. 김현.이 연구의 목적은 국어 폐쇄음의 음성 실현 양상이 세대 혹은 연령이 다른 집단에서 어떻게 나타나는지를 비교함으로써 폐쇄음의 음성 실현 양상이 어떤 요인에 의해 달리 나타나는지 논의하는 것이다. 그간의 논의는 폐쇄음의 음변이가 세대차나 연령차에 의한 것임을 주장하였는데, 이때 세대, 연령, 성별이라는 요인이 함께 고려되지는 않았다. 이에 본고는 20여 년 전에 구축된 음성 말뭉치를 이용하면서도, 말뭉치 화자와 현재 비슷한 연령인 사람들에게 산출 실험을 시행하여 연구를 수행하였다. 또, 그간의 관련 연구가 어두 폐쇄음에만 한정되어 이루어졌기 때문에 출현 환경을 모음 간으로 달리 했을 때의 음성 실현 양상도 함께 다루었다. 본고에서는 어두 폐쇄음의 발성 유형 변별에 중요한 역할을 하는 것으로 알려진 VOT와 후행 모음의 f0를, 상대적 수치인 r_VOT와 f0(A), f0(A-B)로 변환하여 절대적 수치와 함께 살펴보았다. 어두 폐쇄음에서 주목할 만한 차이를 보이는 것은 평음과 격음에서였다. 세대별 비교 결과, 음향 단서로 VOT를 이용했을 때에는 음변이가 계속해서 진행 중인 것으로, r_VOT를 이용했을 때에는 음변이가 완료된 것으로 나타났다. 다음으로 f0(A)는 모든 집단에서 격음이 평음보다 큰 것으로 나타났지만, f0(A-B)는 발성 유형에 따른 양상이 r_VOT와 평행하게 나타났다. 이를 통해 어두 폐쇄음의 음향 단서로서 f0(A-B) 또한 중요하게 기능할 수 있다는 것과, 길이 요소의 감소와 f0의 기능 강화는 동시에 일어나는 것일 수 있다는 것을 확인하였다. 다음으로 연령별 비교 결과, 연령이 증가함에 따라 어두 폐쇄음의 r_VOT과 f0(A)이 감소하는 것을 확인하였고, f0(A-B)는 발성 유형에 따른 차이를 보이지 않았다. 즉 연령별 비교 결과가 노화에 의한 것이기보다는, 어두 평음과 격음에서의 음변이 세력이 우위를 차지함으로써 언어 변화가 완료되어 가는 과정을 반영하고 있는 것일 수 있다는 결론을 내렸다. 한편 모음 간 폐쇄음의 발성 유형 변별에 중요한 역할을 하는 것으로 알려진 것은 폐쇄 구간의 길이와 후행 모음의 f0이다. 어두 폐쇄음과 마찬가지로, 본고에서는 이 음향 단서들을 상대적 수치로 변환한 r_c, f0(A), f0(A-C), f0(A-B) 등과 함께 다루었다. 세대별 비교 결과, 폐쇄 구간 길이의 절대적, 상대적 수치는 모두 다음 세대에서와 여성에서 큰 값을 가지는 것으로 나타났다. 그러나 경음과 격음의 변별에 있어서는 절대적 수치로는 유의한 평균차를 보이지 못하고, 상대적 수치인 r_c로는 유의한 평균차를 보이는 것으로 나타났다. 다음으로 f0(A)는 어두 폐쇄음과는 달리 평음과 긴장음 사이에서 유의한 차이를 지니지 못하는 것을 알 수 있었으며, f0(A-C)는 남성이 여성보다 큰 값을 갖는 것으로 나타나 모음 간 폐쇄음의 음향 단서로서 폐쇄 구간의 길이와 함께 사용될 수 있음을 확인하였다. 연령별 비교 결과, 폐쇄 구간의 길이 요소는 중장년층과 여성에서 큰 값을 가지는 것으로 나타났다. f0(A), f0(A-C), f0(A-B) 등은 성별, 연령, 발성 유형에 따른 일관된 양상을 보이지는 않는 것으로 나타났다. 이를 통해 폐쇄음은 연령차에 의한 노화가 아니라 세대차에 의해 달리 실현된다는 것을 확인할 수 있었다. 본 연구는 연령과 세대의 차이를 아우르는 자료를 이용하여 음변이와 변화에 대해 논의하였다는 점, 기존의 음향적 단서와 함께 이들을 상대적 수치로 변환하여 이것들이 폐쇄음 연구에서 어떻게 이용될 수 있는지를 살펴보았다는 점에서 의의가 있다.1. 서론 1 1.1. 연구 목적 1 1.2. 선행 연구 4 2. 연구 방법 11 2.1. 자료 소개 11 2.2. 산출 실험 15 2.3. 자료 분석 18 2.3.1. 측정 방법 18 2.3.2. 분석 빛 통계 방법 23 3. 어두 폐쇄음의 음향적 특성 비교 29 3.1. VOT 29 3.1.1. 세대별 비교 31 3.1.2. 연령별 비교 35 3.2. f0 37 3.2.1. 세대별 비교 40 3.2.2. 연령별 비교 44 3.3. 정리 46 4. 모음 간 폐쇄음의 음향적 특성 비교 49 4.1. 폐쇄구간의 길이 49 4.1.1. 세대별 비교 50 4.1.2. 연령별 비교 54 4.2. f0 56 4.2.1. 세대별 비교 59 4.2.2. 연령별 비교 63 4.3. 정리 65 5. 결론 67 참고 문헌 71 부록 1 75 부록 2 78 부록 3 91 Abstract 106석

Vision and training strategy for health management specialist

The identity crisis of preventive medicine appears to have been deepening. As a solution, it is insisted that preventive medicine should focus on clinical preventive medicine. However, in the field of heath policy and management, the better solution should be found in a serious search for visions and perspectives of its study on population and society. In this regard, the specialist who studies the field can be defined as a medical doctor majoring in public health. In this paper, I first forecasted major socioeconomic changes to occur in medical and public health arena and explored the role of those studying health policy and management. Secondly, I summarized their career paths and main activities in order to establish visions. Finally, I proposed curriculums on health policy and management for medical school undergraduates and for specialists majoring in preventive medicine, respectively.ope

(A) study on the urban architectural methodology considering the urban fabric

학위논문(석사) --서울대학교 대학원 :건축학과, 2009.2.Maste

Development of nonlinear structural analysis model for semi-rigid thin-walled frame structures

학위논문(박사)--서울大學校 大學院 :農工學科 農業土木專攻,1997.Docto

An analysis of direct financial compensation of hospital personnel in Korea

compensation is a major function of human resources management. The hospital industry is characterized by its remarkable labor intensity and human resource input by unit. That is why the hospital industry has a higher level of wage/cost ration. The issues of how much the hospital personnel's direct financial compensation amounts to and how the organizational and other factors generate compensation differentiation, are central problems for research in hospitals. But there have been few approaches to study staff compensation in hospitals, its magnitude and inter-hospital relative compensation amounts for the same personnel. A worker who moves from low-wage to a high-wage employer can usually increase his or her pay without change in job description. This means in the cases of same jobs, relative importance is different for each hospitals. The purpse of this study were to find the compensation levels of hospital personnel and to determine the factors affecting compensation levels of hospital personnel. The unit of analysis is the hospital and 145 hospitals were studied for nurse(RN), medical technoloist(MT), managerial personnel(MP) and 100 hospitals for medical doctor(MD). In this study the definitions of direct financial compensation are before tax, excluding employer's contriution and total annual remuneration received by the employee. Main findings of the research can be summarized as follows. 1. Direct financial compensation of hospital personnel are MD 45,056,000 won, RN 9,222,000 won, MT 9,513,000 won and MP 9,185,000 won in the starting year's employment in hospital. 2. According to determinants of hospital personnel compensations, there are no statistical significant variables to determine the level of MD's compensation. Wlith RN and MT's compensation level, the greater the patient revenue per 100 hospital beds, the higher the RN compensation and the tertiary hospital's compensation is much more than other types of hospitals. The location of hospital is another determinant factor for the MT's compensation level. Hospitals that are in the uban area have lower compensation level than rural area. There are the same results in MP with MT. Conclusions can be drawn from the results of the study. First, the wage differentiation of MD and other health personnel still remains and the differentiation existed in inter and intra job personnel of hospitals. Second, determinants of hospital personnel personnel compensation level are patient revenue, location, and type of hospital level.ope

Determinants of Self-Rated Health Among the Korean Elderly Living in the Community

The aim of this study was to identify major factors related to global self-rated health among the community-dwelling elderly people in Korea using data from the 1994 Survey on the Living Status of Korean Elderly. The study subjects consisted of a nationally representative sample of 2,058 people aged 60 years or over living in the community. Results from multiple regression analysis showed poor self-rated health to be significantly associated with lower age, being of male gender, absence of a paid work, number of chronic illness, and poor physical and mental health. The influence of comorbidity and functional status in determining the elderly`s self-assessment of their health suggests the importance of health promotion and disease prevention activities in this population. A better understanding of factors related to self-rated health would help to improve older people`s assessment of their own health.restrictio