Equity of health care financing in South Korea: 1990–2016

Abstract Background The National Health Insurance in Korea has been in operation for more than 30 years since having achieved universal health coverage in 1989 and has gone through several policy reforms. Despite its achievements, the Korean health insurance has some shortfalls, one of which concerns the fairness of paying for health care. Method Using the population representative Household Income and Expenditure Survey data in Korea, this study examined the yearly changes in the vertical equity of paying for health care between 1990 and 2016 by the source of financing using the Kakwani index, considering health insurance and other related policy reforms in Korea during this period. Results The study results suggest that direct tax was the most progressive mode of health care financing in all years, whereas indirect tax was proportional. The out-of-pocket payments were weakly regressive in all years. The Kakwani index for health insurance contributions was regressive but now is proportional to the ability to pay, whereas the Kakwani index for private health insurance premiums turned from progressive to weakly regressive. The Kakwani index for overall health care financing showed a weak regressivity during the study period. Discussion The overall health care financing in Korea has transformed from a slight regressivity to proportional over time between 1990 and 2016. It is expected that these changes were closely related to the improved equity of health insurance contributions from 1998 to 2008, which was the result of a merger of the health insurance societies and an amendment in the health insurance contribution structure. These results suggest that standardizing insurance managing organizations and financing rules potentially has positive implications for the equity of healthcare financing in a country where the major method of health care financing is social health insurance

SENSING MECHANISM AND APPLICATION OF MECHANICAL STRAIN SENSOR: A MINI-REVIEW

This study reviews the potential of flexible strain sensors based on nanomaterials such as carbon nanotubes (CNTs), graphene, and metal nanowires (NWs). These nanomaterials have excellent flexibility, conductivity, and mechanical properties, which enable them to be integrated into clothing or attached to the skin for the real-time monitoring of various activities. However, the main challenge is balancing high stretchability and sensitivity. This paper explains the basic concept of strain sensors that can convert mechanical deformation into electrical signals. Moreover, this paper focuses on simple, flexible, and stretchable resistive and capacitive sensors. It also discusses the important factors in choosing materials and fabrication methods, emphasizing the crucial role of suitable polymers in high-performance strain sensing. This study reviews the fabrication processes, mechanisms, performance, and applications of stretchable strain sensors in detail. It analyzes key aspects, such as sensitivity, stretchability, linearity, response time, and durability. This review provides useful insights into the current status and prospects of stretchable strain sensors in wearable technology and human–machine interfaces

Evaluation of the Satisfaction and Usefulness of a Web-Based Educational Program for Breast Cancer Patients

The purpose of this study was to evaluate the effectiveness of a web-based breast cancer educational program which consists of special features such as flash animations and online counseling as well as 7 different categories of information on breast cancer. The effectiveness of the program was analyzed in terms of its function and content. A total of 147 women with breast cancer who visited the website for at least 30 minutes and a minimum of 3 visits, participated in the survey

Harvesting electrical energy using plasmon-enhanced light pressure in a platinum cut cone

We have designed a method of harvesting electrical energy using plasmon-enhanced light pressure. A device was fabricated as a cut cone structure that optimizes light collection so that the weak incident light pressure can be sufficiently enhanced inside the cut cone to generate electrical energy. An increase in the device's current output is a strong indication that the pressure of incident light has been enhanced by the surface plasmons on a platinum layer inside the cut cone. The electrical energy harvested in a few minutes by irradiating pulsed laser light on a single micro device was possible to illuminate a blue LED

Induced neural stem cells from distinct genetic backgrounds exhibit different reprogramming status

Somatic cells could be directly converted into induced neural stem cells (iNSCs) by ectopic expression of defined transcription factors. However, the underlying mechanism of direct lineage transition into iNSCs is largely unknown. In this study, we examined the effect of genetic background on the direct conversion process into an iNSC state. The iNSCs from two different mouse strains exhibited the distinct efficiency of lineage conversion as well as clonal expansion. Furthermore, the expression levels of endogenous NSC markers, silencing of transgenes, and in vitro differentiation potential were also different between iNSC lines from different strains. Therefore, our data suggest that the genetic background of starting cells influences the conversion efficiency as well as reprogramming status of directly converted iNSCs.ope

N-doped graphitic self-encapsulation for high performance silicon anodes in lithium-ion batteries

N-doped sites at CNT and graphene trigger spontaneous encapsulation of Si particles by simple pH control at room temperature. Significantly, N-doped CNT encapsulated Si composite electrode materials show remarkable cycle life and rate performance in battery operations. Superior capacity retention of 79.4% is obtained after 200 cycles and excellent rate capability of 914 mA h g -1 is observed at a 10 C rate.close13

Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice

Background/AimsWe aimed to assess the rate of histologic discrepancy (HD) between endoscopic forceps biopsy (EFB) and totally resected specimens in colorectal polyp and analyze the risk factors of discordant group, especially under-diagnosis (UD) cases before complete removal of colorectal polyp.MethodsFrom 2010 to 2015, a total of 290 polyps in 210 patients which had baseline pathology report before endoscopic resection (ER) were analyzed. UD cases were defined as those in which the diagnosis changed to a more advanced histologic feature after ER.ResultsA change in the final histology after ER was noted in 137 cases (47.2%), and after excluding 9 insignificant cases, 128 cases were further categorized into over-diagnosed and under-diagnosed group. UD occurred in 86 cases (29.7%) and change from benign to malignancy was noted in 26 cases (8.9%). On univariate analysis, a larger polyp size (>10 mm) was significantly associated with both HD (P10 mm was the single most significant predictor of both HD (P10 mm was the most important predictor of both HD and UD. We should be careful in making treatment strategy of colorectal polyp based on histologic report of EFB especially when the size of polyp is >10 mm

Spatial Changes in the Atrial Fibrillation Wave-Dynamics After Using Antiarrhythmic Drugs: A Computational Modeling Study

Background: We previously reported that a computational modeling-guided antiarrhythmic drug (AAD) test was feasible for evaluating multiple AADs in patients with atrial fibrillation (AF). We explored the anti-AF mechanisms of AADs and spatial change in the AF wave-dynamics by a realistic computational model.Methods: We used realistic computational modeling of 25 AF patients (68% male, 59.8 ± 9.8 years old, 32.0% paroxysmal AF) reflecting the anatomy, histology, and electrophysiology of the left atrium (LA) to characterize the effects of five AADs (amiodarone, sotalol, dronedarone, flecainide, and propafenone). We evaluated the spatial change in the AF wave-dynamics by measuring the mean dominant frequency (DF) and its coefficient of variation [dominant frequency-coefficient of variation (DF-COV)] in 10 segments of the LA. The mean DF and DF-COV were compared according to the pulmonary vein (PV) vs. extra-PV, maximal slope of the restitution curves (Smax), and defragmentation of AF.Results: The mean DF decreased after the administration of AADs in the dose dependent manner (p < 0.001). Under AADs, the DF was significantly lower (p < 0.001) and COV-DF higher (p = 0.003) in the PV than extra-PV region. The mean DF was significantly lower at a high Smax (≥1.4) than a lower Smax condition under AADs. During the episodes of AF defragmentation, the mean DF was lower (p < 0.001), but the COV-DF was higher (p < 0.001) than that in those without defragmentation.Conclusions: The DF reduction with AADs is predominant in the PVs and during a high Smax condition and causes AF termination or defragmentation during a lower DF and spatially unstable (higher DF-COV) condition