의료생활협동조합 한의원의 일차의료서비스 수준 평가

Patient Assessment of Primary Care for Health Cooperative Korean Medicine Clinics in South Korea

  • 성태경 (부산대학교 한의학전문대학원 한의학과) ;
  • 임병묵 (부산대학교 한의학전문대학원 한의학과)
  • Seong, Taekyung (Department of Korean medicine, School of Korean medicine, Pusan National University) ;
  • Lim, Byungmook (Department of Korean medicine, School of Korean medicine, Pusan National University)
  • 투고 : 2013.07.25
  • 심사 : 2013.08.23
  • 발행 : 2013.08.31

초록

Objectives : Health cooperative movement is of increasing concern among medical consumers and professionals in Korea. Most health cooperative clinics provide Western Medicine and Korean Medicine(KM) to patients. This study aimed to evaluate the primary care level of health cooperative KM clinics and compare it with local KM clinics in Korea. Methods : Face to face survey was performed at the 3 health cooperative KM clinics and 5 local KM clinics with the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients or guardians who had visited KM clinics five times or more during the last 3 months. We compared primary care scores of each domain between health cooperative KM clinics and local KM clinics. Results : Data were collected from 200 respondents (100 patients from health cooperative KM clinics and 100 local KM clinics). Total average scores of the KPCAT for health cooperative clinics and local KM clinics were $81.1{\pm}12.0$ and $75.4{\pm}9.5$, respectively. Among primary care domains, personalized care was the highest ($89.2{\pm}12.0$, $89.6{\pm}8.4$, respectively), and comprehensiveness function was the lowest ($68.5{\pm}22.5$, $54.5{\pm}22.0$, respectively). Significant differences between two groups were noted in comprehensiveness function (68.5 vs. 54.5, P=0.000), family-community orientation (79.5 vs. 73.0, P=0.004), first contact(89.2 vs 84.0, p=0.001) and coordination function(74.0 vs 68.7, p=0.025). Conclusions : Based on the patients assessment, health cooperative KM clinics provide more primary care-oriented services than local KM clinics. This means that health cooperative clinic can be one of alternatives to strengthen the primary health care in Korea. Future researches are recommended to measure patients satisfaction and treatment effectiveness in the health cooperative clinics.

키워드

참고문헌

  1. Park SY. A Study on the Contents of Revision and Improvement Plan for the Medical Consumer Cooperativesinthe Revision of the Consumer Cooperative Act. The Korean Journal of Cooperative Studies 2010;28(2)
  2. Kim SY. Defining the concept of primary carein South Korea and Development of the Korean primary care assessment tool. Proceedings of the Korean Society of Health Policy and Administration Conference 2007 Nov:230-237
  3. Lee ID. Experience of Ahnseong health cooperative. Korean journal of Family Medicine 1998;19:971-8.
  4. Koran Health Cooperative Federation.[internet]. Seoul:Koran Health Cooperative Federation; [cited 2010 Jul 26].available from:http:// medcoop.ewonju.com
  5. Lee JH, Choi YJ, Sung NJ, Kim SU, Chung SJ, Kim J, etal. Development of the Korean primary care assessmenttool- measuring user experience:tests of data quality and measurement performance. International Journal for Quality in Health Care 2009;21:103-11. https://doi.org/10.1093/intqhc/mzp007
  6. Sung NJ, Suh SY, Lee DW, Ahn HY, Choi YJ, Lee JH. Patient's assessment of primary care of medical institutions in South Korea by structural type. International Journal for Quality in Health Care 2010;22(6):493-499 https://doi.org/10.1093/intqhc/mzq053
  7. LEIYU S,JIAHONG X. Validating the Adult Primary Care Assessment Tool. The Journal of Family Practice 2001;50(2)
  8. Choi YG, Kim KW, Choi YJ, Sung NJ, Kim JY, Park JH, Hong SK, Lee JH, Korean Primary Care Research Group. Patient Assessment of Primary Care of Health Cooperative Clinicsin South Korea.Korean Journal of Family Medicine 2010;31:765-777 https://doi.org/10.4082/kjfm.2010.31.10.765
  9. Lee JH, Choi YJ, Volk RJ, Kim SY, Kim YS, Park HK, etal. Defining the concept of primary care in South Korea usinga delphi method. Korean Journal of Family Medicine 2007;39:425-31.
  10. Han DW. Use of Integrative Medicine among primary care patients in Western counties. Korean Journal of Oriental Preventive Medical Society 2012;16(1):1-13
  11. Lee EK. Study of Primary Care Oriental Medical doctor Institution. The Association of Korean Medicine. 2011:49-56.
  12. Kim YH, Lee WH, Chang HJ, Lim S.A Study on Oriental Medical Fee Demanded by Supplier of Medical Services. Journal of Meridian and Acupoint 2007;24(3):67-79
  13. Kwon YC, Yoo WK, Seo BI .A Study on the Current Status of Prescribed Drugs in Orienta lHealth In surance and theirI mprovement. Korean Journal of Herbology 2012; 27(2):1-16
  14. Jo HS. Strategies for improvement of primary care in Korea. Journal of Korean Medicine Association 2012 Oct;55(10):959-968 https://doi.org/10.5124/jkma.2012.55.10.959
  15. Kwon YK, Lee HJ. Attitudes of Medical Professions towards the Cooperated Medical Treatments of Korean Oriental Medicine and Western Medicine. Korean Journal of Oriental Physiology & Pathology 2006;20 (1):10-14.
  16. Leem JH. the most humanistic medicine. Story Planer. 2011:237-244.
  17. Lee WC. The Problems of Cooperative Medical System of Oriental and Western Medicine and Their Solutions. Journal of Korean Medicine.1999;20(2)