Objective : We analyzed present condition of cooperative medical care using claims data of HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE form patients treated by Korean-Western cooperative medicine. The study aimed to offer guidelines in selecting disease-related research in developing Korean-Western convergence technology. Method : Based on the patients using Korean medical service, we analyzed claims data of patients using Korean medical service and western medical service from January 2012 to December 2013. We were assigned to the server remotely. With the concept of 'episode of care', we rebuilt claims data and analyzed present condition of cooperative medical usage. Results : We analyzed present condition of cooperative medical care per episode of care. Among outpatients, Low back pain, lumbar region(M5456) was the highest number. Among inpatients, Sciatica due to intervertebral disc disorder(M511) was the highest number. Conclusion : Based on the claims data provided by HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE, we have derived a list of multy frequently disease frequently treated by cooperative medical care by analyzing present condition.
The Korean system of health and medical care has been organized with both Oriental and Western medical sciences. To get complete clinical treatment results is not possible with only one-sided medical care, therefore we need to formulate an interdisciplinary plan for better health care, that is to say our ultimate purpose is the cooperative medical care for the promotion of social welfare and health. Hereupon, I made a searching inquiry into the present condition of cooperative medical care and its problems and also took a consideration into the medical state of other countries like China. Japan and North Korea where the Oriental medical care is used. The results of this investigation are as follows. There are some problems in both Oriental and Western(general) medical care, such as a lack of mutual confidence, a severance of interdisciplinary study, a shortage of professional human resources and so on. There also used to be problems of the system such as, the responsibility of medical care, the double charge for medical treatment, the governmental passive participation and policy, the private-oriented study system and so on. The solutions of these problems are that the mutual understanding and coexistence between both Oriental and Western medical sciences should be preceded and the interdisciplinary study, identified terminology and cooperative medical specialists would be necessary. Furthermore, the government has to seek some policies and legislation for the cooperative medical system and needs to support the public research institutes and centers of the cooperative medical care. After all, we have to train the cooperative medical specialists for the mutual aid of both Oriental and Western medical sciences and the government also has to support it with some policies and legislation for the better medical care system.
Objectives : The aim of this study is to give a statistical basis for the characteristics of patients who received cooperative medical care after being referred from Western medical departments to the Department of Acupuncture and Moxibustion in a Korean medical hospital. Methods : The request records were searched for cooperative medical treatment at the Department of Acupuncture and Moxibustion in a Korean medical hospital between September 1st, 2011 and August 31, 2016, based on the Order Communication system(OCS). The records were reviewed and retrospectively analyzed according to the patient's general characteristics, the chief diagnosis code based on the 7th Korean standard classification of diseases(KCD-7) before and after the cooperative medical care in the Department of Acupuncture and Moxibustion, and the actual treatment measures which patients received as a result of the cooperative medical care. Results : Among the 2702 records, 1549 patients were included in the analysis. The male to female ratio was 1 : 1.17. Sexagenarians formed the highest age group and the number of patients whose age was over 50 was 1176(75.92 %). The surgery department requested the cooperative care from the department of Acupuncture and Moxibustion for the highest number of patients, 1194(77.08 %). When analysing specific medical departments, Neurosurgery, General Surgery, Neurology, Otorhinolaryngology, and Physical medicine and rehabilitation followed. The frequency of chief diagnosis code used before the cooperative medical care was in the order of I, C, G, S, and M code, from highest to lowest. The order of the codes after the cooperative medical care was the same. Acupuncture treatment was the most frequently-used measure after the cooperative medical care. Following were infrared, moxibustion, transfer, herbal acupuncture, cupping, electroacupuncture, and so on. Conclusion : This study provides a statistical basis for the demands placed on the Department of Acupunture and Moxibustion for cooperative medical care with the Western medical department. Based on the present condition of cooperative medical care, more preparation and effort is required for its activation.
Purpose: This study was to examine whether a health care model that provides comprehensive medical services based on population groups to members of the medical cooperative is applicable as a policy alternative in terms of medical use and cost. Methods: Data were derived from National Health Insurance claim data in 2019. We compared the medical volume and expenses of patients who visited social cooperative-type medical clinics with other patients, control group who visited other clinics in a local area. Results: The average number of visit days was 25.3 days in social cooperative-type medical clinics, more than 24.2 days in the control group (p=.004). However, the average medical cost per visit was KRW 46 thousand in social cooperative-type medical clinics, which was significantly lower than KRW 51 thousand in the control group (p<.001), and the total medical cost was also KRW 16.1 billion in social cooperative-type medical clinics and KRW 16.9 billion in the control group. Conclusion: We identified that a population-based health care model might change patients' behaviors to health care services and decrease total medical cost. Further population based experiment is needed to develop alternative healthcare model.
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.
Lee, Jung Hee;Choi, Hong Sik;Kim, Jae Soo;Kim, Sang-Ho
Journal of Acupuncture Research
/
제34권3호
/
pp.49-58
/
2017
Objectives : The purpose of this study is to provide data to guide dementia health-care policy in Korea and to establish the position of Korean medical specialists in long-term care hospitals by analyzing the data of dementia inpatients. We analyzed the actual condition of dementia patients in care hospital and the effect of Western-Korean cooperative medicine on the progress of dementia. Methods : From January 1, 2016 to December 31, 2016, inpatients who were diagnosed with dementia at Mungyeong municipal long-term care hospital and admitted for more than 3 months were enrolled. Their medical records and simple tests were analyzed retrospectively. Results : We examined the detailed diagnosis, including both main and sub diagnosis, and Alzheimer disease dementia, at 97%, was the most common. At the time of admission, Korean Version of the Mini-Mental State Exam (K-MMSE) analysis showed that severe dementia affected 52%, and most were rated as Geriatric Depression Scale (GDS) 6. Based on the admission date, the results of a simplified test applied to the dementia patients every 6 months showed an maintain in the K-MMSE and GDS scores in 83%. Conclusion : The results of this study show that the rate of progression of dementia is somewhat lower in inpatients with moderate to severe Alzheimer's who have received Western-Korean cooperative treatment. However, due to institutional limitations, long-term inpatients such as those with dementia do not receive active traditional Korean medical treatment; hence, it is necessary to improve the national institution of traditional Korean medicine in long-term care hospitals.
Currently the oriental medical care services in the health centers is getting popularity because of their unique aspects which western medicine can not cover. This study was conducted to speculate the current status of oriental medical care services in health centers and possibility of how to effectively provide the oriental medical care services(or traditional medical care services) in health centers. For the study, the survey questionnaires were distributed to all 269 health centers and 138(51.3%) of them were collected. Eight of the collected were inadequate for the analysis and 130 of 269 questionnaires were finally chosen for the study. The SPSS/PC WIN 8.0 was used for the statistical analysis. The results are as follows. First, 91 out of 130 sample health centers(70%) are providing oriental medical care services. The results show that the willingness of the directors and the public awareness in community are the most important factors to provide oriental medical care services in health centers. In contrast, the lack of cooperative efforts between western and oriental medical doctors and the lack of government supports are considered as factors that intervene the oriental medical care services in health centers. About 80% of the sample health centers respond that the government supports is needed for oriental medical care services in health centers. Second, it was asked to the directors of 39 health centers which do not provide oriental medical care services regarding their future plan to include the services. About 70% of health centers respond that no plan is available now. They acknowledge that the demand on the services is the most important factor to consider the oriental services as their future medical services. Third, 69.2% of the oriental medical doctors in health centers are public health doctor. 95.6% of the sample health centers have space for the oriental medical care services in their facilities and some health centers provide the services through the private clinics nearby facilities. Finally, the surveyors consider both budgetary constraints and difficulty in recruiting doctors as barriers for the effective oriental medical care services in health centers. Finally, t-test and LSD were employed to find out the difference among several groups. The analysis shows statistically significant difference among groups about their recognition on health care policy, health care system, and effectiveness of oriental medical care services. To be conclude, the study shows the necessity of oriental medical care services in health centers. To do so, the government supports, cooperative efforts between oriental and western medical doctors, and providing job security for doctors should proceed to provide effective oriental medical care services in health centers.
Objectives : This study was aimed to promote the cooperative system of Korean and Western medicine in the dual health care system through a survey of physicians on recognition, problems and solution of the cooperative system. Methods : The research took place at Dongguk University Hospital from May 25 to 27, 2009 with 44 professors, residents, and interns employed by the hospital. Results : Of total 44 surveyed doctors, positive and moderate responses on the cooperative system between Korean and Western medicines were 40.9% and 43.2%, respectively. They scored it positive (62.5%) and moderate (31.3%) based on their experiences. These results can be supposed to represent the environment for the interdisciplinary medicine. Even in the interdisciplinary hospital of Korean and Western medicine, 68.2% of responders had no experience of the cooperative medical system. Expected interdisciplinary efficient departments were ordered rehabilitation medicine, neurology and orthopedics and associated with musculoskeletal disorders, the most frequent diseases treated by Korean traditional medicine. Conclusions : Korean and Western medical doctors, as medical personnel, intellectual persons as well as specialists, need a recognition and attitude to understand and respect each others' medicine. However, both groups also realize there are many complicated issues in the treatment of patients. It is difficult to require a change of Western doctors' perceptions and attitude toward Korean traditional medicine only with results of a survey. For the efficient cooperative system in the medical field, Korean medical doctors will need to study and consider specific problems mentioned by Western medicine.
Purpose: We analyzed the characteristics of women who gave birth at an obstetrician and those who received oriental medicine postpartum care, and investigated the level of their satisfaction to obtain fundamental data for Oriental-Western cooperative medicine treatment for postpartum care. Methods: The review was based on a 5-months' data, from August 1 through December 31, 2009. Information on age, labor record, level of education, and occupation of the patients who had received postpartum oriental-western cooperative medicine treatment was based on Electric Medical Record(EMR) of O O Oriental Medicine Hospital. The questionnaires were completed by the patients at the time of their discharge from the hospital. Results: The patients who were admitted to oriental medicine hospitals tended to be primiparae, and they were more likely to be younger women with higher education levels. The level of satisfaction on postpartum care program of oriental medicine hospitals was high. Conclusion: It is necessary to specialize the facilities, dietary formula, and staff training of oriental medicine hospitals through a survey of postpartum patients' demand and satisfaction level. In oriental-western cooperative medicine hospitals, it is needed to specialize the postpartum program for creating demand of premature delivery mothers.
Objectives The purpose of this study is to investigate present status of cooperation through Korean medicine and Western medicine collaboration process. Methods We have established Korean medicine and Western medicine collaboration process to examine the status of cooperation. The medical records were investigated retrospectively, the general characteristics of gender, age of cooperative patients, classification of disease, frequency of medical treatment and type of insurance were analyzed. Results The Korean medicine and Western medicine collaboration process conducted in 4 stages, the convenience of patient movements is considered. A total of 245 people received cooperative medical treatment, 156 were out-patient department (OPD) patients and 89 were hospitalized patients, both group have more women than men. When classified as disease, OPD patients were most diagnosed with Sprain and strain of lumbar spine, while hospitalized patients were most diagnosed with lumbar and other intervertebral disc disorders with radiculopathy. A total of 72.7% patients were received cooperative medical treatment at once. In a survey of cooperative satisfaction, 68.5% of all medical staff responded positively to the treatment effect, and 68.6% said the need for cooperation was necessary. Conclusions As a result of this study, we were able to see the present status of cooperation, and through this, we found an improvement in the continuation of the cooperation. Based on the present study, It is hoped that a cooperative process will emerge that can improve the problems shown in this study.
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