• 제목/요약/키워드: Diagnosis and prescription

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일 종합병원 정신건강의학과 외래환자에서 벤조디아제핀 사용 (Prescription Patterns of Benzodiazepine for Outpatients in a Psychiatric Department in Korea)

  • 이재영;강원섭;김종우;김영종
    • 대한불안의학회지
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    • 제11권2호
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    • pp.143-148
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    • 2015
  • Objective : This study examined benzodiazepine prescription patterns of outpatients visiting the psychiatry department in a single general hospital in Korea. Methods : A retrospective descriptive analysis of benzodiazepine prescriptions was performed on a database from 2014 in a general hospital in Korea. We analyzed the following factors of adult outpatients: demographic factors such as sex and age, amount of benzodiazepine prescribed, treatment duration, and diagnosis based on the ICD-10. Results : In 2014, benzodiazepines were prescribed to 46.4% of the outpatients. Percentage of benzodiazepine prescription increased with age and was highest in the age group 40-59 years. Prescription was more prevalent in women and the prescription percentage increased by treatment duration. Patients with the F4 diagnosis (neurotic, stress-related and somatoform disorders) were the most highly prescribed group. For all diagnosis groups, prescription was more prevalent in females or similar for both sexes except for patients with F5 diagnosis (behavioral syndromes associated with physiological disturbances and physical factors), with males being more predominant. Conclusion : Despite the concern regarding the rate of benzodiazepine prescription and administration to geriatric patients, long-term prescription and usage among older patients is still prevalent.

의원 가감지급사업 실시 전후에 따른 급성호흡기계질환의 의약품 처방특성 -국민건강보험 빅데이터를 활용하여- (Prescription Characteristics of Medication for Acute Respiratory Diseases before and after Pay-for-Performance -using National Health Insurance Big data-)

  • 공미진;황병덕
    • 보건의료산업학회지
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    • 제14권1호
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    • pp.93-102
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    • 2020
  • Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

1차 의료기관의 급성 상기도 감염 질환자 의약품 처방특성 - 가정의학과, 내과, 소아청소년과, 이비인후과, 일반의 중심으로 - (Characteristics of Prescription Drugs for Acute Upper Respiratory Tract Infection in Outpatient Clinics - Centered on Family Medicine, Internal Medicine, Pediatrics, Otorhinolaryngology and General Practitioner Clinics -)

  • 공미진;황병덕
    • 보건의료산업학회지
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    • 제11권3호
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    • pp.37-49
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    • 2017
  • Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

급성호흡기감염 환자의 표시과목별 항생제 처방특성 -국민건강보험 빅데이터를 활용하여- (Prescription Characteristics of Antibiotics for Clinical Subjects of Acute Respiratory Infection Outpatients -Using National Health Insurance Big Data-)

  • 공미진;황병덕
    • 보건의료산업학회지
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    • 제13권4호
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    • pp.121-132
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    • 2019
  • Objectives: This study analyzed the prescription antibiotics characteristics of Acute respiratory infection outpatients. It provides a basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods: The research data were collected from the National Health Insurance Corporation's 2014 sample cohort for Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics classification of diseases codes J00-J06, J20-J22, J40 outpatients. Results: The antibiotic prescription rate on the evaluation project for appropriate prescribing indicators of Health Insurance Review & Assessment Service was 43.54%, whereas in this study it was about 10% higher because the analysis targeted the entire acute respiratory infection diagnosis. Conclusions: There is a need to identify the correct antibiotic prescription by expanding the current assessment standard. Such standard must include acute lower respiratory infections and minor diagnosis because current evaluation projects on appropriate prescribing indicators targets only the major diagnosis of acute upper respiratory infection.

인터넷 기반 한의진단전문가 시스템(KHU-PIPE) 개발 (Development of Web-based Diagnosis Expert System of Traditional Oriental Medicine)

  • 최승훈
    • 동의생리병리학회지
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    • 제16권3호
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    • pp.528-531
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    • 2002
  • In Traditional Oriental Medicine, there has been a growing needs for computerized diagnosis expert system, which can implement pre-diagnosis and correct the errors of practitioners. Therefore, we developed the expert system (KHU-PIPE : Kyung Hee University - Pattern Identification and Prescription Expert) for diagnosis and treatment. It has three characteristics as following. First. this system has the knowledge base which modified the standardized data designed by Chinese government during 1980s. Second, it provides the objective and standardized diagnosis as the results of pattern identification and their appropriate prescriptions for treatment. Third, it is applied to both LAN system and internet. Furthermore, it can be used as an educational methods for the practices of pattern identification and prescription, and provide the objective criteria for clinical studies and promote the Traditional Oriental Medicine as an evidence-based medicine.

폐암 환자의 항우울제 처방현황과 관련 요인 분석 (An Analysis on Prescribing Patterns of Antidepressants and Their Associated Factors in Lung Cancer Patients)

  • 성경은;정경혜;김애리;김은영
    • 한국임상약학회지
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    • 제26권2호
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    • pp.107-114
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    • 2016
  • Background: Depression is the leading cause of lowering the quality of life of cancer patients and lung cancer is the most likely to cause depression. It is necessary to find out depression-related factors in lung cancer patients. Methods: The study was a retrospective cohort study using medical records, and was a non-equivalent comparison group design. It involved patients diagnosed of lung cancer at the Konkuk University Medical Center from January to December 2012. Between antidepressants prescription group and non prescription group, socio-demographic factors, clinical factors, treatment-related factors and other factors were analyzed statistically. Results: Antidepressant prescription group consisted of 23 people and non-prescription group of 206 people. Prescription rate of quetiapine was the highest 47.8% (11/23), followed by escitalopram (43.5%, 10/23), amitryptyline and trazodone (30.4%, 7/23). The prescription group was prescribed with an average of 1.9 antidepressants. Antidepressants were prescribed after average of 248 days from lung cancer diagnosis and prescription period per patient was average 177.5 days. According to the result of univariate logistic regression analysis between 2 groups, factors such as number of outpatient visit, number of admission, days of hospitalization, sleep disorder, and comorbidity were found to be statistically significant (p < 0.05). However, According multivariate logistic regression analysis showed that number of admission, days of hospitalization and sleep disorder were statistically significant (p < 0.05) excluding comorbidity. Conclusion: About 10% of lung cancer patients had received a prescription for antidepressants after lung cancer diagnosis. A sleep disorder, number of hospitalization and length of stay were identified as factors influencing the prescribing antidepressants.

의사 환자 간 원격 의료의 의료법상 적법성에 관하여 - 원격 환자에 대한 처방 중심으로 - (On the Legality of the Telemedicine between the Patient and Doctor Under the Medical Service Act - Focused on the Prescriptions to the Distanced Patients-)

  • 김장한
    • 의료법학
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    • 제22권1호
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    • pp.3-23
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    • 2021
  • 원격의료는 원격지에서 영상, 통화 등 기기를 사용하여 환자를 진단, 치료하는 의료의 한 분야이다. 환자를 대면하여 진단, 치료, 처방하는 전통적인 방식에서 벗어나, 원격에 있는 환자에게 의료를 제공하기 때문에, 의료 소외 지역, 거동이 불편한 환자에 도움이 될 것이고, 의사들은 공간적 제약을 벗어나 환자를 볼 수 있다는 장점이 있다. 하지만 의사가 환자를 대면 진료하는 것에 비하면, 진료의 질이 떨어지는 문제가 나타날 수 있어서, 허용 여부와 한계를 정하는 것도 필요하다. 원격의료 유형 중에서 의사가 환자를 원격에서 진료하고 처방전을 발행하는 것을 원격진료라고 정의할 수 있는데, 현행 의료법상 허용되는지에 대하여 법 해석이 일관되지 못하고 있다. 의료법 처방전 조항은 의사의 '진찰' 또는 '직접 진찰' 규정에 의하여 처방전을 발급한다고 규정하고 있는데, 이것을 대면 진료를 요구하는 규정이라고 해석하는 헌법재판소 결정과 일정한 제한 하에서 전화 처방을 인정할 수 있다는 대법원 판결이 대립하고 있다. 또한 의료법상 원격의료 규정에 의하여 명백하게 법상 허용되는 원격의료자문 외에 의사 환자 간 원격진료는 불법이라는 대법원 판결이 있다. 본 논문에서는 의료법 개정 연혁, 개정 이유 및 관련 의료법 조항과의 관련성을 통하여 원격진료에 대한 대법원 판례를 해석하고자 한다. 결론적으로 의료법상 처방전 규정에 의한, 의사의 직접 진찰 후, 처방전 발급 조항은 환자를 진찰한 의사가 처방전을 발급해야 한다는 처방전 발급 명의에 관한 의무 조항으로 해석하며, 의료법 원격의료 규정에 의하여 의사-환자 간 원격진료는 허용되지 않은 것으로 판단한다.

건선(乾癬)의 임상 치험례 보고 (7 Clinical Cases Report for Psoriasi)

  • 노영호;엄현섭;김경철;신순식
    • 동의생리병리학회지
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    • 제19권2호
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    • pp.553-556
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    • 2005
  • The purpose of this study was to contribute to the development of clinical treatment for psoriasis through analyzing and investigating the result of the process of the treatment used for the treatment for psoriasis with prescription of Gamisoyosan, prescription for psoriasis No.1, and No.2. This clinical treatment approached by using 3 steps. In Step 1 7 patients with psoriasis were classified based on the severity of the disease and the types of psoriasis. Step 2, Proper treatment was applied to patients in accordance with typical types of symptoms and types of diagnosis in Oriental Medicine. In step 3, all the process of the treatment was recorded with pictures and the patients' signs of self-consciousness from initial treatment to final treatment determined the result. As a result of the treatment, it showed that prescription of Gamisoyosan applied to pustular psoriasis on the palms, pustular psoriasis on the sole of feet and geographic psoriasis on the whole bodies worked effectively and prescription for psoriasis No.1 applied to nummular psoriasis and prescription for psoriasis No.2. applied to nummular psoriasis made progress for the patients. Side effects and any other abnormal symptoms were not found. In conclusion, therefore, it is anticipated that selected treatment and prescription should be given according to types of diagnosis in Oriental Medicine referring the types of psoriasis. It is considered that more attention, deep and thorough study in mechanism of pathogenesis mechanism of treatment according to the types of psoriasis may make it possible for doctors to treat and prescribe patients.

동의수세보원(東醫壽世保元) 경험방(經驗方)에 근거한 사상체질별 설진(舌診)의 문헌연구 (A Literature study on the Sasang Constitutional Tongue Diagnosis based on Experience Prescriptions(經驗方) in the Donguisusebowon (Longevity and Life Preservation in Oriental Medicine))

  • 이재철;김종열;유현희;김근호
    • 사상체질의학회지
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    • 제22권1호
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    • pp.1-8
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    • 2010
  • 1. Objectives: This study was performed to research the relationship between Sasang Constitution and characteristics of tongue diagnosis based on Donguisusebowon's Experience prescriptions(經驗方). 2. Methods: We searched tongue diagnosis factors in Donguisusebowon and classified this. Based on Donguisusebowon's Experience prescriptions(經驗方), we find tongue diagnosis factors in 6 contemporary Oriental medicine prescription books. 3. Results: Most So-eumin has white thin tongue coating and clear redish tongue color. Yellow tongue coatings are found in symptoms for Yinjinho-tang(Yinchenhao-tang), Soseungki-tang(Xiaochengqi-tang), Daeseungki-tang(Dachengqi-tang). Shortened Tongue is found in So-eumin's experience prescription and So-yangin's treat histroy. It didn't shown that So-eumin's Semen Crotonis included 6 prescritions' factors of tongue diagnosis. So-yangin's white tongue coating is found in Hyungbangpaedok-san(Jingfangbaidu-san), Sipjo-tang(Shizao-tang), Sosiho-tang(Xiaocihu-tang), Shinki-hwan(Shenqi-wan). Most of other So-yangin's tongue coatings are Yellowish and tongue color is deep red. Tae-eumin have thin white tongue coating at the Mahuang-tang(Mahuang-tang). Red tongue color and drying tongue are found at Jowiseungki-tang(Tiaoweichengqi-tang)Daesiho-tang(Dacihu-tang)Saengmaek-san(Shengmai-san) 4. Conclusions: Following So-eumin's Experience prescriptions, So-eumin's tongue color is clear red and tongue coatings are thin white and greasy. Following So-yangin's Experience prescriptions, So-yangin's tongue color is deep red and tongue coatings are yellowish and scarce except Exterior cold disease. And So-yangin has specific symptom of irritability, oral sores. Tae-eumin's tongue has two sides of white thin tongue coatings and Red and drying tongue.

사상체질병증(四象體質病症)과 맥진(脈診)의 상관성(相關性)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Bibliographical Research of the Correlation Among Sasang Constitutional Disease(사상체질병증) and the Pulse Diagnosis(맥진))

  • 김동준;김정렬;김달래
    • 대한약침학회지
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    • 제6권3호
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    • pp.23-37
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    • 2003
  • The purpose of this research was to investigate the correlation Among Sasang Constitutional Disease and Examination of the pulse. I have gone over literatures of mainly ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ and the others Oriental Medical book was studied about the Pulse Diagnosis. And then I came to get some conclusion as follows. 1. Soeumin(소음인) the initial-stage symptoms of wulkwang disease(울광증) ; when the Superficial Pulse and the Superficial+ Moderate Pulse is made a diagnosis, Ceongunggyegitang(천궁계지탕) and Gunggyuhyangsosan(궁귀향소산) can be used. 2. Soeumin(소음인) the initial-stage blood disease symptoms of wulkwang disease(울광증) ; when the Minute+deep Pulse is made a diagnosis, Palmulgnnjatang(팔물군자탕) and Guakhyanggeonggisan(곽향정기산) can be used. 3. Soeumin(소음인) the initial-stage symptoms of mangyang disease(망양증) ; when the Yang region Superficial Pulse and the Yin region Weak Pulse is made a diagnosis, Hwanggigyegitang(황기계지탕), Bojungikgitang(보증익기탕) and Sengyangikgitang(승양익기탕) can be used. 4. Soeumin(소음인) the symptoms of taeum disease(태음증) ; when the Minute Pulse and Deep+Thin Pulse is made a diagnosis, Sasang Prescription can be used. 5. Soeumin(소음인) the symptoms of soeum disease(소음증) ; when the Minute+Thin Pulse, Deep Pulse and Thin+Deep+Rapid Pulse is made a diagnosis, Sasang Prescription can be used. 6. Soyangin(소양인) Wind of soyang disease(소양상풍증) ; when the Superficial+Tight Pulse is made a diagnosis, Hungbangpaedogsan(형방패독산) can be used. And when the Deep+Full with strong power Pulse is made a diagnosis, Hyungbangdojeoksan(형방도적산) can be used. 7. Soyangin(소양인) the symptoms of mangyeum disease(망음증) ; when the Superficial+Large+Rapid Pulse and Flood+Large Pulse is made a diagnosis, Hungbangsabaeksan(형방사백산) can be used. And when the Wiry+Thin Pulse is made a diagnosis, Hungbanggiwhangtang(형방지황탕) can be used. 8. Soyangin(소양인) the chest-phrenic fever syndrome(흉격열증) ; when the Superficial Pulse, Flood+Full+Rapid Pulse and Flood+Large Pulse is made a diagnosis, Sasang Prescription can be used. 9. Soyangin(소양인) the after fever syndrome(음허오열증) ; when the Empty+Soft+Rapid Pulse is made a diagnosis, Sasang Prescription can be used. 10. Taeumin(태음인) the upper neck exterior disease caused by Cold(배추표병) ; when the Superficial and Superficial+Tight Pulse is made a diagnosis, Mawhangbalpoytang(마황발표탕) can be used, And when the Superficial and Superficial+Tight with strong power on left hand Pulse is made a diagnosis, Ungdamsan(웅담산) and Handayulsotang(한다열소탕) can be used. 11. Taeumin(태음인) the Coldness syndrome in esophagus(위완한증) ; when the Superficial+Tight Pulse with weak power on left hand Pulse is made a diagnosis, Taeumjowetang(태음조위탕) can be used. 12. Taeumin(태음인) the Dryness-Heat syndrome(조열증) ; when the Flood+Large Pulse, Long Pulse and Long+Large Pulse is made a diagnosis, Galgeunhaegitang(갈근해기탕) can be used. And when the Tight+Full+Rapid Pulse with deep region is made a diagnosis, Yuldahansotang(열다한소탕) can be used. And when the Superficial+Slippery Pulse is made a diagnosis, Chungsimyunjatang(청심연자탕) can be used. 13. Taeumin(태음인) the symptoms of Yin-blood Exhaustion(음혈모갈증) ; when the Superficial with weak power Pulse is made a diagnosis, Nokyongdaebotang(녹용대보탕) can be used. And when the Deep with weak power Pulse is made a diagnosis, Gongjinheukwondan(공진흑원단) can be used. 14. Taeyangin(태양인) a slight Lumbar vertebrae disease(외감경증) ; when the Superficial+Hollow Pulse is made a diagnosis, Gunshitang(건시탕) can be used. 15. Taeyangin(태양인) the Generalized and Fatigue syndrome(해역증) ; when the Moderate+Choppy Pulse with left hand chi region(척맥) is made a diagnosis, Ogapijangchuktang(오가피장척탕) can be used. 16. Taeyangin(태양인) a slight Small Intestine disease(내촉경증)