• 제목/요약/키워드: Drug utilization review system

검색결과 32건 처리시간 0.021초

불안장애 환자에서의 치료약제 중복사용에 대한 후향적 의약품사용평가 연구 (Retrospective Drug Utilization Review Study on the Therapeutic Duplication in Patients with Anxiety Disorders)

  • 박찬현;손현순;신현택;최경업
    • 한국임상약학회지
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    • 제20권1호
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    • pp.39-49
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    • 2010
  • The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.

약물역학분야의 한약연구동향 (Current Research Trend of Herbal Medicine in Pharmacoepidemiology)

  • 우연주
    • 대한예방한의학회지
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    • 제22권3호
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    • pp.11-19
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    • 2018
  • Objectives : The aim of this study is to investigate the current research trend of herbal medicine based on the published articles in pharmacoepidemiologic journals. Methods : A total of 3 electronic journals, Pharmacoepidemiology and Drug Safety(PDS), Drug Safety and Journal of Pharmacoepidemiology and Risk Management(JPERM) from January 2013 to August 2018 were used for searching articles about herbal medicine. Selected articles were reviewed and classified under 5 categories-collection of adverse events in herbal medicine, statistical modeling and methodology, pharmaco-epidemiologic outcome study, drug utilization review(DUR), risk management system and regulation. Results : A total of 8 articles were finally included for analysis. 2 articles were categorized in collection of adverse events in herbal medicine, 1 was statistical modeling and methodology, 2 were pharmacoepidemiologic outcome study and 3 were risk management system and regulation. There was no article in DUR. And then pharmacoepidemiologic research trends of herbal medicine were summarized in classification of 5 categories. Conclusions : To sum up with these 8 articles of herbal medicine in pharmacoepidemiologic journals, herbal medicine was of interesting concern among researchers. The need for research on safety and risk management of herbal medicine is steadily increasing, pharmacoepidemiologic research about herbal medicine must be activated in Korea.

전산 데이타를 활용한 약물이상반응검토 및 시그널 (Adverse Drug Event Surveillance System using Electronic Data and the Signals)

  • 김은영;강원구;권광일
    • 한국임상약학회지
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    • 제21권4호
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    • pp.383-389
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    • 2011
  • 약물요법에 있어 약물이상반응은 환자의 사망률과 이환율에 영향을 미치는 중요한 요인이다. 약물이상반응 발생시 이를 신속히 보고하는 것과 함께 약물치료과정에서 일어날 수 있는 약물 관련부작용을 조기에 인지하고 능동적으로 조치함으로써 환자에게 가해지는 위해를 최소화하는 것 또한 실제 환자치료의 질적인 관리에서 중요한 부분이다. 본 연구에서는 의료기록의 전산화에 따른 전산데이터들을 활용한 약물이상반응감시방법 중 하나로 평가 받고 있는 Computerized surveillance system (CSS)에 대한 사례 연구들의 방법들을 비교해 보고, 제시된 관련 시그널들 중 약물이상반응을 능동적인 방법 즉 실시간 혹은 예방적으로 적용 가능한 시그널들을 찾아 정리해 보고자 하였다. 이를 위해 가장 대표적인 연구가 진행되었던 연구사례들을 분석하였고 약 20여 개의 시그널들을 선정하여 분야별로 제시하였다.

POULTRY WASTES AS FOODS FOR RUMINANTS AND ASSOCIATED ASPECTS OF ANIMAL WELFARE - Review -

  • Roothaert, R.L.;Matthewman, R.W.
    • Asian-Australasian Journal of Animal Sciences
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    • 제5권4호
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    • pp.593-600
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    • 1992
  • Animal welfare is often neglected by livestock productionists when considering the utilization of animal wastes for livestock feeds. The present review has been carried out to examine the nutritive value of poultry wastes for ruminants, the health risks involved with feeding it, the treatment and feeding methods and the production responses of animals fed on it. It was found that mineral, crude protein, crude fibre and metabolisable energy concentrations are influenced by the system of poultry production, the storage of the waste and the treatment method. Heating at $60^{\circ}C$ kills all pathogens apart from Clostidium botulinum whereas proper ensiling kills all. Apart from the kidney fat and the liver, animal tissues have not shown residues of drugs or heavy metals from poultry wastes. Palatability is affected when the moisture is more than 200 g/kg. Production responses are satisfactory when poultry wastes replace portions of concentrates. It was concluded that poultry litter generally has higher metabolisable energy contents than poultry manure, but research is needed to classify poultry litters on their energy values. The adverse effects of toxic minerals and drug residues are negligible in balanced poultry waste feeding systems.

포괄수가제 당연적용 후 의약품 사용현황 분석 (Analysis of Drug Utilization after the Mandatory Application of the DRG Payment System in Korea)

  • 강희정;김지만;임재영;이상규;신의철
    • 한국병원경영학회지
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    • 제23권2호
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    • pp.18-27
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    • 2018
  • Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.

국내 2018년 의약품 소비량 및 판매액 통계 산출 및 국제 비교 (A Critical Evaluation and International Comparison of Pharmaceutical Consumption and Sales Statistics)

  • 김지혜;이다희;김수연;김동숙
    • 보건행정학회지
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    • 제30권3호
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    • pp.311-325
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    • 2020
  • Background: Health statistics of pharmaceutical use and expenditure are essential to make and implement evidence-based pharmaceutical policy. This study aims to demonstrate the methods and results of pharmaceutical consumption and sales in 2018 according to the sources and methods given by the Organization for Economic Cooperation and Development (OECD). Methods: The medication list contains 39,346 medicines both reimbursed and non-reimbursed by the National Health Insurance in 2018. We used the therapeutic categories based on Anatomic Therapeutic Chemical Classification of World Health Organization. This study analyzed National Health Insurance claims data and supply data generated from wholesalers to health care facilities. The indicators are defined daily dose (DDD), per 1,000 inhabitants per day and US$ per capita. Results: In South Korea, the number of medications to which DDD were assigned was 18,055 and it was 45.9% of the total number of medications on the list. The consumption in anti-infective for systemic use (J) and musculo-skeletal system (M) was higher than the mean consumption among the OECD countries. The pharmaceutical sales per person in Korea was also higher than the mean sales per person across the OECD countries. Conclusion: We sought to explain the methods to produce pharmaceutical consumption and sales statistics which we had submitted annually to OECD. Considering the characteristics of pharmaceutical statistics, a direct comparison should be approached with caution. Since the growth in pharmaceutical spending has greatly increased over the past decade, we need to monitor pharmaceutical consumption and expenditure consistently.

주요 치료재료 품목군의 건강보험청구액 결정요인분석 (Analysis on the Determinants of Therapeutic Materials Expenditure in National Health Insurance)

  • 변진옥;이주향;김유리;이혜재
    • 보건행정학회지
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    • 제26권4호
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    • pp.333-342
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    • 2016
  • Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

병원 의사결정지원시스템의 서비스 품질이 경영성과에 미치는 영향 : K대병원 사례 중심으로 (A Study on the Effects of the Service Quality of Hospital's Decision Support System on Management Performance : the Case of K-University Hospital)

  • 박진희;권두순;이미영
    • Journal of Information Technology Applications and Management
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    • 제21권2호
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    • pp.81-98
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    • 2014
  • Recently, due to external environment like the changes in health policy and various healthcare accreditations, along with hospital's internal efforts to improve the quality of medical services, demands for the development of medical information systems are increasing. Some examples are clinical information like DUR (Drug Utilization Review), CVR (Critical Value Report), and automatic benefit processing by treatment purposes, or hospital DSS (Decision Support System) on overall medical practice. Such systems act as a guide in making clinic judgments during practice or in other medical practice, and their effects on the medical treatment improvements are being proven by previous studies. In the reality of increasing attention in the effects of medical treatment improvement, studies related to hospital DDS were mostly focused on clinical, technical, and engineering points of view, and studies focusing on the user viewpoint are very limited. In order to verify the effects of DSS on practice improvements and hospital's management performance, this study used a research model constructed to verify how SERVQUAL of hospital DSS affects hospital management performance in BSC (Balanced Score Card) point of view. To empirically verify the research model, a questionnaire was conducted on the basis of "K-University Hospital's DSS" on clinicians and hospital employees related to system development, and the relationships between the factors were analyzed through path analysis. As a result of path analysis, excluding reactivity, tangibility, confidence, reliability, empathy among service qualities, had partially significant effects on management performance factors (learning and growth, internal process, financial affairs). This study is to prepare the theoretical ground on the management performance analysis of hospital DSS, and suggest the service quality of the system that should be considered in the planning and development stages for improved system.

의약분업 초기의 서울지역 외래환자의 투약실태 (A Study on the Medication in an early Implementation Period of Separation System of Pharmacy and Clinic in Seoul)

  • 조원순
    • 한국보건간호학회지
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    • 제15권2호
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    • pp.398-411
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    • 2001
  • The separation system of pharmacy and clinic has begun on the purpose of preventing drug misuse and abuse since July 1st of 2000. The system revealed some conflicts between doctors. pharmacists and consumers. Consequently pharmaceutical law and related policies undergone some change. Now in an early period of the implementation of the system, the necessity to examine relevance of those policies and law enforcement to medical doctors' prescriptions pattern evolves. This study tries to verify the pattern through a field study. For the purpose, 930 prescriptions collected in May of 2001, from a pharmacy located in Gangnam-gu in Seoul, were analysed. The prescriptions were issued from several clinics: 459 prescriptions from otorhinolaryngological clinic(ENT), 177 from internal medicine clinic(IM), 130 from ophthalmic clinic(Opt), 52 from obstetric and gynecologic clinic(OB & GY), and 112 from miscellaneous clinics. ENT, IM, Opt. OB & GY are situated in a clinic building of 40m distance. The general findings are following: 1) $88.8\%$ of the total patients came from 5clinics in nearby single clinic building. 2) Average prescribing days were 6.2 days and the average number of used drugs were 4.0 drugs, i.e. 2-4 times of WHO criteria 1-2 drugs. 3) Use of antibiotics in the oral administration drugs rated $71.8\%(WHO: \;22.7\%)$ 4) Use of injection rated $31.3\%(WHO:\;17.2\%)$ 5) $96.2\%$ of the patients use multiple antibiotics in the injection and oral administration together. 6) The patients had multiple disease : ENT patients 1.7 disease and 1M patients has 2.7 disease in average and several regular prescribing types evolved particularly in the ENT prescription. With this result we found that drugs. especially antibiotics are still abused a lot, and there were significant differences in the number of used drugs and prescrbing days between the clinics. It implies somes differences of the preparation work and time for pharmacists. And preparation can be done in advance by pharmacists' own efforts through noticing regular prescribing types. The study suggests the followings: 1) Patient counseling should be done to minimize the incidence of adverse events. 2) The enforcement of the standardized differential preparation price system should be reconsidered. 3) Preparation of typical regularly appeared prescription in advance. which is regarded as 'a prearranged work between doctors and pharmacists' and has been prohibited should be reconsidered. 4) Drug utilization review program should be established to prevent drugs abuse. especially antibiotics abuse.

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한방건강보험 약제 투약 실태 및 활성화 방안 연구 (A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement)

  • 권용찬;유왕근;서부일
    • 대한본초학회지
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    • 제27권2호
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.