• The Journal of Korean Medicine
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• v.35 no.1
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• pp.99-113
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• 2014

Objectives: To provide theoretical basis for the classification of medicinal moxibustion(藥灸劑) in Health Insurance Medical Benefit in Korea through investigating trend of judicial precedents on indirect moxibustion and usage of medicinal moxibustion in "Donguibogam". Methods: We analyzed statistical data of moxibustion from Health Insurance Review & Assessment Service and National Health Insurance Statistical Yearbook. We investigated major judicial precedents on indirect moxibustion to find out some trend and we searched the usages of medicinal moxibustion in "ZhenJiuDaCheng" and "Donguibogam". Results: According to recent judicial precedents, indirect moxibustion with equipment is no loner regarded as Korean Medical Procedure. In composition of 'Oriental Health Treatment', amount for acupuncture has gradually decreased instead, amount for moxibustion has increased steadily for 5 years. Medicinal moxibustion(藥灸劑) is often used as a form of indirect medicinal moxibustion with moxa in "Donguibogam". Argyi Folium, Moschus, Natrii Chloridium, Radix Preparata, Realgar and Olibanum are most frequently used for medicinal moxibustion in "Donguibogam". Medicinal moxibustions are composed of simple prescription or herb-pair or multiple prescription in "Donguibogam". Conclusions: In Health Insurance Medical Benefit in Korea, under the division of moxibustion, direct medicinal moxibustion and indirect medicinal moxibustion should be classified in addition.

• Health Policy and Management
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• v.32 no.3
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• pp.282-292
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• 2022

Background: Aging societies face social problems of increased medical expenses for older adults due to increased geriatric diseases. This study aims to analyze the relationship between the state change of multiple chronic conditions (MCC) and out-of-pocket medical expenses in the elderly aged 60 or older. Methods: The 2014-2018 Korean Longitudinal Study of Aging data were used for 2,202 elderly people. Four status change groups were established according to the change in the number of chronic diseases. The association between the change of MCC and the out-of-pocket medical cost was analyzed using the generalized estimating equation model analysis. Results: The average out-of-pocket total medical costs were 1,384,900 won for participants with MCC and 542,700 won for those without MCC, which was a statistically significant difference (p<0.0001). Compared to the reference group (simple chronic disease, SCD→SCD), the change in multiple chronic conditions significantly increased the total out-of-pocket medical expenses in MCC→MCC and SCD→MCC groups (MCC→MCC: 𝛽=0.8260, p<0.0001; SCD→MCC: 𝛽=0.6607, p<0.0001). Conclusion: In this study, it was confirmed that the prevalence of MCC increased with age, and the out-of-pocket medical cost increased in the case of MCC. Continuity of treatment can be achieved for patients with MCC, and the system and management of treatment for MCC are required to receive appropriate treatment.

• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.137-177
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• 2007

The medical expenses review system in Korea has developed under fee-for-service system with its own unique structure. The importance of reviewing medical expenses has been emphasized, as the size of medical expenditures moving through the health insurance legal context and its weight in the national economy have increased very rapidly. It is, however, analyzed that the feuds and arguments continue among the stakeholders for the lack of laws supporting the medical expenses review system. The medical expenses review is a series of administrative procedures, deciding whether claims from medical care institutions to the insurer are legal and valid or not. It mainly controls the increase of unnecessarily excessive health insurance claim and prevents fraudulent claim and abuse and checks the less use or unsuitable use of medical resources. It also works a function guarantees medical benefits for the appropriate treatment according to the object of health insurance system as a social insurance scheme. The dispute on legal base of the medical expenses review is about the source of law in the medical expenses review. There are the Health Insurance Act and administrative laws as jus scriptum and the guidelines of review as administrative orders. The medical expenses review should reflect various factors, such as the development of medical healthcare technologies, the health expenditures distribution, the financial situation of the health insurance, and the evaluation on the level of appropriate benefits. It is also likely to adapt to the traits of characters of medicine, and trends and transition, Besides it should judge the legality and the validity of medical benefits expenditures by synthesizing these all factors. And the evaluation system of appropriateness of medical benefits was administrative procedure which was consecutive with reviewing the medical expenses system and it was intended to make up for the result of reviewing the medical expenses in more comprehensive levels.

• Health Policy and Management
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• v.10 no.3
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• pp.1-18
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• 2000

This study was conducted to find medical care utilization pattern and to examine the affecting factors on medical facilities utilization using Andersen's medical care service behavioral model. Three hundreds and five public officials with detected disease through the health examination in 1998 were surveyed using self-administered questionnaire. And 230 data were available and analyzed. The results of this study were summarized as follows: Among variables of predisposing factors, knowledge for disease, confidence about periodic health examination program in health insurance, and the attitude toward medical utilization in the usual showed significant relations with the medical utilization. Other variables were not related with the medical utilization. Variables of enabling factors did not show significant relations with the medical utilization. Recognition of family members for detected disease had significant relations with the medical utilization. Among variables of need factors, absence caused by detected disease was significantly related with the medical utilization. The number of non-occupational diseases detected, but untreated people were 75(32.6%) of total subjects, mainly because detected diseases seemed insignificant to them. With multiple logistic regression analysis, the significant variables having an effect on the medical facilities utilization were 'knowledge for disease', 'attitude toward medical utilization in the usual', 'recognition of family members for detected disease' and 'experience of absence caused by detected disease'. On considerations of above findings, counselling for detected disease and its treatment, health education for individuals and program for family support promotion are needed for health management of public officials with diseases detected in health examination.

• Journal of The Korea Institute of Healthcare Architecture
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• v.18 no.2
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• pp.77-84
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• 2012

This study is to understand the architectural types and characteristics of the medical facilities during ancient period. The study is based on the research of the medical and architectural history. The medical or healthcare facilities are influenced by their social, cultural and conceptual idea, especially how they think about 'disease', 'cure' and the 'medicine'. As the results of the examination of this study can be summarized as followings. Firstly, Ancient medical facilities are classified into four types according to the ideas of 'disease' and 'cure' ; 1) God oriented facility 2) health welfare facility 3) treatment oriented facility 4) practice & educational facility. Secondly, there are three typical types of the spatial characteristics what modern hospitals have ; 1) nursing ward 2) treatment ward 3) hostel or hospice. And they are all assembled around the courtyard in common. Thirdly, their architectures are not 'designed' but 'derived' plan by reasonable other building types, and transformed by medical function. Fourthly, a consideration of the surrounding circumstances is the most important point to make the medical health facilities during ancient period.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.44 no.3
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• pp.146-164
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• 2021

This study examines the effects of the public's perception of emergency medical service (EMS) on the public health system's brand equity and the moderating effect of governance on this relationship using Keller's customer-based brand equity model. It uses four EMS functions: rescue/first-aid and transfer activities; disaster prevention, preparation, and response activities; educational activities in urgent situations; and medical treatment in emergency rooms to examine the effects of them on brand meaning of the public health system. Our findings are important for understanding the public as customers of the public health system and devising and/ or adapting healthcare policies and marketing strategies to develop brand equity and increase customers' loyalty to the public health system.

• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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• pp.163-173
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• 1974

A study on the health care of Ewha Womans University staff, faculty and families was conducted during the period from March 1973 to August 1974 using designed questionaire. A total of 196 persons who were randomly sampled as 27.3% of the total staff and faculty 789 were studied. The response rates were 96.0%. The results and findings obtained from the study are summerized as follow. 1. The sex ratio of the members the faculty and the staff shows 83.2% and the singles are 37.2% of the total. Their mean family size being 4.6 persons per capita, each family has mean number of 2.3 childeren. 2. The median monthly income of a member of faculty amounts \114,000 and that of a staff \43,077. It amounts \79,333 when the median monthly income of both the members of the faculty and the staff are taken. Consequently, it amounts \91,727\ per family (Assumed mean). 3. 71.4% of the total hold the house of their own. A spouses of 59.4% of them are working for the additional income of the family. 4. Their health condition is rated fair, i. e. 92.3% of them enjoy good health. Out of total members faculty and the staff, 20.6% are cared by family physician. 36.2% of them feel that they are burdened by heavy medical expense. 5. 76.7% of them have affirmatively responded that they would purchase medical insurance policy when they were offered. It reaches 84.0% of the total who consider buying the policy for their dependents. 74.0% of them desire to purchase the policy for their spouse's parents. 6. The monthly prevalence rate reaches 17.0% and the hospital admission rate 4.7%.12.3% of them affirmatively responded that they had chronic diseas. The number of sick call per capita counts 0.2 per month and the hospital admission rate 0.05. 7. To examine the nature of their disease, the respiratory disease is rated to be the top and the gastro-intestinal disease comes to the next. As far as chronic disease is concerned, the gastro-intestinal disease is predominent. 8. As to their treatment, 65.4% of them get the physician's treatment and 17.0% treatment of drug purchasing and 7.7% prefer Chinesedrug. 6.6% of them gets no medical treatment at all. 9. The treatment ratio, including drug purchasing and other means, reaches 93.4%. 60.7% of them affirmatively responded that they did not or could not get physician's treatment at least once even though they thought they had to. It is disclosed that 25.4% of them are caused by economical reason. 10. Average medical expense per case amounts \7,116 and monthly medical expense per capita \1,345. Consequently, average monthly medical expense per family amounts \6,185. 11. The medical expense of a family is rated 7.7% of total earnings of the same period.

• The Journal of Pediatrics of Korean Medicine
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• v.14 no.2
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• pp.169-184
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• 2000

A literature study was progressed for oriental medical treatment for atopic dermatitis. Atopic dermatitis is a chronic or chronically relapsing, pruritic dermatitis. In oriental medical treatment is classified into the treatment of inside(herb tea), treatment of outside(medicine for external application), treatment of inside & outside. The method of inside treatment is improving in health for the spleen and clearing wetness(健脾利濕), extinguishing wind and refreshing fever(消風淸熱), nourishing blood and making dryness gloss(養血潤燥). The method of outside treatment is refreshing fever and removing wetness(淸熱燥濕), counteracting the poison and getting rid of itch(解毒止痒), removing the boil and forming proud flesh(消腫生肌). The method of inside & outside is improving in health for the spleen and clearing wetness(健脾利濕), refreshing fever and getting rid of itch(淸熱止痒). refreshing blood and extinguishing wind(凉血祛風).