• Title/Summary/Keyword: Health service accessibility

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

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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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.

우리나라 농촌지역의 출산조절행태 및 출산조절행위의 결정요인 분석

  • Chung, Kyung-Hee;Han, Seung-Hyun;Bang, Sook
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.33-53
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    • 1988
  • This study aimed at developing a desirable family planning policy and strategy by examining the current status of family planning practice in rural Korea and by indentifying the crucial factors which affect fertility control behavior. For this purpose, an analytical study was conducted, using the survey data collected in July 1985, on an interview basis, on 1, 440 married women living in the Soyi, Wonnam and Maingdong townships of Eumseong County(in North Chungcheong Province). This study population has the typical characteristics of rural areas, and the results of the analysis can be summarized as follows: 1. In regard to the demographic characteristics of the study population : their average age at marriage was 23.7, they had an average of 2.6 children( 1.3 boys, 1.3 girls) :10% experienced the death of their child (ren) :14% had spontaneous abortion(s) :4% weathered stillbirth(s) :35% went through induced abortion (s) : and 5.5% were currently pregnant. The average of their ideal numbers of children was 2.2, while 44% felt that they must have a son. 2. Looking at the contact rate with medical & health institutions, over the past 1 year, the visit rate to health subcenters was 43.7%, while 26.9% visited the (county) health center :59.6% had been to private clinics : and 41.5% went to the Soonchunhyang - Eumsung hospital : thus showing a relatively high rate of accessibility. 3. The utilization rate of family planning services was 76.5%, with tubectomy being the most prominent method at 52.3%, while the informants were health workers in 54.2% of the acceptors. Of the 8.4% who discontinued the use of contraceptive methods, only 26% did so due to want for pregnancy, natural infertility (meno - pause), or other reasons, while the remaining 74% stopped usage on account of side effects, failure in the methods themselves, and inconvenience of use, thus pointing to a situation where the proper choice of family planning methods have not yet been made. It can be noted that there is a strong motivation for early birth stopping as 35.3% practice family planning even with only one child, of which 38.3% have had sterilization operations. According to results of a multiple regression analysis, among the variables affecting contraception usage the most significant variable was the number of sons. 4. 34.8% experienced induced abortions. It was shown as a result of multiple regression analysis that the number of children and attitudes toward induced abortions extensively affected their frequency of abortions conducted. 5. In the regard to the relation between family planning and induced abortions, 33.7% of the women used both, while 52.0% of them used only the former(family planning), with only 1.4 % utilizing solely the latter(abortion), and 12.9% totally abstaining from fertility regulation : again, the discriminant analysis indicated that the choice of family planning and/or induced abortion was determined by the number of children and attitudes toward induced abortion. In view of the above mentioned results, the following are some comments and suggestions concerning problems related to the current family planning policies, in Korea : 1. It is difficult to expect a further quantitative expansion in family planning program operations, as there has been an excessive supply of target-oriented sterilization operations on women. From a maternal and child health care point of view, it will be desirable to have a diversification of service points in the future where family planning methods may be properly chosen, so that choices of methods which suit the mothers' characteristics and tastes may be made by the individuals themselves by strengthening their quality of family planning information services. 2. Along with the strengthening of the qualitative improvement of family planning services policies must be implemented to effectively promote the moral (ethical) deterrents to induced abortions and to preference for sons. From a maternal care standpoint, the social permissive norm toward induced abortion must be modified, and the bias towards son must be analyzed as the women with more daughters have a lower rate of family planning acceptance. Such changes in attitudes, however, can not be hoped to be accomplished with ad hoc policies, but will only be possible when an enhancement of the women's status(within the society) is brought about in a long - term perspective.

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The effects of family stress and social support resources on marital satisfaction among middle-aged married men and women (중년기 기혼남녀의 가족스트레스, 사회적 지지 자원이 결혼생활만족도에 미치는 영향)

  • Park, Ju-Hee
    • Journal of Family Resource Management and Policy Review
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    • v.19 no.4
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    • pp.71-94
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    • 2015
  • The purpose of this study is to propose measures for social work practice to enhance the happiness of middle-aged married men and women by identifying the effects of family stress and social support resources (formal and informal support resources) on marital satisfaction among mid-life married couples. Subjects were selected through purposive sampling among married men and women aged between 40 and 59 and living in Seoul City and Gyeonggi province. The study results are follows. First, the average score of family stress was 3.06 points (SD=.56), slightly higher than the median value of 3 points. Of all subscales of family stress, the subjects experienced the most stress from family relationships, followed by financial problems, health and loss of families, and work-family compatibility. In regard to social support resources, the mean value of all social support resources categories was greater than the median. Among the subscales, informal support (family support and support from other people) was found to be higher than formal support. The level of marital satisfaction was higher than the median, and the score was 3.21 points (SD=.78). Second, in order to explore differences in marital satisfaction according to family stress and social support, differences in marital satisfaction were analyzed by grouping subjects who scored high, middle, and low levels of marital satisfaction. According to the results, marital satisfaction was statistically significantly higher in the group that experienced less family stress (F=6.25, p<.01). With respect to social support, marital satisfaction was statistically significantly higher in the group that received high social support (F=29.68, p<.001). Third, according to the analysis of factors affecting marital satisfaction in middle-aged married men and women, subjective economic status, family relationship stress, economic stress, and family support showed statistical significance. The higher the subjective economic status and the lower the family relationship stress and economic stress levels, the higher the marital satisfaction among middle-aged married men and women. In addition, the greater the family support, the higher the marital satisfaction. The results of this study underscore the need to improve family relationships in middle-aged married couples and to distribute family life education programs that can strengthen family support resources. For example, family relationship enhancement programs are currently performed, including "Family School for Middle-Aged Baby Boomers" and others as part of the Healthy Family Support Work regarding the promotion of marital satisfaction of middle-aged couples. In addition, continuing effort is warranted to include content on strengthening family support resources, maximizing the effectiveness of programs, and promoting service accessibility.

The Development of Evaluation Indicator for Eco-experience in Rural Village (농촌마을 생태체험 공간으로 활용하기 위한 연못형습지 평가지표 개발)

  • Lee, Sang-Young;Kim, Mi-Heui;Kang, Banghun;Son, Jin-Kwan
    • Journal of Agricultural Extension & Community Development
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    • v.21 no.4
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    • pp.1125-1147
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    • 2014
  • This study was conducted to develop the health evaluation indicator of pond wetland in order to enhance the quality of eco-experience in rural area. The methods for development of evaluation indicator were consisted of 3 stages; 1st, the precedent assessment protocol was applied to 10 pond wetlands in farm villages, and eco-experience expert survey was conducted to selection the evaluation item and criteria at 2nd and 3rd stages. In the results of applying the precedent assessment protocol, we found out two problems; 1) the evaluation result of value determination and conservation value were too simple, and 2) the score by evaluation items were nearly the same, because evaluation criteria in not precisely for application in rural area. These results were reflected to expert survey. According to the 1st survey results, they suggested that 4 items should be maintained, and 3 items should be deleted, and 2 items should be modified among a total of 9 times. Therefore, it was modified into the evaluation protocol having a total of 8 items. According to the 2nd survey results, the selected evaluation items were generally proper. With regard to items for assessing the health condition of pond wetland, we selected a total of 8 items; (1) Connectivity to forest, (2) Connectivity between water body and wetland connection, (3) Number of Vegetation, (4) Surround land use, (5) Interspersion of Vegetation, (6) Crossing Structure, (7) Wetland size, and (8) Outlet structure. In addition, it was suggested that accessibility, visibility, and trash were need for utilization of pond wetland as a place for eco-experience. It is expected that the selected evaluation indicator can help to utilize the pond wetland as an eco-experience space in rural area, and maintain the pond wetland as a space for conservation of biodiversity.