Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.
Objectives: Although Korean Medicine (KM) subsidized by the National Health Insurance (NHI) has been used for a long time, there has been no active analysis using claims data. Therefore, the purpose of this study was to examine the NHI KM utilization trend using NHI statistics and to measure the level of market concentration by year. Methods: By restructuring the contents of NHI Statistics for Pharmaceuticals for 2010-2019, the claim cases, costs, and annual growth rates of KM were demonstrated by year, sex, age group, region, therapeutic group, and KM treatment. The proportion of highly used k treatments in cost was calculated as the concentration ratio (CR) k and its trend by year was investigated. Results: In 2019, the NHI cost on KM amounted to ₩38.2 billion KRW, increasing by 11.6% per year on average in 2010-2019. Notably, KM was used more frequently among women and patients aged ≥ 65 years, and the mixed formulation accounted for 95% of the total cost of KM. The CR of the simple formulation increased rapidly, whereas that of the mixed formulation remained constant. In 2019, three simple formulation treatments- peony, licorice, and ginseng- accounted for 93.8% of the total cost for KM (CR3 = 93.8%). Conclusion: NHI KM is rapidly increasing. Investigating the CR of KM confirmed that KM prescriptions have been concentrated in small numbers over the past 10 years.
Objective : The aim of this study was to review the use of Korean medicine (KM) or Complementary and Alternative Medicine (CAM) therapies among children with cerebral palsy (CP). Method : Literature searches were performed using Pudmed, CNKI, J-STAGE and four Korean databases. We investigated the frequency, types, predictors of the use of KM or CAM therapies used in children with CP. Results : Thirteen survey studies including use of KM or CAM among children with CP were selected - six Korean studies and seven overseas studies. The utilization rate of CAM among children with CP varied 26.8~56.0% according to the studies. CP children used KM or CAM more than other children with chronic disease. Acupuncture and Korean herbal medicine was the major treatment used in Korea, however physical manipulations such as massage, osteopathy and chiropractic were in high demand in western country. Disease severity of CP, use of CAM in the past by the parent or family member and high education of parent are the factors that significantly affect CAM utilization. Conclusion : Further studies on effectiveness and safety of KM therapies combined with conventional rehabilitation treatment would be required to expand the implementation of KM treatment for CP children.
Objectives : This study was aimed to investigate attitude of western medicine(WM), Korean medicine (KM), and nursing school students toward the east-west collaborative medical practices(EWCMP). Methods : The participants were 185 WM students, 123 KM students, and 230 nursing students belonging to two universities (P and D) in Busan metropolitan city, Korea. Data were collected with self-administered questionnaires and analyzed with descriptive statistics, $X^2$ test, t-test and ANOVA with SPSS win 14.0. Results : Of 538 participants, overall 87.1% has heard EWCMP. Preferred type of EWCMP was significantly different by participants' backgrounds. WM students preferred (western) medical treatment with minor supportive Korean medical care(85.5%). However, KM students emphasized EWCMP with the same weight in both medical and Korean medical treatment(59.0%), and nursing students were in between two schools. Intention to recommend EWCMP for the consumer was 67.4%, and also showed very different between WM students and others, 37.3% of WM students, 89.4% of KM students, and 83.9% of nursing students. WM students showed more negative opinion on the EWCMP than KM and nursing students, Conclusions : The attitude of WM, KM, and nursing school students toward EWCMP was very similar to that of WM doctors, KM doctors, and nurses, respectively. WM students showed big difference in the overall attitude toward EWCMP from that of KM and nursing students. It is recommended to introduce the joint curriculum or exchange programs between WM and KM schools.
Background : The introduction of policies expanding the coverage of uninsured Korean Medicine (KM) services have requires an understanding of the following components of the service : current financial expenses, degree of financial burden on the patient, and financial effect of the coverage expansion. Objectives : This study aims to determine the annual trend of outpatients' characteristics and the category of out-of-pocket spending in KM. Methods : This study uses data from the Korea Health Panel to analyze use of KM in the Korean population. Using the user characteristics and behavior drawn from the Korea Health Panel data, out-of-pocket spending trends of KM were analyzed by year. The diagnosis and prescription of out-of-pocket spending were also analyzed. Results : The proportion of patients receiving uninsured medical treatment and the number of uninsured medical treatment in outpatient clinics have increased. However, the average out-of-pocket spending per person and out-of-pocket spending per visit are consistent or have decreased. Meaningful trends are the increase of R00-R99 (unclassified symptoms) and the decrease of K00-K93 (digestive system disease) and J00-J99 (respiratory system disease). Conclusions : Expansion of KM medical service and insurance is influenced by uninsured medical treatment of KM. Hence, research to increase medical treatment categories for out-of-pocket spending or explore diseases where KM diagnosis has been proven effective should be further developed.
Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.
Objectives : This study aimed to analyze the structure and the trend of utilization and expenditure for Korean Medicine (KM) in Korea. Methods : Data were drawn from the 2008-2013 annual Korea Health Panel (Version 1.2.2), a national representative sample. We combined the data of household members with the data of outpatient KM service use. The volume of KM use was estimated based on the frequency of use and co-payment. Results : The KM utilization rate slightly increased in recent years, and it is presumed to be resulted from the increase of elderly population. Most KM outpatient visits were being concentrated in treating musculoskeletal diseases, and the procedures used frequently were acupuncture, moxibustion, cupping, and physical therapy. The imbalance of KM use between lower income group and higher income group was deepening. Conclusions : To expand restricted disease areas KM covered, the more herbal prescriptions should be insured and the insured form of herbal medicines need to be diversified.
Objectives: The aim of this scoping review was to analyze research trends about mental health of nurses working in Korean medicine (KM) hospitals in Republic of Korea. Methods: Searches were conducted using four electronic databases including Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, Research Information Sharing Service, Korea Citation Index to collect relevant studies. The search date was March 4, 2021. All studies published up to the search date were considered. Observational studies reporting mental health outcomes of nurses working at KM Hospital were included. Results: A total of 11 cross-sectional observation studies were included. Four of them compared mental health of nurses working on KM and Western medicine (WM). Commonly reported outcomes related to mental health were job satisfaction, role conflict, and work stress. As a result of meta-analysis based on a 5-point Likert scale, the following factors were related to mental health of KM nurses: job satisfaction (2.844±0.067 points), role conflict (3.678±0.058 points), work stress (3.142±0.021 points), turnover intention (3.483±0.028 points), and burnout (3.180±0.033). Compared to WM nurses, KM nurses had significantly less work stress (p=0.000), role conflict (p=0.039), and job satisfaction (p=0.000). Conclusions: Mental health problems of nurses are known to be very common. Although improving them is an important social task, studies on mental health of KM nurses remain insufficient. Based on findings of this study, more cooperation between nurses and KM doctors should be made to improve the mental health of KM nurses, especially their job satisfaction in the future. The Korean Society of Oriental Neuropsychiatry needs to pay more attention to this topic.
Journal of Physiology & Pathology in Korean Medicine
/
v.30
no.6
/
pp.412-418
/
2016
The emergence of systems biology in the 21st century is changing the paradigm of biomedical research. Whereas the reductionist approaches focus on components rather than time or contexts, systems biology focus more on interrelationships, dynamics, and contexts. The key ideas of the systems biology shares much with the philosophy of Korean Medicine(KM) and therefore, the paradigm shift is shedding light on understanding the mechanism of action of KM at system level. In this article, I provide a guide to learning systems biology for KM researchers using online learning resources. Thanks to the recent development of MOOC(massive open online courses) and other online learning platforms, learners can access to plenty of high-quality resources from top-tier universities in the world. I expect this guide help researchers to employ systems biology methods into their KM researches, and will lead to the development of future curricula for training "bi-lingual" experts, KM and computational approaches.
Objectives: We noticed that hyperhidrosis can be differentiated by whether it is topical or systemic in both Korean medicine(KM) and Modern medicine(MM). Comparing between topical and systemic sweating, we will figure out similarity between KM and MM about stimuli on sweat. Methods: All research is done by finding information on text-book, article, books. Results: Hyperhidrosis is differentiated by whether it is topical or systemic in both Korean medicine(KM) and Modern medicine(MM). First, systemic sweating(SS) is affected by body temperature. In KM, Heat and Cold(plus yang deficiency) can make human sweat systemically. In MM, heat is also mentioned as stimulus. Second, topical sweating(TS) can occur on emotionally-stressed situation especially on palms-and-soles. In KM, this phenomenon is explained by heart spirit(心神) and disease transmitted by pericardium meridian(手厥陰心包經 是動病). In MM, anatomically hyperhidrosis on palms-and-soles is generated by adrenergic sympathetic nerve which is involved with stress. Third, sweating on palms-and-soles also can be generated by internal organ. In KM, hyperhidrosis on palms-and-soles is explained as illness on stomach meridian(足陽明胃經). The 70% of parasympathetic nerve is vagus nerve which is located at internal organs-usually gastrointestinal tract. In that point, stomach and parasympathetic nerve seem to be involved in hyperhidrosis on palms-and-soles. Conclusion: Hyperhidrosis is differentiated similarly by whether it is topical or systemic in both Korean medicine and Modern medicine. Conserving each perspective of KM and MM, one perspective can be useful to other by supplementing other's weak point.
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