• Korean Journal of Health Education and Promotion
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• v.17 no.1
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• pp.131-154
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• 2000

This study was conducted to provide basic data for development of public information program and public policy which could prevent the medicine abuse in Korea, examining the level of knowledge of medicine and its related factors. Data were collected from the 2,011 residents who live in mtropolitan cities, large-sized cities, small and medium cities, and small towns The results of this study are summarized as follows. 1) In case of purchasing of medicines in pharmacy, 67.3％ of the respondents chose the medicines through recommendations of the professionals such as pharmacists and doctors, while 32.7％ of the respondents chose the medicine through self-judgement, advertizing, or recommendation of relative. 2) 64.7％ of the respondents obtained the information on medicines through TV. It appeared to be higher in the groups of female of the twenties, the unmarred, a brother and sister threesome, highschool graduates, housewives, residents in small and medium cities, atheists, and the middle class, displaying the significant difference from the other groups. 3) 40.5％ of the respondents recognized the side effect of the medicine when they took the medicine, while 34.4％ did not recognize it. The rate of experience in the side effect was 39.7％. The informations on the medicine abuse and the risk of addiction were obtained through broadcast media (47.9％), publications (12.1％), and health professionals (11.6％). 4) 81.1％ of the respondents experienced taking of the fatigue relieving medicine. The experience in taking of the fatigue relieving medicine appeared to be higher in the groups of the forties. the married. a brother and sister threesome. highschool graduates. persons engaging in farming, livestock raising, and forestry, the residents in small towns, and Christians. Each group displayed the significant difference from the other groups. 5) According to the level of knowledge of medicines, the respondents marked average 11.7 ± 3.76 points on the base of 24 points. It appeared to be higher in the groups of female of the twenties, a brother and sister foursome, college graduates, teachers, Catholics, and the middle class, displays the significant difference from the other groups. 6) According to the experience in taking of health medicine and health food, 81.1％ of respondents had the experience in taking ‘the fatigue relieving medicine’; 72.4％ ‘carrot or vegetable juice’; 69.5％ ‘ginseng’; 63.0％ ‘mushroom’; 42.5％ ‘dog meat’; 38.0％ ‘aloe’; 36.4 ‘deer antlers’; 11.4％ ‘snake’; 2.0％ ‘the penis of a fur seal’. 7) The factors influencing the level of knowledge of medicine include experiences in taking of the tonic, the fatigue relieving medicine, and the nutritive medicine, economic status, the number of brothers and sisters, education level, marital status, father's education level, and age. The factors influencing the experience in side effect of medicine are experiences in taking of the fatigue relieving medicine, the nutritive medicine, and the tonic, sex, age, education level, father's education level, marital status, economic status, religion, and the number of brothers and sisters. In conclusion, it is estimated that the level of knowledge of medicines is significantly low in Korea. Especially, it is found out that workmen, students, the upper class, the class of low education level, and persons engaging in farming, livestock raising, and forestry neglect importance of knowledge of medicine. Therefore, it is necessary for public authority, associations related, and health professionals to develop programs for public information and education to help people obtain basic knowledge of medicine.

• Journal of agricultural medicine and community health
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• v.4 no.1
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• pp.20-30
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• 1979

To investigate the status of morbidity and medicare utilization during last 8 months from 1 st Oct. 1977 to 31th May, 1978 in the area under Sam-Wha Medicare Insurance Union, a study was carried out through analyzing the medicare records of patients who are enrolled. For the study, 3 doctors and one nurse were mobilized and the results are as follows: 1) The total number of the Medicare insurance Union members in the study area were 5,735 composed of 3,000 males(52.3%) and 2,735 females(47.7%). 2) The total number of patients were 1,405 composed of 783 males (55. 0%) and 622 females(45. 0%) and the incidence rate per 1,000 population was 245.0 of total(261.0 in males and 227.4 in females). 3) Five major diseases with 52, 7% of total patients were acute upper respiratory infection(20.7%), peptic ulcer(12.2%), bronchitis(5.5%), injuries(5.2%) and dental problems(5.1%). 4) The order of the incidence rate of age group per 1,000 population was the year group on 0-4(342.6), 25-44(312.7), 45-64(307.0), 65 and over(240.3), 15-24(178.8) and 5-14(164.8). 5) Of the 1,405 total patients, the out-patients were 1,661(96.9%) and the in-patients were 44(3.1%) and the ratio wae 30.9 : 1.0. 6) Among the out-patients 96.7% of them were cared in primary medicare facilities, 1.0,% in secondary care, and 2.3% in tertiary care. And among the in-patients 50. 5% of them were cared in primary medicare facilities, 4. 5% in secondary care, 45. 5% in tertiary care. 7) Duration of medicare was concentrated within a week in 84. 3% of total patients.

• Journal of Preventive Medicine and Public Health
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• v.37 no.1
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• pp.59-71
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• 2004

Objectives: This study aimed to measure the disability weights for the Korean Burden of Disease study, and to compare them with those adopted in the Australian study to examine the validity and describe the distinctive features. Methods : The standardized valuation protocol was developed from the Global Burden of Disease (GBD) study and the Dutch Disability Weights study. Disability weights were measured for 123 diseases of the Korean version of Disease Classification by three panels of 10 medical doctors each. Then, overall distribution, correlation coefficients, difference by each disease, and mean of differences by disease group were analyzed for comparison of disability weights between the Korean and Australian studies. Results : Korean disability weights ranged from 0.037 to 0.927. While the rank correlation coefficient was moderate to high ($r_s$=0.68), Korean disability weights were higher than the corresponding Australian ones in 79.7% of the 118 diseases. Of these, war, leprosy, and most injuries showed the biggest differences. On the contrary, many infectious and parasitic diseases comprised the greater part of diseases of which Korean disability weights were lower. The mean of the differ ences was the highest in injuries of GBD disease groups, and in cardiovascular disease, injuries, and malignant neoplasm of the Korean disease category. Conclusions : Korean disability weights were found to be valid on the basis of overall distribution pattern and correlation, and are expected to be used as basic data for broadening the scope of burden of disease study. However, some distinctive features still remain to be explored in following studies.

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.343-346
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• 1999

Objectives : In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. Methods : Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. Results: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. Conclusions : The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.

• Health Policy and Management
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• v.28 no.2
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• pp.128-137
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• 2018

Background: This study aims to utilize Organization for Economic Cooperation and Development (OECD) data to identify macroscopic determinants of health at national level and to utilize it in health policy development through comparison and analysis with Korea. Methods: The potential years of life lost (PYLL) were used as dependent variables and 19 indicators were selected as health determinants to be independent variables based on the results of previous studies. Data analysis was done using SAS ver. 9.4 package (SAS Institute Inc., Cary, NC, USA) and model used in technical statistics concerning PYLL by countries, multi-linearity test between independent variables and OECD economic studies were modified and used. Results: From 1994 to 2012, the average PYLL for OECD countries was 4,262.9 years, the highest in Estonia and the lowest in Iceland. As a result of the analysis using the fixed effect model, the significant variables affecting PYLL were four variables: gross domestic product, nitric oxide, tobacco consumption, and number of doctors. The health determinants that had more influence on the PYLL of Korean people compared to other OECD countries were tobacco consumption, calorie consumption, fat intake and total health expenditure. Conclusion: In order to effectively reduce unnecessary deaths, we must continue to strengthen our smoking policy and nutrition policies such as calorie and fat intake. It is necessary to prevent the increase of total health expenditure due to the increase in the prevalence of chronic diseases and to strengthen the public health aspect.

• Journal of the Korean Society of School Health
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• v.6 no.1
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• pp.9-44
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• 1993

An explorative and descriptive study in order to determine the effect of family structure and other socio-demographic variables on health behavior, belief, locus, and value and utilization of public health service was carried out. Data were collected from 1,653 subjects randomly sampled in three areas, Seoul, Kyunggi province, and Cheju province. From Seoul 849 subjects were selected, 397 subjects Kyunggi, and 407 subjects from Cheju, respectively. Self-reporting questionaires were administered during the period from March to June, 1992. The major findings were as follows: 1) The subjects visited herb-doctor's at irregular intervals mainly to have tonic medicine prepared. They preferred herb-doctor's rather than with doctors at clinics and hospitals. Statistically significant difference was found among the regions studied (p<0.05). 2) The reason for visiting hospitals was primarily for treatment of diseases. They preferred hospital because they felt that the hospitals offer much highly reliable treatment services as well as medical accessibility. For the purpose of hospital utilization, statistically significant differences existed among sex, educational level, family type and region. However, no significance was found among sex, educational level, and region (p<0.05). 3) The subjects utilized general hospitals mainly for diagnosis and treatment of diseases. They preferred general hospitals because of their much better facilities and reliability. Statistical significance was found among sex, educational level, and region (p<0.05). 4) The subjects visited dentist at irregular intervals basis. They visited once half a year or three to four months. their purpose of visit was mainly for diagnosis and treatment of diseases. Statistical significance differences were found among educational level, region and economic standard (p<0.05). 5) Whenever their illnesses were mild and the pharmacies was located in nearby they visited to pharmacies. They visited once a month and patient medicines. Statistically significant differences were found among sex, educational level and region (p<0.05). 6) The subjects believed that herb medicine was quite efficacious for treatment of some diseases, particularly by information handed down through time-honored tradition and experience. However, they recognized that the efficacy of folk medicine can vary with type and severity of diseases. Statistical significance was among sex, educational level, region and economic standard (p<0.05). 7) The reason why subjects believed that pray and superstition are effective for treatment of certain type of diseases, particularly in neuropathy, was the belief in God's almighty. Statistically significant differences were found among sex, educational level, regions and economic standard (p<0.05). 8) Most of subjects under same condition preferred western medicine because they believed that it is more scientific and prompts in showing therapeutic effect. Statistical significance was not found in the choice of type of public health service among, regions. But significant differences were found among sex, educational level and region (p<0.05). 9) The subjects looked for pharmacy if they thought the symptom was mild. However, they visited hospitals for chronic disease and general hospitals for emergency treatment. Statistical significances were found among educational level, region and economic standard (p<0.05). 10) Although most of students wanted to have a healthy life as for the component of health standard and value, they think that they are not healthy (p<0.05). As for the health behavior, significant difference was found in the proportion of smoking and drinking between educational level and region (p<0.05). The health locus was affected by educational level, and health behavior was influenced by region, sex and educational level. The utilization of type of public health service was influenced by family type and region, and health belief by region and educational level, and the health values by region and economic standard respectively, most of correlation showed statistical significance. Among them, the highest correlation was seen between locus of control and external/internal locus of control, which is quite obvious. The correlation between health belief and behavior was the next highest, but still low (0.343). All the other variables are low but significant except only a few of those. These findings indicate that health education should be incorporated into the curriculum so as to develop desirable health habit, and ability of self-control in accordance with their growth stages. A systematic and scientific understanding on the herb/folk medicine is needed, and greater reliability of the utilization of public health services are is still required. Health policy for equal distribution of health service throughout the country along the hierarchical health service system and complementary mutual assistance and cooperation among various health organizations are also required.

• Journal of Society of Preventive Korean Medicine
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• v.9 no.2
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• pp.77-91
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• 2005

The purpose of this study is to examine the recognition of the student of oriental medical school on cooperative system between Oriental and Western medicine and to provide basic information for the development of oriental medicine. In order to look at the level of recognition on cooperative system between Oriental and Western medicine, from September 1st to 15th of 2005, this study had been conducted through personal interview and questionnaires to 600 students who were attending the Department of Oriental Medicine (in both prep and regular courses) in D University, located in the City of Daegu. The data has been analyzed using statistic program, the SPSS WIN 12.0. Statistical analysis tools used for this study were frequency analysis, cross-over analysis and the t-test. The results are as follows; The students of oriental medical school had relatively high level of recognition on the basic concept, interests, necessity and potential for cooperative system between Oriental and Western medicine. However, they had negative understandings on the issue of unification of the two medical systems and it's possibility in the future. The students were optimistic about possible merits of cooperative system between Oriental and Western medicine, especially in the field of rehabilitation. On the reasons for lack of development of cooperative system between Oriental and Western medicine, the students listed prejudices existing on both sides firstly, followed by their contrasting approach on human illness, lack of legal and institutional support system, the indifferences of doctors and indifferences of oriental medical doctors. In addition, students understood that the dualism existing in our current medical system is aggravating mutual distrust between the two sides, causing the confusion of patients on the choice of medical facilities, and raising their medical bills. Therefore, in order to vitalize collaboration between Oriental and Western medicine in new health care environment, the following measures should be needed decreasing the prejudices between the two medical spheres with open mind improving educational programs in Western and Oriental medical schools; promoting joint academic research or exchange programs between the schools, and increasing government effort to minimize legal and institutional restrictions cooperative system between Oriental and Western medicine.

• Health Policy and Management
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• v.3 no.2
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• pp.100-129
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• 1993

This study is designed to find out some intra-clinic factors affecting the content of practice provided by primary care physicians in Korea, and proposed factors in this study are characteristcs of each private clinc --- physician-related variables(age, sex, specialty), bfed-related variables for inpatient care, laboratory-related variables for precise diagnosis. We have tried to estimate the difference of disease entities cared by each primary care physician according to above factors by analyzin gdisease data claimed during one month(April, 1992) to National Federation of Medical Insurance. The diagnosis codes by ICD-9 in the research disease data were reclassified to 'diagnosis clusters' by virtue of clinical similarities for effective analyses. We have converted frequent-tsing ICD-9 codes to 86 diagnosis clusters, which incorporated 97.4 percents of all ambulatory visits to private clinics. This result means proposed diagnosis-cluster method is effective tool for analysis of the content of ambulatory medical care carried out by primary care physicians. Comparisons and analyses of multiple diagnosis-clusters made on the basis of presented factors were done and the results were as follows; - Major factors affecting the difference between diagnosis-cluster pattern by each variables were phyusician's age, sex, specialty and bed counts of each private clinic for inpatient care and the size of laboratories of each clinic. - Middle aged(30th to 40th) group physicians are providing more comprehensive care than 20th or above 50th aged groups. Male physicians are more adequate for comprehensive care than female physicians, because woman-doctors are providing narrow-spectrum care. The content of practice of obstetricians and gynecologists shows much difference from primary medical practice, and they cannot be included in primary care physician, this study suggested. Pediatricians are also providing short-spectum acre, and nearly all visits to pediatricians were incorporated only 2-3 diagnosis-clusters. General surgeons' practices are very similar to general practioners' or family physicians' practices, the means they are providing primary care rather than special surgical care. And small number of beds(under 5 beds) and only basic(2-3 sorts of)diagnostic apparatuses are sufficient for primary physicians' clinic to carry out primary care. In conclusion, to reinforce primary care department in Korea, there must be support with health policy to expand office-based primary care practice-- with small number of beds for inpatient care and only basic laboratories-- provided by general practitioner of family physician.

• Health Policy and Management
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• v.16 no.2
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• pp.117-134
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• 2006

Korean health care system introduced the reform for separation between prescribing and dispensing of drugs (SPD reform) in the latter part of the year 2000. The objective of this paper is to look at what change this reform has brought about in the financial situation of Korean public health insurance scheme, particularly in terms of insurance benefit outlay. Since the inception of the reform is a development of more than five years ago, its impact on the finance situation would now start to become apparent. Hypothesis is set in this study for each of three components of drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. In terms of the classification of health care services by mode of production, the impact of the SPD reform is confined mainly to the last two among three drug reimbursement fields including inpatient department, out-patient department and pharmacy. Pure impact of the SPD reform was estimated to be more or less than 1.7 trillion won, 13.1% of the total outlay of the Nation Health Insurance in 2001, and more than 2.0 trillion won, 14.9% of the total outlay of the Nation Health Insurance in 2003. Both dispensing fees for the pharmacists, which had been newly introduced on occasion of the SPD reform, and larger share of expensive drugs in the medicines prescribed by doctors were confirmed to be main drivers of the augmentation of drug reimbursement.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.