• Herbal Formula Science
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• v.30 no.3
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• pp.165-174
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• 2022

Objectives: Donguibogam has helped progress of Eastern medicine across Asia and almost all of Korean medicine doctors still use the book as a classic reference. In this study, the prescriptions used in the treatment of stroke in Donguibogam are analyzed and the results are to be used for our subsequent studies. Methods: The frequency of use of prescriptions and the frequency of combination of medicines were analyzed from 89 prescriptions used in the Stroke chapter of Donguibogam, and it was intended to derive a combination prescription and a monosyllabic medicine that can be effectively used in the treatment of stroke for preclinical studies. Results: Ganghwalyupung-tang (羌活愈風湯) was the most mentioned prescription among 89 prescriptions, and Glycyrrhizae Radix et Rhizoma, among 165 species of medicines used in the 89 prescriptions, mixed in 55 prescriptions. However, considering the ratio of frequently used medicines, Sagunja-tang (四君子湯) was the highest in terms of composition ratio. Conclusions: Through this study, Glycyrrhizae Radix et Rhizoma and Sagunja-tang were selected as materials for our subsequent studies.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.195-209
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• 2000

The purpose of this study is to estimate the population requiring nursing home services among elderly people in Korea. This study identifies the need of nursing home services determined by health care professionals and estimates the proportion of elderly people requiring nursing home service according to the admission criteria. Surveys were conducted on health care professionals including medical doctors, home care nurses, and nurse practitioners. They were asked to assess nursing home need based on four content areas: Physical function (Activities of Daily Living), chronic disease, Physical symptoms (incontinence), mobility, eating, and sensory function. Based on the professionally determined need criteria the proportion of elderly people requiring nursing home services was estimated using secondary data from the 1994 Survey on the Living Status of the Korean Elderly. The number of study subjects to estimate nursing home need who were 60 and older totaled 2,058. The most important factor contributing to the admission eligibility criteria was the elderly living alone. Other factors related were the elderly being unable or having difficulty carrying out activities, and having insufficient help from other our activities, and having insufficient help from other members of the household. Using only physical function, the proportion of elderly people requiring nursing home was $8{\sim}9%$. When only chronic disease was used, proportions varied widely; for the doctor's group, the proportion was over 30%. Using all areas, the proportions of elderly people requiring nursing home were between 13% and 38%. The estimate using chronic disease and physical function was similar to the on using all areas.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.71-92
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• 2005

The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.

• Journal of Korean Academy of Nursing
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• v.5 no.2
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• pp.92-103
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• 1975

This study was conducted to find out status of delivery environments, delivery attendants, and various immunization practices towards 513 babies who were born during the period from January 1, 1972 to December 31, 1974, in Dongnae Area, Shindong Myon, Chunseong Gun, Ganwon Do. The results and findings obtained from the study are summarized as follows : 1. Of all deliveries, 10.7% of the babies were reported born at the hospitals. 2. Deliveries attended by qualified professionals such as, doctors, midwives or public health nurses, were 22.2% of the total deliveries. Those who delivered alone without having anyone's assistants were as much as 9.7%, The percentage of the deliveries attended by the professional groups were increased year by year among the younger group mothers with the babies birth order being first or second place. 3. Sewing scissors were most frequently used as a tool for cutting the umbilical cord indicating 87.5% in this area. Sterilized tools were used among 50.3% of the women. 4. The usage af vinyl sheet and cement bag paper were frequently used as a delivery sheet, indicating 32.3%. Delivery set which was distributed by the health center was used 18.0%. (excluded the deliveries attended by professional attendants) 5. Immunization practices for the infant were observed as relatively high rate: 92.8% of the infant received D. p. T., 81, 3u/o received against poliomyelitis, 52.8% for small pox, 78.9% with B. C. G., and 18.5%against measles. The percentage af babies complected 3 times shot for D. P. T. and 2 times shot for poliomyelitis vaccine turned out be to 67.8% and 87.5%, respectively.

• Journal of Preventive Medicine and Public Health
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• v.31 no.4 s.63
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• pp.740-750
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• 1998

The methods for the early diagnosis of breast cancer are mammography, physical examination, breast self-examination(BSE). This study was conducted to investigate the knowledge and practice of BSE by structured questionnaire which included questions on general characteristics, performance of mammography, physical examination of breast, knowledge and practice of BSE. The subjects in this study were 412 females between 20 and 69 year old who visit to the Health Care Center of College of medicine of Inje University from December 1997 to February 1998. The results were as follows. 1. Women who have Soften the regular mammography are 8.19% of these subjects and women who have gotten the regular physical examination by doctors are 4.19% of these subjects. 2. Regarding BSE, 77.4% of these subjects said that they knew BSE and 3.88% of these subjects said that they practiced BSE regularly. It was that women who knew BSE were more younger, better-educated and higher economic status(p=0.001) and lived a normal life with he. husband(p=0.033). And women who practiced BSE regularly were more younger, and married(p=0.001). 3. The most common barrier to doing BSE is 'Do not see the needs/worry unnecessarily', and the most common reasons for doing BSE is 'Early detection of Breast cancer'. 4. The overall frequency and percentage distribution of recommended BSE step in Korea is lower than U.S.A.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.427-453
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• 2009

This study aims to review legal problems of similar medical practice and suggest methods of improvement. Similar medical practice refers to all medical practices conducted in the state that human qualification is not fulfilled. It may cause serious damages on health and lives of national people. Currently, similar medical practices are recognized as unlicensed medical practices and prohibited based on the Medical law and additionally punished by then special law in Korea. However, the current Medical Law does not provide clear and accurate concept of medical practices so that it is difficult to regulate similar medical practices. The issue of complementary and alternative therapy related to similar medical practices is also in special state different from other countries. In addition, since similar medical practices lack of evidences in terms of safety, the dangerousness of accidents is high and it may affect badly on health of national people and health care policies. Methods of improvement in order to resolve problems regarding similar medical practices are: first, concept and scope of medical practice should be clear, accurate and concrete. Second, complementary and alternative therapies related to similar medical practices need to be strictly examined and the supervisory right should be given to doctors should be given even though a part of it is allowed. Third, research institutes specialized in the field should be established for scientific examination of complementary and alternative therapy and objective research results should be open to the public. Finally, since damage cases caused by similar medical practices by non-medical personnel, national management and supervision for similar medical practices should be reinforced.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.37-55
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• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• Journal of Society of Preventive Korean Medicine
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• v.25 no.3
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• pp.117-124
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• 2021

Objectives : The purpose of this study is to analyze the factors affecting the enactment of local municipalities' ordinance for supporting Korean Medicine infertility treatment in the metropolitan area. Methods : For Seoul, Incheon, and Gyeonggi Province, data on the enactment of Korean Medicine infertility treatment and socio-demographic data of the local municipalities were collected through the Enhanced Local laws and regulations Information System and on-line statistical database. Logistic regression analysis was performed to analyze the factors affecting the enactment of the ordinance, The enactment of the ordinance was dependent variable, and the budgeting of local municipalities, the number of population, the number of births, the number of Korean Medicine doctors, and the total fertility rate were used as independent variables. Results : Up to 2000, the ordinances for supporting Korean Medicine infertility treatment were enacted in 16 local municipalities and the budget for that was supported by 18 local municipalities. Regarding the effect on the enactment of the ordinances, it was found that budgeting of Korean Medicine infertility treatment had a positive (+) effect, and the metropolitan government's budgeting and the total fertility rate had a negative (-) effect. Conclusions : This study suggests that the ordinance for Korean Medicine infertility treatment is a policy tool derived based on the problem of low fertility faced by each local municipality rather than the political influence of health provider's groups.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.51-95
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• 2002

1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.39-51
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• 2003

Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.