• 대한한의학회지
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• 제35권1호
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• pp.157-170
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• 2014

Objectives: The purpose of this study was to develop a standard instrument of diagnosis and assessment for spleen qi deficiency pattern. Methods: Reports published in Korea and China related to spleen qi deficiency pattern were selected. Assessments of selected references were performed to select major symptoms of spleen qi deficiency pattern. Korean translation and review by a Korean linguist were performed to create a draft of [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)]. The final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment on inclusion or exclusion, on importance of items and on validity of translation by an expert committee, consisting of professors from the National College of Korean Medicine. Results & Conclusions: 1. 14 major symptoms were selected by frequency from 45 references which were related to standard identification of spleen qi deficiency pattern, translated into Korean and reviewed by a Korean linguist. 2. 11 symptoms were selected after assessment on inclusion yes or no by the expert group. Items were listed in order of importance: tiredness of extremities (肢体倦怠), sallow complexion (面色萎黃), reduced appetite (食欲减退), abdominal distension after eating (腹胀食後尤甚), inability to eat (納少), pale tongue and white fur (舌淡苔白), lethargy (神疲), emaciation (消瘦), loose stool (大便溏薄), shortness of breath and reluctance to speak (少氣懶言), and weak pulse (脈緩弱). 3. Final [Standard instrument of diagnosis and assessment for spleen qi deficiency (for subject)] was completed after assessment of translation validity, reflection of individual opinions by the expert committee, and application of weighted value computed from assessment on importance of items.

• 통상정보연구
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• 제14권4호
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• pp.491-516
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• 2012

본 논문은 현재 협상 중인 한 중 FTA관련하여 예상되는 무역의 기술장벽의 현안을 도출하고 그 문제점과 대응방안에 대하여 중점적으로 고찰해 보았다. 우선 FTA 무역 기술장벽의 이론적 배경인 의의와 유형을 살펴보았고, WTO의 주요 협정 내용 및 한국과 중국의 FTA 기술부문의 동향에 대해서도 알아보았다. 중국과의 무역의 기술장벽에서 쟁점이 될 수 있는 현안을 통보문 건수가 많은 "사람의 건강과 또는 안전의 보호", "환경보호" 및 "국제표준과의 조화", "투명성" 등으로 도출하였다. 대응방안으로는 중국의 배타적 기술규정에 대해 정부 차원에서 철회할 수 있도록 해야 하며 한국기업은 높은 수준의 환경규제에 충족하는 제품을 개발해야 하고 정부에서도 이러한 기업들에게 재정지원, 세제혜택 및 금융지원 등의 장려책을 실시해야 한다. 국제표준 활동의 역량강화와 전문인력의 확보가 중요하다 하겠다. 또한 한 중 정보 전달의 속도를 높이고 투명성을 제고하기 위하여 상호 직접적인 통보망을 설치하면 효율적이다. 중국의 지역통보자문센터와 유기적이고 협력적인 교류가 필요하며 기술규제의 재 개정 및 새로운 기술규제의 의견 수렴기간을 다양하게 해야 한다.

• 한국컴퓨터정보학회논문지
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• 제21권6호
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• pp.97-106
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• 2016

This study tries to seek the is the realistic improvements and legislative measures about current medical advertising which was in the Court on 12 May 2015 by presenting and discussion the understanding, problems and its alternative direction of pre-deliberation on the existing law which is the decision on the constitutionality of health care advertising regulated health care advertising General commercial advertising has the right which have to be protected as the terms of the protection of know and freedom of expression and advertiser's there are sure to be in a value to be protected. Medical advertising is also a person in addition to the absolute value that includes both Due to the particularity of medical advertising in terms of life and the right to health Until now, this has been the target of strong regulations are changing the policy of gradual deregulation in our country, including the country. Medical advertising on the current medical law had been to be checked by pre-deliberation of the executive power. However, due to unconstitutional, in the circumstances which a false hype is flooding and increasing, it has been realized that the fair competition of medical community, life and health rights of the people are threatened by in reverse. In this regard, the abolition of the pre-deliberation system of medical advertising can be welcomed by abolition of the old system which is the legal and institutional censorship. Since its abolition, the alternative policy direction is insufficient also it is not clear. Therefore we need to study this. Therefore, in this paper, we try to find general theoretical background and problem of pre-deliberation system of medical advertising. Also, as trying to find feasibility or ambiguity of regulation and issues about medical advertising on medical law, we argued the provision of special measures of the medical advertising for introduction of integrated medical advertising deliberation committee which can ensure the independence and autonomy, strengthening of the monitoring on the internet advertising, legal resolving through amendments, strengthening of penalties, and establish special measures of medical advertising for the medical privatization and demand for the foreign medical tourist, etc. Empirical study about practical regulatory measures of medical advertising which converged the various opinions of consumer groups, government and academia, and medical community, and we expect hope to see the more realistic alternative provision.

• Weed & Turfgrass Science
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• 제3권3호
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• pp.165-173
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• 2014

국내에 등록된 제초제의 효율적 사용을 위해서 제초제저항성관리위원회에서 제시한 제초제 작용기작별 분류를 기초로 23그룹으로 분류하였다. 세부그룹으로는 acetyl CoA carboxylase 억제제, acetolactate synthase 억제제, photosystem과 억제제, protoporphyrinogen oxidase 억제제, carotenoid biosynthesis 억제제, enolpyruvyl shikimate-3-phosphate synthase 억제제, glutamine synthetase 억제제, dihydropteroate synthetase 억제제, 세포분열 저해제(mitosis inhibitors), cellulose 생합성억제제, oxidative phosphorylation uncouplers, 지방산 및 지질생합성 억제제, synthetic auxins, auxin transport 억제제, potential nucleic acid Inhibitors 혹은 non-descript mode of action으로 나누었다. 이와 같은 그룹화 기준을 토대로 국내 등록되어 사용중인 논 제초제 성분들을 그룹화 하였다. 따라서, 이러한 약제 작용기작 관련 정보를 농약사용자에게 제공함으로써 특정약제의 연용과 중복사용을 방지하여 국내에서 제초제 저항성잡초 발생 문제를 줄일 수 있을 것으로 기대된다.

• 우울조울병
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• 제16권3호
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• pp.123-128
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed to provide more proper guidelines for clinicians. In this study, we evaluated treatment strategies of elderly patients with bipolar disorders of KMAP-BP 2018. Methods : Sixty-one psychiatrists of the review committee with vast clinical experiences in treating bipolar disorders, completed the survey. An expert consensus was obtained, on pharmacological treatment strategies for elderly patients with bipolar disorder. The executive committee analyzed results, and discussed the results to produce the final algorithm. Results : In elderly patients with bipolar disorder, first-line treatment option for acute manic episode is monotherapy, with atypical antipsychotics or mood stabilizer, and a combination of mood stabilizer and atypical antipsychotics. First-line treatment option for acute depressive episode, was a combination of mood stabilizer and atypical antipsychotics, monotherapy with atypical antipsychotic or mood stabilizer, and atypical antipsychotics with lamotrigine. Conclusion : In KMAP-BP 2018, the recommendation for treatment option in elderly patients with bipolar disorder, was newly introduced. We expect this algorithm may provide valuable information, and facilitate treatment of elderly patients with bipolar disorder.

• 우울조울병
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• 제16권3호
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• pp.129-133
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• 2018

Objectives : The fourth revision of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was performed in 2018, to provide newer guidelines for clinicians. In this section, we examined expert opinions to facilitate clinical decisions relative to treating bipolar disorder with medical comorbidity. Methods : The survey was completed by the review committee, consisting of 61 experienced psychiatrists. This part of the survey constitutes treatment strategies, under major medical comorbidities. The executive committee analyzed results, and discussed the final production of algorithm. Results : Aripiprazole was the first-line medication for bipolar patients with metabolic syndrome, cardiovascular, hepatic, renal, and cerebrovascular comorbidities. Ziprasidone also was recommended as the first-line medication in case of metabolic syndrome. Lithium also was regarded as the first-line medication, in case of hepatic problems. Valproate also was considered as the first-line medication, in case of cerebrovascular problems. Conclusion : This study provided the most recent consensus among experts, for treatment of bipolar disorder with physical problems.

• 대한한의학회지
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• 제40권3호
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• pp.59-75
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• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• 한방재활의학과학회지
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• 제32권3호
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• pp.141-151
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• 2022

Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• 보건행정학회지
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• 제23권1호
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• pp.3-18
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• 2013

This paper investigates the possibility of expanding pay-for-performance (P4P) program as a provider payment system, in terms of financial, economical, and political sustainability. In order to expand the sustainable P4P, P4P should have usefulness in terms of economic value as well as efficiency in the financial aspects of health care. More importantly, the P4P would be politically sustainable only when both providers and consumers can accept. Korea's healthcare system seems to have logical ground for the P4P program financially and economically. However, how well the P4P can work remains to be proven in its implementation. After 43 tertiary hospitals applied the P4P program for acute myocardial infarction (AMI) and C-section in 2007, the number of hospitals adopting the P4P program for AMI and C-section has increased to 316 in 2011, and an incentive for hospitals applying the P4P has risen to 2% from 1% of health insurance benefits. This shows that the P4P program introduced by Health Insurance Review and Assessment Service is quite successful. In addition, people are aware of the need for improved P4P program and policy alternatives have been already made. Therefore, it is very important to come up with politically supportable strategies that can make providers and consumers accept the P4P program while maintaining the governance of the existing health insurance policy. To this end, there are some tasks to be considered. First, the expansion of the P4P program should be placed on the agenda of the Health Insurance Policy Review Committee, the highest decision-making body, and a separate agency for P4P planning should be established. Second, for more efficient P4P program, the processes of review and assessment, currently carried out separately, should be integrated into a single process. Third, infrastructure to measure the quality of medical services should be sharply expanded. Fourth, the current paradigm for the assessment should be changed. Lastly, a P4P program for consumers should be considered. Given that the consumers in Korea can use medical services freely, the National Health Insurance Corporation could initiate the P4P program for consumers as a means of controlling excessive use of medical services and adjusting consumer's moral hazard.