• 보건행정학회지
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• 제2권2호
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• pp.179-193
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• 1992

This paper attempts to explain why the prescribing-dispensing services are not seperated in Korea. The main reason why physicians and pharmacists do not compromise, even though the two parties support the seperation policy in public, is contended to be that both parties would lose their interests if the policy were implemented. Physicians' loss from giving up their vested rights to dispensing would be larger than their gain from an increase in the number of prescriptions. Pharmacists' loww from being forced not to to sell medicines without prescriptions would also be larger than their gain from prohibiting physicians from dispensing. The net ganier form the seperation policy would be the patients. Therefore, the seperation policy would not be implemented unless political pressure from general public surpasses that from physicians and pharmacists.

• 보건행정학회지
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• 제2권1호
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• pp.66-79
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• 1992

The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.