• Title/Summary/Keyword: Social prescription

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Analysis of Current Status and Drug Expenditure of Drug Shortage Prevention Program (퇴장방지의약품관리제도의 운영 현황과 약품비 분석)

  • Chae, Su-Mi;Lee, Eui-Kyung
    • YAKHAK HOEJI
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    • v.52 no.2
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    • pp.160-164
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    • 2008
  • This study investigated the current status and drug expenditure of the drug shortage prevention program in Korea. National health insurance claims data from 2001 to 2005 were analyzed for the drugs with inadequate supply, which were designated as shortage prevention drugs (SPDs). Drug use of SPDs have increased every year, but the average increase rate of drug expenditure for SPDs, 13.5% was lower than that for all the reimbursed drugs, 18.6%. Drugs with price increase based on production cost were more actively used than drugs with prescription incentives for doctors.

Change of Prescribing Pattern after Clozapine Discontinuation: A Retrospective Chart Review (클로자핀 중단 이후 처방 패턴의 변화: 후향적 의무기록 분석)

  • Kang, Shi Hyun
    • Korean Journal of Schizophrenia Research
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    • v.24 no.1
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    • pp.36-43
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    • 2021
  • Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

Analysis of Factors Related to the Prescription of Antibiotics for the Acute Upper Respiratory Infection (급성상기도감염 환자의 항생제 처방에 영향을 주는 요인)

  • Choi, Won Jung;Yim, Eunshil;Kim, Tae Hyun;Suh, Hae Sun;Choi, Ki Chun;Chung, Woojin
    • Health Policy and Management
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    • v.25 no.4
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    • pp.256-263
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    • 2015
  • Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

Pattern of Pharmacist Consultation among the Health Counseling Services via Internet Portal Sites: A Pilot Study (국내 포털사이트에서의 지식검색서비스를 이용한 약사와의 상담 패턴에 대한 시험적 연구)

  • Kim, Heejin;Park, Jun Ha;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.324-329
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    • 2016
  • Background: With the development of information and communication technology, there is a growing number of people looking for health information on the internet. This pilot study was performed to analyze the pattern of pharmacist consultation on the internet portal site. Methods: Questions and answers posted on the portal site "Naver Jisik-iN" from March 1st to 31th in 2016 were collected. Medications asked were categorized into prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others. Medications were subcategorized into 14 according to the anatomical therapeutic chemical classification system. Questions were divided into 10 categories based on Hepler's drug-related problems. Results: Of the 955 cases, females accounted for 59.5% and inquirers from 11 to 40 years old, 89.4%. The number of prescription drugs, nonprescription drugs, sanitary aids, emergency drugs, functional health foods, and others were 428 (44.8%), 328 (34.3%), 31 (3.3%), 2 (0.2%), 122 (12.8%), and 44 (4.6%), respectively. Questions for drugs acting on alimentary tract and metabolism took up 27.4% followed by those on nervous system, 13.6% and anti-infectives for systemic use, 12.2%. Pharmacist consultation regarding drug information, drug interaction, and adverse reaction occupied 47.9%, 15.2%, and 12.3%, respectively. Conclusion: Health counseling through online is predicted to increase steadily, so pharmacists should broaden their boundaries beyond off-line pharmacies to meet social needs.

The Liability for Unsafe Medical Product and The Preemption Clause of Medical Device Act (의료기기의 결함으로 인한 손해배상책임과 미국 연방법 우선 적용 이론에 관하여)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.63-89
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    • 2014
  • In 1976, the Dalkon Shield-intrauterine device injured several thousand women in U.S.A. which caused the changes of medical deivce regulation. The Medical Device Regulation Act or Medical Device Amendments of 1976 (MDA) was introduce. As part of the process of regulating medical devices, the MDA divides medical devices into three categories. The class II, and III devices which have moderate harm or more can use the section 510 (k), premarket notification process if the manufacturer can establish that its device is "substantially equivalent" to a device that was marketed before 1976. In 21 U.S.C. ${\S}$ 360k(a), MDA introduced a provision which expressly preempts competing state laws or regulations. After that, the judicial debates had began over the proper interpretation and application of Section 360(k) In February 2008, the U.S. Supreme Court ruled in Riegel v. Medtronic that manufacturer approved by the Food and Drug Administration (FDA)'s pre-market approval process are preempted from liability, even when the devices have defective design or lack of labeling. But the Supreme Court ruled in Medtronic Inc. v. Lora Lohr that the manufactures which use the section 510 (k) process cannot be preempted and in Bausch v. Stryker Corp. that manufactures which violated the CGMP standard are also liable to the damage of patient at the state courts. In 2009, the Supreme Court ruled in Wyeth v. Levine that patients harmed by prescription drugs can claim damages in state courts. This may cause a double standard between prescription drugs and medical devices. FDA Preemption is the legal theory in the United States that exempts product manufacturers from tort claims regarding Food and Drug Administration approved products. FDA Preemption has been a highly contentious issue. In general, consumer groups are against it while the FDA and pharmaceutical manufacturers are in favor of it. This issues also influences the theory of product liability of U.S.A. Complete immunity preemption is an issue need to be more declared.

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A Study on the legal definition and the demands of the times of a medical technician according to changes in the medical market (의료시장 변화에 의한 의료기사의 법률적 정의와 시대적 요구에 관한 연구)

  • Kim, Jeong-Ho;Han, Man-Seok;Kim, Chang-Gyu;Seo, Sun-Youl;Kim, Gap-Jung;Bae, Seok-Hwan;Kim, Yong-Kyun
    • Journal of Digital Convergence
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    • v.19 no.11
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    • pp.397-406
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    • 2021
  • Under the Act on Medical Technicians, etc. in Korea, medical technicians are supposed to perform their duties under the guidance of a doctor or dentist. However, considering the actual work behavior, domestic and international trends, and the level of education of medical technicians, professionalism must be recognized. Such a professional and independent operating system must guarantee the autonomy of medical technicians, and it can be said that changes are necessary in law. In other words, it is necessary to change to "request and prescription" rather than "supervision" according to the needs of the times when the concept of "request" and "cooperation" is applied in many countries and an excellent curriculum. These changes can be called the demands of the times and changes for the improvement of medical services and social contribution.

Related Factors of Depression according to Individual Attributes and Regional Environment: Using Multi-Level Analysis (다수준분석을 활용한 개인특성 및 지역환경에 따른 우울증 관련 영향요인 분석)

  • Moon, Seok-Jun;Lee, Ga Ram;Nam, Eun-Woo
    • Health Policy and Management
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    • v.30 no.3
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    • pp.355-365
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    • 2020
  • Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

Analysis of the Hospital Pharmacists Turnover after the Separation of Prescribing and Dispensing Practice (의약분업 후 종합병원 약사의 이직요인분석)

  • Han, Kyung Ae;Lee, Eui Kyung;Park, Eun Ja
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.2
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    • pp.85-90
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    • 2002
  • The aim of this study was to examine the current turnover status of hospital pharmacists and to analyze the factors which affected the turnover of them after the separation of prescribing and dispensing practice. We surveyed 19 managers of hospital pharmacies and 154 hospital pharmacists. Results are as follows. Pharmacist manpower of hospital pharmacies was only $63.99\%$ in tertiary hospitals and $76.78\%$ in general hospitals respectively of the number of pharmacists before the separation of prescription and dispensing practice. The ratio of those who left hospital pharmacies during the period of January 2000 and October 2001 was $80.23\%$ for tertiary hospitals, and $100.84\%$ for general hospitals. Decrease in the number of pharmacists brought the increase of work load and night duty. Major factors which affected the turnover of hospital pharmacists were found as following: income gap between hospital pharmacists and community pharmacists, increasing workload especially at night and on holidays, infrequent chance for the promotion, and low chance to provide clinical pharmacy services after the separation of prescribing and dispensing practice. Adequate manpower is the basic factor for providing hospital pharmacy services and improving clinical pharmacy services. The study suggested that proper number of hospital pharmacists is to be ensured through strengthening the legal requirement for the hospital pharmacists and improving health insurance reimbursement rate for the pharmaceutical services at hospital.

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A Study on the Frequencies of Medicinal Herb Mombinations in the Prescriptions of "Wenbingtiaobian(溫病條辨)" ("온병조변(溫病條辨)" 수록(收錄) 처방(處方) 내(內)의 약물(藥物) 조합 빈도(頻度) 연구)

  • Baek, Jin-Ung;Shin, Sang-Woo;Lee, Byung-Wook
    • Korean Journal of Oriental Medicine
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    • v.17 no.3
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    • pp.61-68
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    • 2011
  • Through analyzing the frequencies of medicinal herb combinations in the prescriptions of "Wenbingtiaobian(溫病條辨)", we could understand the characteristics of prescription composition and author's medical thoughts. So we conducted this study that analyze combination of 258 medicinal herbs in 206 prescriptions, and found meaningful combinations of 700. Among these, the most meaningful combinations are the two of 8 herbs. One consists of Glycyrrhiza uralensis Fischer, Platycodon grandiflorum, Lonicera japonica Thunberg, Sojae Semen Praeparatum, Mentha piperascens (Malinv.) Holmes, Forsythia suspensa, Phyllostachys nigra var henonis, Schizonepeta tenuifolia var. japonic, the other consists of Glycyrrhiza uralensis Fischer, Platycodon grandiflorum, Lonicera japonica Thunberg, Mentha piperascens (Malinv.) Holmes, Forsythia suspensa, Arctium lappa, Phyllostachys nigra var henonis, Schizonepeta tenuifolia var. japonica. The former is Yeonkyo-san without Arctium lapp, the letter is Yeonkyo-san without Sojae Semen Praeparatum. It means these combinations are kind of modified Yeonkyo-san which is effective in outthrustting through the exterior with pungent-cool and clearing heat and detoxify. In conclusion, prescriptions of "Wenbingtiaobian(溫病條辨)" involve herbs mostly used to outthrust through the exterior with pungent-cool and clear heat and detoxify. Through this study, we know the author' s one of medical view points on outthrustting through the exterior with pungent-cool and clearing heat and detoxify.

Christian Education for the Post-Corona World (코로나 이후 세계를 위한 기독교교육)

  • Jae-Deog Yu
    • Journal of Christian Education in Korea
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    • v.72
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    • pp.7-24
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    • 2022
  • Christian education for the world after COVID-19 needs to use rapid changes in the surrounding situation as an opportunity to overcome a new crisis so that the church can achieve its educational mission. If the biggest dilemma in the post-Corona era is that there is no authoritative educational prescription anywhere, the most reasonable option for church education in this situation is to emphasize and cultivate learners' ability to flexibly cope with rules that are completely different than before COVID-19. As a natural result of the crisis, Christian education needs to be more interested in the trend of social change in the pandemic era(glocalization, digital transformation, economic inequality, educational environment change, church crisis) and actively reflect its contents in education. In addition, while operating a mobile(or online) church school that combines offline and online, there is an urgent need for an innovative transition to a core church school where certain church schools and churches cooperate with each other, a church school that guarantees a safe learning space, and an ecological church school that is interested in education dealing with climate change and ecology.