• 보건행정학회지
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• 제14권4호
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• pp.48-74
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• 2004

Considering the existence of asymmetric information between doctor and patient, the doctor's reimbursement method has been considered as a desirable policy device of improving efficiency of patient's use of medical care in terms of its affecting doctor's practice pattern by determining doctor's practice revenue. By using the Community Tracking Study (CTS) physician data set, which includes not only various information on doctors practice arrangements and sources of practice revenue, but also vignettes of various clinical presentations, this paper investigates doctor's reaction to the financial incentive under the control of patient's specific medical situation. Under the econometric model for exploring the effect of doctor's reimbursement method on his/her practice patterns; referring patients, recommend doctor-visit or medical tests, the Hausman's specification test was used for checking out the possibility of the doctor's reimbursement method being endogeneized explanatory variable. In the case where the endogeneity problem of doctor's reimbursement method exists, the 2SLS method was used for correcting that problem, and the multiple regression method was used in the case where the problem is found to be nonexistent. Based on the empirical results, this paper finds that doctors do appear to respond to financial incentive. The empirical results show that the doctor's reimbursement method statistically significantly affects doctor's practice pattern and are coincident with the theoretical result proposed by previous researches, This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would more refer their patients to specialists, and hesitate in recommending doctor-visit or medical exam.

• 대한한방내과학회지
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• 제44권4호
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• pp.703-725
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• 2023

Objectives: This study investigated Korean medicine doctors' perspectives on clinical practice patterns in the process of developing Korean medicine clinical practice guidelines for benign prostatic hyperplasia. Methods: A questionnaire was developed for Korean medicine doctors. A total of 323 oriental medicine doctors participated in the survey, which was live for a total of 9 days from September 22, 2022, to September 30, 2022. Results: Regarding awareness of treatments for benign prostatic hyperplasia, 63.8% of respondents showed high awareness of Korean medical treatments. However, items such as diagnostic criteria (17.7%), evaluation methods (17.0%), and Western medical treatments (22.9%) showed low recognition rates. In clinical practice, 76.2% of respondents were found to treat five or fewer patients with benign prostatic hyperplasia per month, and the average treatment period was 1 to 3 months for most at 41.2%. Korean medicine doctors diagnosed benign prostatic hyperplasia based on clinical features. The main interventions used were acupuncture, herbal medicine (prescription medicine), and moxibustion. This study has several limitations because of the low response rate for this survey; therefore, the participants are not representative of all Korean medicine doctors. In addition, because the study was conducted broadly on various topics related to benign prostatic hyperplasia, sufficient quality management was not carried out. Further studies that include a larger sample size and more in-depth studies on benign prostatic hyperplasia are needed. Conclusions: It is necessary to develop appropriate and reasonable Korean medicine clinical practice guidelines for benign prostatic hyperplasia.

• 대한융합한의학회지
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• 제6권1호
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• pp.37-42
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• 2024

Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

• 대한치과교정학회지
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• 제44권1호
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• pp.5-12
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• 2014

The committee of admitted doctors developed a questionnaire regarding medical dispute and distributed it to 1,600 members of Korean Academy of Orthodontics. The questionnaire consisted of three categories and 56 items covering basic information about the doctors and patients who had experienced medical disputes, the cause and workaround of medical accidents, and methods for taking precautions. The present survey showed a similar proportion of responders who had experienced a medical accident compared to the study in 1997. The primary reason for medical disputes was dissatisfaction with appearance. Many doctors felt that they would likely experience a medical dispute at some point. Most disputes were settled by doctors themselves, usually for an amount of less than 5 million Korean won. For some doctors, medical accidents lead to ongoing psychological problems. Responders felt that continuing education for medical dispute is very necessary. These results reveal a need for the association of orthodontists to lead advancements in education and countermeasures for preventing and managing medical accidents and disputes.

• 대한예방한의학회지
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• 제21권3호
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• pp.1-10
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• 2017

Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

• 한방재활의학과학회지
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• 제34권2호
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• pp.149-164
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• 2024

Objectives This study aimed to develop Korean medicine clinical practice guidelines for myofascial pain syndrome that can actually be applied clinically. Methods A text message containing a link to an online survey was sent to 26,987 Korean medicine doctors registered with the association of Korean medicine. The survey period was from December 29, 2023 to January 19, 2024. Results There were 2,762 Korean medicine doctors who responded to an online survey over a three-week period. Awareness of the standard clinical practice guidelines of Korean medicine was 74.5%, and utilization was 35.8%. The most frequently used diagnostic tool was a numerical evaluation tool, the treatment tool was acupuncture, and the prognosis management guidance was lifestyle guidance. Conclusions If standard Korean medicine clinical practice guidelines for myofascial pain syndrome are developed based on the results of this survey, guidelines that are highly usable in clinical settings will be developed.

• 척추신경추나의학회지
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• 제16권1호
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• pp.73-89
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• 2021

Objectives We conducted an online survey to understand the current status of Korean Medicine clinical practice related to carpal tunnel syndrome (CTS) to develop the CTS Korean Medicine Clinical Practice Guidelines (CPG). Methods A thoroughly reviewed questionnaire was distributed by e-mail to 21,719 Korean Medicine doctors between March 26 and April 30, 2021. All raw data were arranged and analyzed systematically. Results The response rate among the doctors was 4%. Of the respondents, 82.1% responded that it is necessary to develop the CTS Korean Medicine CPG. We also obtained data related to the specific diagnosis, treatment, and prognosis management methods used at various treatment sites for patients with CTS. Conclusions This online survey will be helpful in developing the CTS CPG, which will contribute to the standardization of guidelines and improvements in the reliability of Korean Medicine. Our findings will provide valuable data and resources for future clinical studies on CTS.

• 한방재활의학과학회지
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• 제28권4호
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• pp.89-101
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• 2018

Objectives To understand current status of clinical practice patterns on Korean Medicine treatment practice of traffic injury patients by 2nd on-line survey for developing Korean Medicine treatment clinical pratice guideline (CPG) for traffic injuries. Methods A revised questionnaire about current practice patterns of Korean Medicine treatments for traffic injuries was distributed by e-mail survey to 19,385 respondents of Korean Medicine doctors from May 21th in 2018 to June 21th in 2018. All data were statistically analysed. Results The response rate was 3.5%. Most of the respondents felt necessity of the development of Korean Medicine CPG for traffic injuries. The results showed the detailed usage and trend of current Korean Medicine treatment such as acupuncture, pharmacopuncture, moxibustion, Chuna manual therapy, cupping, Korean Medicine physiotherpy for traffic injury patients. Conclusions This survey helps to determine current Korea Medicine treatments' clinical practice patterns for traffic injury patients. All data from the survey will provide basic data for future clinical studies and adaptation for the revision of Korean Medicine CPG for traffic injuries.

• 대한한방내과학회지
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• 제42권4호
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• pp.532-546
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• 2021

Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

• Nutrition Research and Practice
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• 제8권6호
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• pp.662-669
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• 2014

BACKGROUND/OBJECTIVES: Osteoporosis and osteoporosis-related disease are drawing a lot of attention in Korea as one of the serious health problems. Bone health status may be influenced by the general dietary quality and dietary pattern. SUBJECTS/METHODS: To determine the relationship between dietary quality and intake patterns and bone health status, the %RNI, NAR, DDS, and food group intake patterns were assessed according to their bone health status for 847 postmenopausal women using the 2010 KNHANES data after eliminating those of likely changing their diet under the advice of doctors or those taking estrogen. RESULTS: Bone health became worse as dietary quality deteriorated. All NAR and %RNI values were highly associated with bone health levels and the consumption frequency of Ca sources, DDS and the food group intake patterns also confirmed the findings. CONCLUSIONS: This study confirmed that dietary quality and dietary patterns were important for bone health. Nutritional education on eating foods from the five basic food groups has to be emphasized to prevent osteoporosis among older women.