• Title/Summary/Keyword: drug policy

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개국약사의 적정조제건수 산출 (Estimation of the Number of Optimal Dispensing Cases for the Community Pharmacist)

  • 이의경;박정영
    • 보건행정학회지
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    • 제11권4호
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    • pp.88-108
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    • 2001
  • Separation of prescribing and dispensing practice in Korea has changed the service pattern of the pharmacy. The prescription dispensing activities, however, are concentrated excessively on the pharmacies near hospitals or clinics. Thus this study was conducted to estimate the number of optimal dispensing cases for the community pharmacy. Forty-six pharmacies were selected using systematic stratified random sampling method, and ninety-five pharmacists were interviewed on their workload of dispensing and other activities at pharmacies. One hundred and seventy prescriptions were chosen based on the length of drug administration and drug dosage form, and the dispensing time was measured by time-watch method. Also pharmacy benefit claims data were analyzed to identify the characteristics of the pharmacies which performed more than optimal dispensing cases. According to the study results, the average work time per pharmacist per day was found to be 10hours 32minutes and the dispensing activities occupied 7hours 36minutes. It took 5.72minutes on average for each dispensing case. The optimal dispensing case was estimated as 75 cases under the condition of 10hours 32minutes work time and 6% allowance rate. Even though the pharmacies near hospitals or clinics participated dispensing services actively, only pharmacies near clinics dealt with more than optimal dispensing cases. For the pharmacies near hospitals they dealt with less than optimal cases, but drug administration period per prescription was almost 3 times longer than that of pharmacies near clinics. Thus the intensity of dispensing activities such as drug administration period is to be considered to estimate optimal dispensing cases more accurately.

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나트륨 섭취량 감소 정책의 비용편익 분석 (Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea)

  • 이철희;김대일;홍정림;고은미;강백원;김종욱;박혜경;김초일
    • 대한지역사회영양학회지
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    • 제17권3호
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    • pp.341-352
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    • 2012
  • It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

우리나라의 현행 의약품분류체계에 대한 고찰 및 개선 방안 (Current Drug Classification System in Korea and Its Improvement)

  • 손현순;오옥희;김종주;이소현;변선혜;신현택
    • 한국임상약학회지
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    • 제15권2호
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    • pp.139-148
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    • 2005
  • Appropriate drug classification is important fur rational drug consumption. This study was conducted to evaluate the appropriateness of current drug classification system and suggest possible ways for improving the system. Nonprescription drug market has been decreased. Since total 27,962 products had been classified (prescription 17,187 vs. nonprescription 10,775 products, 61.5% vs. 38.5%) in July 2000 for implementing separation of drug prescribing and dispensing system, there are no classification changes. Reclassification is not motivated by product holder and regulatory system did not lead classification change either. Consumers' ease access to some nonprescription drugs is demanded. But point of public awareness and cultural and health environmental views, saff drug use rather than advantages from broad supply of nonprescription drugs is more critical. We concluded that current 2-categorized (prescription and nonprescription) drug classification system is appropriate, and addition of general sale category should be approached carefully with long term Preparations such as establishment of better nonprescription drug consuming infrastructure by public information provision and education for improving public medicinal knowledge and strengthening self medication guidance, and review of current classification status of marketed drugs and switching possibilities. For systemizing and encouraging reclassification, introduction of regulatory renewal system as a continuous reevaluation program which is the best way to review appropriateness of drug classification as well as provision of detailed guidance for industry including policy, requirement and process fer reclassification application, are necessary.

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정부의 위기 커뮤니케이션 연구: 의약품 부작용 관련 언론 보도에 나타난 주요 주제, 정보원, 위기 책임 귀인, 프레임 분석 및 네트워크 분석을 중심으로 (Government's Crisis Communication based on the Main Theme, Source, Crisis Responsibility, Frame Analysis and the Network Analysis on the Side Effects of Drug of the Press)

  • 홍주현;차희원
    • 한국콘텐츠학회논문지
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    • 제18권4호
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    • pp.575-585
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    • 2018
  • 의약품 부작용과 같이 국민의 건강과 밀접한 관련이 있고, 전문적인 이슈의 경우 언론 보도는 국민들의 위기 대응과 정부의 위기관리에 영향을 미칠 수 있다는 점에서 중요하다. 이 연구는 의약품 부작용과 관련된 언론 보도를 주요 주제, 정보원, 위기 책임 귀인, 프레임을 분석하고 언론의 주목을 받은 의약품 부작용보도에 대해 네트워크 분석을 실시해 정부의 위기관리 방안을 제시했다. 일간지, 경제지, 전문지의 보도에 차이가 있었는데, 일간지는 부작용 발생과 같은 위기 발생을 중심으로, 경제지는 제약업계 관련된 기사를, 전문지는 의약품 정책을 비판하는 기사 중심으로 보도했다. 의약품 부작용과 관련된 주요 정보원은 국회의원이었다. 위기의 책임을 언급한 기사는 적었지만, 위기 해결의 주체에 대해서는 의약품을 생산한 업체가 해결해야 한다는 기사가 많았지만 전문지의 경우에는 정부가 문제를 해결해야 한다고 했다. 네트워크 분석을 통해 기사에서 중요하게 언급된 단어를 찾고, 단어와 단어의 관계 분석으로 기사에서 전달하고자 하는 의미를 찾았다. 이 연구는 내용분석과 네트워크 분석을 통해 의약품 부작용 기사를 분석하고 정부의 위기 커뮤니케이션 관점에서 공중별 정부의 위기 대응 방안을 고려해봤다는 데 의의가 있다.

선택실험법을 이용한 의약품 급여결정기준에 대한 선호분석 (Eliciting stated preferences for drugs reimbursement decision criteria in South Korea)

  • 임민경;배은영
    • 보건행정학회지
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    • 제19권4호
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    • pp.98-120
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    • 2009
  • The purpose of this study is to elicit preference for drug listing decision criteria and to estimate the ICER threshold in South Korea using the discrete choice experiment (DCE) method. To collect the data, a DCE survey was administered to a subject sample either educated in the principle concepts of pharmacoeconomics or were decision makers within that field. Subjects chose between alternative drug profiles differing in four attributes: ICER, uncertainty, budget impact and severity of disease. The orthogonal and balanced designs were determined through computer algorithm to take the optimal set of drug profiles. The survey employed 15 hypothetical choice sets. A random effect probit model was used to analyze the relative importance of attributes and the probabilities of a recommendation response. Parameter estimates from the models indicated that three attributes (ICER, Impact, Severity of disease) influenced respondents' choice significantly(p${\pm}$0.001). In addition, each parameter displayed an expected sign. The Lower the ICER, the higher the probability of choosing that alternative. Respondents also preferred low levels of uncertainty and smaller impact on health service budget. They were also more likely to choose drugs for serious diseases rather than mild or moderate ones. Uncertainty however is not statistically significant. The ICER threshold, at which the probability of a recommendation was 0.5, was 29,000,000 KW/QALY in expert group and 46,500,000 KW/QALY in industry group. We also found that those in our sample were willing to accept high ICER to get medication for severe diseases. This study demonstrates that the cost-effectiveness, budget impact and severity of disease are the main reimbursement decision criteria in South Korea, and that DCE can be a useful tool in analyzing the decision making process where a variety of factors are considered and prioritized.

델파이 조사법을 이용한 의료 자원 사용의 효율성 평가지표 개발 (Development of efficiency indicators for medical resources use using Delphi technique)

  • 최윤정;권영대;김창수;김윤
    • 보건행정학회지
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    • 제22권1호
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    • pp.65-84
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    • 2012
  • Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

나트륨 실측치와 식품교환표 및 식품성분표를 이용한 추정치의 비교 (Differences Between Analyzed and Estimated Sodium Contents of Food Composition Table or Food Exchange List)

  • 권용주;이무용;김지영;권광일;김소진;신희준;박성수;이은주;박혜경;박용순
    • 한국식품영양과학회지
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    • 제39권4호
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    • pp.535-541
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    • 2010
  • 나트륨의 과잉섭취가 고혈압의 주요한 위험요인으로 알려져 있는데, 한국인의 성인 하루 평균 소금 섭취량은 영양 섭취기준보다 3배 이상 높다. 본 연구에서는 식품교환표를 이용하여 14일간의 식단을 작성하고 조리된 음식의 나트륨 함량을 실제로 측정한 후 식품교환표와 식품성분표에서 계산된 나트륨 추정치와 비교하여, 각각 방법의 정확성 및 문제점을 파악하고자 하였다. 그 결과를 요약하면 아래와 같다. 하루 식단의 나트륨 함량에서 식품교환표로 계산한 추정치는 실측치와 유의한 차이가 났으나, 식품성분표는 실측치와 유사하였다. 음식별 절대값의 비교에서는 식품교환표로 계산한 나트륨 추정치와 식품성분표로 계산한 나트륨 추정치가 모두 실측치와 유의한 차이가 났다. 음식군별 절대값 비교에서는 양념류의 나트륨 함량이 많은 주요리, 부식, 국물요리에서 상당히 유의한 차이가 났으며, 식품교환표로 계산한 추정치, 식품성분표로 계산한 추정치, 실측치간의 차이가 큰 음식들이 모두 주요리, 부식, 국물요리였다. 이상의 결과에 따르면, 단순히 하루 식단의 나트륨 함량 비교에서 식품교환표에 비해 식품성분표의 나트륨 함량이 더 정확하다고 생각할 수 있지만, 음식별 또는 음식군별로 추정치와 실측치간의 차이를 절대값으로 비교한 결과, 식품교환표와 식품성분표의 나트륨 함량 모두 실측치와 차이가 컸다. 특히 나트륨 과잉 섭취의 주요 원인으로 보고되는 양념류의 차이로 장류, 김치 등의 사용이 많은 한국음식에서 식품교환표와 식품성분표를 이용한 추정치와 실측치의 차이가 컸다. 따라서 고혈압 및 신장질환 환자를 위한 저염식단작성시 식품교환표나 식품성분표를 사용할 때 실제 소금량과의 차이를 고려해야한다.