• Health Policy and Management
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• v.15 no.4
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• pp.1-25
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• 2005

Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

• Health Policy and Management
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• v.10 no.3
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• pp.50-67
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• 2000

This study aims to estimate the consumption of antibiotics in Korea and to suggest the further studies. To measure the amount of antibiotics consumption, we referred to the statistic of NFHI(National Federation of Health Insurance) and a private institute of pharmaceutical information(Korea Intercontinental Medical Statistics; IMS Korea). There were 1,563 antibiotics produced in Korea in 1997. The total amount of antibiotics production was 1,197 billion won in 1997. Antibiotics accounted for 17.6% of the total pharmaceutical productions in 1997. Cephalosporins have taken the largest part of antibiotics production since 1992. The estimation using NFHI data showed that the total expenditure of antibiotics used in health facilities was 268 billion won, 608 billion won, 911 billion won in 1990, 1994, 1997 respectively. Tertiary hospitals spent 246 billion won, general hospitals 287 billion won, hospitals 78 billion won, clinics 300 billion won in 1997. The amount of expenditure and the intensity of antibiotics consumption in hospitals have increased more steeply than any other health facilities. The total expenditure of antibiotics consumption in health facilities and pharmacies was 778 billion won when estimated using the data from IMS Korea, and 999 billion won from NFHI. Cephalosporins was the fast growing antibiotics group in all of the market- hospitals, clinics, pharmacies since 1991. To measure the amount and patterns of antibiotics consumption more precisely, a pharmaceutical monitoring or surveillance system is needed.

• Health Policy and Management
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• v.16 no.4
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• pp.147-168
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• 2006

Technological innovation has been regarded as the core competence for the economic growth of individual, as well as organization and country. Pharmaceutical innovation, what we call new medicines, influence people's longevity and productivity by increasing output per hour worked. Therefore, using claims data on virtually all the drugs and diseases of over 550,000 people enrolled in National Health Insurance Program in Korea, we examined the impact of the vintage (original FDA and KFDA approval year) of drugs used to treat a patients from July 1st to December 31st in 2002 on the patient's mortality at the end of 2004, controlling for demographic characteristics(age and sex), utilization of medical services, and the nature and complexity of illness. We found that people using newer drugs are less likely to die at the end of 2004, conditional on covariates. The estimated mortality rates were declining with respect to drug vintage for 1970s, 1980s and 1990s and highly significant. In addition to estimating the model for the entire sample, we estimated the model separately for several disease categories classified by Korean Classification of Disease. Estimates of three drug vintage variables for subgroups of people with (1)neoplasms, (2)endocrine, nutritional and metabolic diseases, and (3)the diseases of circulatory system displayed similar patterns.

• Research in Community and Public Health Nursing
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• v.20 no.2
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• pp.243-250
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• 2009

Purpose: This is a qualitative study to identify dimensions of long-term care hospital care quality that provide high-level medical services for long-term care patients in Korea. Methods: Service consumers and providers were interviewed, and collected data were analyzed into thesis, type and dimension. The focus group method was applied to two provider groups and individual interview was applied to two persons who had experienced a long-term care hospital. Results: The results of analyzing the consumers and providers was integrated into 8 dimensions: physical environment, staff, clinical care and nursing, multiplicity of activity program, atmosphere, interaction with family, nutrition, and quality improvement system. Conclusion: The dimensions of long-term care hospital care quality from this study can be used as a basis of quality indicators. Quantitative studies to test these dimensions are required for establishing quality management systems.

• The Journal of the Korean dental association
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• v.9 no.10
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• pp.617-622
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• 1971

In order to establish a more concrete dental health education and control program with the investigation of the knowledge levels concerning the dental health and the control of the dental health, twelve questionaires concerning the dental health were given to 263 inhabitants in the farm villages, 105 primary school teachers and 78 school health nurses. The results obtained from the information were as follows: 1. The knowledge levels of the primary school teachers and school health nurses as well as the inhabitants in the farm villages concerning the dental health were very low. 2. Most Korean population have not control ed their oral health in the right method using the toothbrushes and the dentifrices. 3. Most primary school teachers and school health nurses have not the ability to educate the primary school childen for the good dental health. 4. In Korea, the policies of the education and the control concerning the dental health must be reestablished. 5. Many Korean population complained the economic limitation and the over duties in their social life for the good dental health control. 6. It seems the complete medical and dental insurance system to be established for the good dental health control of most Korean population.

• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.173-201
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• 2001

This study purports to examine the current management and information technology related strategy of Korean hospitals and suggest the effective management strategy in the 21st century when is digital era. Specifically the study tries to analyze the changing trends of strategic orientation and investigate the general management and information technology strategy of Korean hospitals. Self-administered Questionnaires were distributed to 721 hospitals nationwide and finally 98 Questionnaires were analyzed for the study. The results of the study are as follows : 1) Half of the respondent hospitals reported that they have an analyzer orientation in 2000, whereas 19.4% were prospectors, reactors 16.4%, and defenders 14.3%. However, the respondent hospitals intended to have a prospector orientation in the future (2002), while 29.6% planned on being analyzers, 17.3% reactors, and 3.1% defenders. 2) Hospital services for improving patient satisfaction were the most common. strategy for the respondent hospitals, followed by cost containment, organizational restructuring, employee education, purchasing system change, specialization of clinical services, quality improvement of medical care, strengthening the networking with the stakeholders, public relations and marketing strategy, diversification, and installing the information system. However, the strategies of annual salary system, retrenchment of unprofitable services, merit payment based on performance were still not popular for the respondent hospitals. 3) As for the strategies related with information technology, most hospitals have not implemented actively, except for the establishment of home-pages, order communication systems, and insurance claims through electronic data interchange system. 4) There were significant differences in the level of strategy implementation in terms of the ownership, bed size, financial performance, and the top managers I knowledge of information technology. The larger bed size, the higher financial performance, the better knowledge of information technology the top managers have, the more strategies the respondent hospitals implemented. The managerial and political implications for Korean hospitals in digital era were also discussed.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.35-45
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• 2019

Objective : To describe our experiences with a fully equipped high-end digital subtraction angiography (DSA) system within a hybrid operating room (OR). Methods : A single-plane DSA system with 3-dimensional rotational angiography, cone-beam computed tomography (CBCT), and real-time navigation software was used in our hybrid OR. Between April 2014 and January 2018, 191 sessions of cerebrovascular procedures were performed in our hybrid OR. After the retrospective review of all cases, the procedures were categorized into three subcategorical procedures : combined endovascular and surgical procedure, complementary rescue procedure during intervention and surgery, and frameless stereotaxic operation. Results : Forty-nine of 191 procedures were performed using hybrid techniques. Four cases of blood blister aneurysms and a ruptured posterior inferior cerebellar artery aneurysm were treated using bypass surgery and endovascular trapping. Eight cases of ruptured aneurysm with intracranial hemorrhage (ICH) were treated by partial embolization and surgical clipping. Six cases of ruptured arteriovenous malformation with ICH were treated by Onyx embolization of nidus and subsequent surgical removal of nidus and ICH. Two (5.4%) of the 37 cases of pre-mature rupture during clipping were secured by endovascular coil embolization. In one (0.8%) complicated case of 103 intra-arterial thrombectomy procedures, emergency surgical embolectomy with bypass surgery was performed. In 27 cases of ICH, frameless stereotaxic hematoma aspiration was performed using $XperGuide^{(R)}$ system (Philips Medical Systems, Best, the Netherlands). All procedures were performed in single sessions without any procedural complications. Conclusion : Hybrid OR with a fully equipped DSA system could provide precise and safe treatment strategies for cerebrovascular diseases. Especially, we could suggest a strategy to cope flexibly in complex lesions or unexpected situations in hybrid OR. CBCT with real-time navigation software could augment the usefulness of hybrid OR.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.2
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• pp.57-62
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• 2020

Objectives : This study is retrospective chart review research on the combined-prescription of Western and Korean medicine in Public Health Center in rural area. Methods : Researchers reviewed medical records of patients who was prescribed Korean medicine and Western medicine from 1st, Jan, 2019 to 31st, Dec, 2019 in Public Health Center. 50 patients' medical records were included. Results : Total number of treatment is 3,808 cases and 1.3% of them is prescribed Korean medicine and Western medicine simultaneously. Prescription of Korean medicine is 153 cases and Western medicine is 160. Jowiseunggi-tang and Diroba tablet were the most frequently prescribed Korean medicine and Western medicine. Furthermore, Korean Medicine Doctors of Public Health Center use muscular skeletal disease system code(M code among KCD code) for prescription and Western Medicine Doctors use diseases of the circulatory system(I code among KCD code) frequently. Conclusions : We analyze 50 patients who were prescribed both Korean medicine and Western medicine. Mostly, patients were prescribed medicine for different diseases in each clinic. In western medicine clinic, drugs about circulatory or endocrine disease were prescribed frequently and in Korean Medicine clinic, drugs about muscular skeletal disease were most frequently prescribed. This result imply the real world's combination of prescription status that was different from result of National health insurance corporation database. Senior patients in rural area take medicine long period and have various underlying disease. We call for some attention about senior and rural area patients' prescription status in interaction studies of Korean medicine and Western medicine.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.407-414
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• 2016

This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.568-583
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• 1994

In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.