• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.219-227
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• 2001

Objectives : To understand the current status of the opening, closing and relocation of primary medical institutes in Korea and identify the underlying decision factors. Methods : Sources of analyzed data included the medical institutional master file at the National Health Insurance Corporation(1998, 2000) and Regional Statistic Annual Bulletins. To investigate changes including the opening, closing and relocation, a total of primary medicalinstitutions(16,757 in 1998, 19,267 in 2000) were analysed. Results : Between 1998 and 2000, there was a 15.0%(2,510) increase in the number of primary medical institutions and the rate of increase in the rural area was higher than the urban area, and higher for specialty clinics than primary practice. However, these findings did not suggestany improvement in the maldistribution of primary medical institutions. During the time period studied, newly opened and closed primary medical institutions numbered 4,085 and 1,573, respectively. Additionally, institutions thatrelocated numbered 2,729, or 16.3% of all primary medical institutions in operation in 1998. These openings and closings were more frequent among young doctors. As a result of our analysis on the underlying regional factors forrelocation, the factors that were statistically significant were local per capita tax burden and the number of schools per ten thousand persons. !n, the case of institutional factors, movements were significantly associated with gender and the location of primary medical institutions. Conclusions : In order to establish effective long-term intervention for primary medical institutions, further study and monitoring of primary medical institutions and the identification of factors influencing opening location and relocation is necessary.

• 대한예방한의학회지
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• 제9권1호
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• pp.91-103
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• 2005

The purpose of this study was to find out the various opinions of Oriental Medical Doctors to give the recommendations for making the proper policy of the supply and demand of Oriental Medical specialist. This study was desinged of 480 doctors who answered about questions that is composed of 105 Oriental medical specialist, 227 Apprentice doctor and 148 Oriental Medical doctors. On the assumption that there are many different situations and visions about the Oriental medical specialty system, we wanted to know about the each situations and visions about oriental specialty system. Generally, as one grows older, they adapted high proportion about the propriate number of specialist. About this difference from each generations, we can explain that young doctors more worry about the supply of specialist. As well each achievement, the more higher achievement, the more higher proportions of specialist is adapted. Answers about the number of present specialist, the more aging the more negative response about the number of present, number of specialist, this is because of the proprotions who wanted to be a specialist in open doctors. About the property of the number of specialist, there are many different views in each other groups. Anyway it is important that hearing the opinion of each Oriental Medical Doctors for the better Oriental Medical System.

• 한국의사학회지
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• 제36권1호
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• pp.31-50
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• 2023

Through this paper, all the provisions of the enforcement statutes stipulated in the Joseon's law code were investigated and major medical issues and interests in the Joseon Dynasty were analyzed. The characteristics of each period reviewed in the text are as follows. The early Joseon Dynasty is divided into three periods. First of all, Joseon filled the gap in the law with the active acceptance of the Ming Dynasty's law code, Daemyeongrul, which conformed to Confucian virtue. Next, the completion of Gyeonggukdaejeon was an opportunity to prepare the basis for Joseon's medical laws. Lastly, from the late 15th century to the 16th century, the existing medicine promotion measures and emphasis on hyangyak(domestic herb) continued. it can be said that Joseon's politicians needed a medical policy based on Confucian virtues and maintained state-led promotion policies, but on the other hand, there was no other alternative to try newly by reflecting the limitations and failures of the policy. The late Joseon Dynasty is also divided into three periods. First of all, the period from the late 16th century to the early 18th century was marked by the growth of families in technical positions. The era of King Yeongjo can be said to be the period of reorganization of medical related laws. Finally, the period after the late 18th century is a period of passive regulation and supplementation. Lastly, the revision of the actual medical law was not made or reflected in era of King Jeongjo. In the case of the early Joseon Dynasty, the policy shifted from state-led to families in technical positions. However, in the 19th century, the weakening of the royal authority led to the weakening of the overall administrative system of the country, and the pharmaceutical policy had to be limited.

• 대한예방한의학회지
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• 제4권1호
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• pp.1-16
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• 2000

From 1998, Oriental Medical Physicians(OMP) is distributed in Public Health Sector. but long term plan for Oriental Medicine in Public Health is not existed. So, this study is designed for the activation of OMP Subjects in this study were comprised 3 groups of oriental medicine related persons, the group of which are Students of 11 Oriental Medical Schools, Oriental Medical Physicians in Public Health Sector, Specialist Croup of Oriental medicine Policy(total 1,458 persons). Data were collected from July 1st to November 30, 1999. Direct interview with key persons, systematic interview by using of interview protocol, e-mail and facsimile have been conducted. The results of survey were coded by Excel 5.0, and analysed with SAS 6.12 statistical package. Inter-group difference determined by T-test, and descriptive statistics have been examined. Major findings can be epitomized as follows. 1) OMP disposition to multifarious organizations and institutes such as Public Health Centers, Public Health Sub-centers, Public Hospitals, Private Hospitals in Remote-Vulnerable Area, Community Social Welfare Centers, Institutes for Heath Policy Research, etc, will promise an effective use of Oriental Medical Physician. 2) Average number of patients treated by OMP was 22.8, average budget for oriental medical department, in which OMP were affiliated, was 39.6 million Won per year. Direct cost per every patient visit was 7,210.9 Won, which is considered expensive for public health service. Therefore, development and transformation for Oriental Medical Service in Public Health Sector is desirable in economic and political aspects. 3) It is recommended that ${\ulcorner}Advisory\;Committee{\lrcorner},{\ulcorner}Planning\;Commission\;for\; Public\;Health\;in\;Oriental\;Medicine{\lrcorner}$ should be established for the activation and for the support of Oriental Medical Physician in Public Health Sector, 4) Most effective programmes for oriental public health doctor are health service programmes for the elderly, Home health visit, chronic degenerative disease control services(p<0.001). 5) Standard guideline for facilities and equipments of Oriental Medicine Department in Public Health Center is needed for optimal supply of resources and activation of public health activity.

• 보건행정학회지
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• 제5권1호
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• pp.106-131
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• 1995

Nowadays there are a lot of medical accidents and medical disputes in Korea. Our government has made efforts to legislate The Medical Disputes Conciliation Law for several years. But this law has many problems. These problems are followings. 1. the problem of going certainly through compulsory screening panels before coming to court. 2. the possibility in making the impartial screening panels for malpractice claims 3. the utilization of a mutual aid association to have low efficiency in paying for damages by medical malpractice and so on. To resolve medical disputes rapidly, we must legislate The Medical Disputes Conciliation Law in a short time. However, all medical disputes are not rationally dissolved by only this law, The Medical Lsw(Arztrecht) is needed to improve the solubility of medical disputes through setting up the decision criteria.

• 보건행정학회지
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• 제29권3호
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• 산업기술연구
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• 제24권B호
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• pp.37-46
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• 2004

The purpose of this study are observing changing direction of lobby space that happen by change of medical environment investigating lobby space of General Hospital by our country's medical policy change time and supply pabulum that need in forward Hospital Architecture planning. Results of this study are as follows ; Since Whole National Insurance enforcement from 1993 to 1995, form of general hospital lobby is form that outpatient entrance and inpatient entrance are detached. And lobby function divided to waiting space for medication, requisition space and also that is appearing being detached with rest space for user. ntil 1999 since 1996 that is since Medical Treatment Information System construction, the biggest characteristic of General Hospital lobby form is making Hospital Street itself do improving efficiency of flow planning being included in lobby.

• 한국한의학연구원논문집
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• 제5권1호
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• pp.133-139
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• 1999

Korean Oriental Medicine has experienced a dramatic status change since the 19th century. Korean Oriental Medicine had been the only authentic medicine, but lost its status and fell as an illegal medicine through the Japanese rule, and recently revived successfully. The dramatic change of Korean Oriental Medicine needs an explanation. This paper explored the cause of the dramatic change and found the following things. First, the medical policy of the State directly influenced to the status of Korean Oriental Medicine. During the Japanese rule, the medical policy for Korean Oriental Medicine was very oppressive. After Liberation, a kind of noninterference policy was carried out. The change of the medical policy gave direct influence to the status of Korean Oriental Medicine. Second, the needs for medical service have been expanded. At the same time, the concern for tradition has been increased. And the supply of Korean Oriental Medicine has also increased by the establishments of Korean Oriental Medicine departments. Third, the internal growth of Korean Oriental Medicine brought to elevating the status of Korean Oriental Medicine. After 1945, Korean Oriental Medicine endeavored to strengthen the organization and to activate the academic society. Based on the above factors, Korean Oriental Medicine has achieved a remarkable status change during last several decades. We can not skip Korean Oriental Medical doctors' desperate efforts to enhance the status of Korean Oriental Medicine. Korean Oriental Medicine achieved the modernization. It's difficult to find similar case. It can be a model of modernization of tradition.

• 보건행정학회지
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• 제28권3호
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• pp.202-209
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• 2018

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.

• 보건행정학회지
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• 제3권1호
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.