• Journal of Society of Preventive Korean Medicine
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• v.6 no.1
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• pp.1-14
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• 2002

The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.2
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• pp.57-66
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• 2015

Objective : This study aims to investigate the priority of education needs of managerial competencies for Korean Medicine doctors. Method : Self-administered questionnaires were sent via on-line survey system to 4,107 Korean Medicine (KM) doctors who were registered in the Association of Korean Medicine and whose business places were in Seoul. The cognition of necessities, present levels, and future importance of managerial competencies were measured. To measure the degree of educational needs on health management, t-test and Borich method were used. Results : The response rate was 1.9%(79 persons) and 68 responses were included in the analysis. The cost-effectiveness studying ability and the public relations ability were the most important competencies. Analyzing the competency groups by t-test and Borich method, the marketing group was the most important competency group. Many KM doctors (53 persons; 68.9%) who answered this questionnaire expressed needs of the business administration course. Conclusion : KM doctors conceded the necessity of business competency to manage their hospitals or clinics. Academic institutions needs to consider the implementation of business administration courses for KM students in accordance with needs of the managerial competencies.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.149-162
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• 2013

Objectives : This study was conducted to estimate the future demand and supply of physicians for korean medicine from 2016 year to 2026 year in order to make an adequate manpower policy in a way of keeping a balance between demand and supply. Methods : Baseline projection method and trend analysis(a polynomial log power equation model) were used in the estimation of future supply and demand respectively. We used data about the amount of oriental doctors from Ministry of Health and Welfare Statistics Yearbook and the treatment days from HIRA Statistics Yearbook. Results : It was projected that the total number of physician of Korean medicine will be 25,178 registered and 18,967 available in clinical setting. According to polynomial equation model which explained the trend of demand and had the highest score of $R^2$ among the equation models, 3,800~5,600 physician in Korean medicine will be oversupplied in 2016 year, 9,000~10,700 physicians in 2021 year and 15,700~17,000 persons in 2026 year depends on annual working days which is 265days, 255days or 239days. Log equation model also showed that overall excess supply of physician manpower in Korean medicine. Conclusions : Alternative manpower policies for Korean medicine doctors should be implemented in a way of both dwindling supplies and growing demand in Korean medical service in terms of Korean medical services utilization and improving physician's productivity.

• Journal of Society of Preventive Korean Medicine
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• v.1 no.1
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• pp.137-148
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• 1997

The Serial Securities and the Social Welfare, as the national policy aimed at securing generals' lives, are the policies or systems for the stabilization in lift; especially of law-incomers and workers, for which the povernment has to establish the Social Security System. No wonder the Social Insurance System is a part of the Social Security System and the most important. The Social Insurance System, along with Public Assistance, is underlying the Social Security System. Social Security System includes medical insurance, industrial accident Compensation insurance, national pention insurance and employment insurance. The study is on 'The Oriental Medical Insurance and the Industrial Accident Compensation in the Social Security System' . The rate of industrial accident in Korea marks the highest rank in the world. for laborer, industrial accident do not merely mean the loss of health but the question of the right to live in terms of their loss of opportunity of life. The industrial accident compensation system should be established as the es post facto remedy system to guarantee the injured worker and his/her family's life. The oriental medical insurance system which began to operate in 1987 in Korea is based on unionism and divided into 3 parts; one part for the worker, a second part for the community inhabitants, and a third part for the public service personnel and private school personnel. Today the medical problem must be the most important social assignment to be considered. The medical system of contemporary industrial society has began greatly stood out in relief as a part of social welfare not emphasized on gainings of physicians. Accordingly systematization of the oriental medical insurance was strongly Pursued and it was developed to to the extent of entire nation insurance. Though the history of it is very short, most of the people are getting benefit from the insurance system by the social security system method. This study develops the Oriental Medical Insurance, the Workmen's Accident Compensation Insurance, the Pension System in relation to the industrial accident compensation of Employees, along with the ideas and principles of social insurance.

• The Journal of Korean Medicine
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• v.35 no.3
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• pp.22-31
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• 2014

Objectives: The aim of this study was to identify the complementary and substitute relationships between the use of Korean medicine (KM) and that of Western medicine (WM) in the treatment of musculoskeletal disease. Methods: We analyzed the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. Logistic regression, negative binominal regression, and Tobit regression analysis were used to identify the relationships between the use of KM and the use, visit frequency, and expenses of WM, respectively. Results: In the treatment of musculoskeletal disease, KM use and non-herbal treatments with Korean medicine significantly reduced WM use. Herb medication use significantly increased WM visit frequency. There were no significant relationships between KM use and WM expenses. Conclusions: There are substitute relationships between WM use and KM use, especially non-herbal treatments in KM. Therefore we need to develop the clinical protocols of KM and WM treatments in the treatment of musculoskeletal disease for proper distribution medical resources.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.2
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• pp.147-158
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• 2006

The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.137-149
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• 2020

Background: Opioids are a class of drugs found in the opium poppy, and used primarily as a pain reliever. About 130 people die every day from opioid abuse in the U.S., and the number of deaths was 6 times higher than it was 20 years ago. Objectives: To derive the implications on Korean Medicine(KM), this study aimed to investigate the current state of opioids abuse in the U.S. and analyze cases to solve opioids abuse using acupuncture. Methods: Literature on opioids abuse in the U.S. were searched through the websites of government, agency, and research institute. Results: There were several cases using acupuncture on opioids abuse. First, the Act on the use of acupuncture was enacted. Second, the clinical practice guidelines by the American College of Physicians recommended using acupuncture. Third, a large clinical study was conducted on whether acupuncture could replace opioids. Fourth, Vermont and Washington State conducted pilot projects on insurance coverage of acupuncture. Conclusions: As opioids issues are also valid in Korea, KM can serve a critical role in pain management to pursue expanded insurance coverage. In order to do so, building the discourses of KM in opioid issues is critical by defining its medical advantage, conducting large-scale clinical researches and implementing pilot projects to tackle social problems.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.3
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• pp.109-119
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• 2019

Background : Germany is the first country in the world to introduce modern systems of public health insurance, and the country which most widely uses complementary alternative medicine(CAM) in Europe. In early 21^st century, a large evaluation studies were conducted to include acupuncture in health insurance payments, which were eventually decided. Objectives : This study is to investigate and analyze the process of public policy determination on insurance coverage for acupuncture in German health insurance system. Methods : We collected the data and information through the literature search and from the websites of German government departments and health insurance organizations. To obtain contextual information, German experts of health insurance and acupuncture clinical study were interviewed. Results : As use of acupuncture had been growing, German public health insurers wanted to evaluate the validity of acupuncture coverage and sponsored three evaluation projects for clinical effectiveness of acupuncture using randomized clinical trials, systematic reviews, and pragmatic trials from 2001 to 2005. For some pain condition, acupuncture was founded not to be effective than sham acupuncture, but more effective than standard care. The federal joint committee of health insurance decided to cover acupuncture for chronic pain of lumbar spine and chronic pain in at least one knee joint due to gonarthrosis. Conclusions : Considering the controversial subject matter in the process of acupuncture's health insurance coverage in Germany, expanding the benefits of Korean medicine in Korea needs to come up with ways to overcome the difficulties of placebo effect, standardization and lack of literature evidence.

• Journal of Oriental Neuropsychiatry
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• v.33 no.4
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• pp.361-376
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• 2022

Objectives: To understand experiences of daily life and Korean medicine treatment process and perspectives of caregivers caring for children with tic disorder. Methods: A semi-structured interview was conducted with caregivers of patients under 13 years who were experiencing Korean medicine treatment for tic disorder. A total of five participants were interviewed. The analysis was performed according to a four-step phenomenological method. Results: The following four components were derived from the experience of caring for children with tic disorder: general perception of tics, negative emotions caused by tics, social deprivation, and living with a child with tics. The following four components were derived from Korean medicine treatment experience for tic disorders: criteria for selecting treatment, awareness of Korean medicine, treatment experience in Korean medicine, and what needs to be improved. Conclusions: According to results of this study, caregivers caring for children with tic disorder experienced negative emotions such as frustration, guilt, and anxiety. They also experienced social deprivation such as stigma and prejudice. Korean medicine treatment can be an effective alternative for improving symptoms of tic disorders. The application of insurance benefits to Korean medicine is needed for patients and caregivers to autonomously choose treatment.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.3
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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.