• Journal of Society of Preventive Korean Medicine
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• v.12 no.2
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• pp.73-83
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• 2008

The rapid change of the health and medical environment and the globalization of medicine has driven doctors to converge and analyse of new and up-to-date medical information and decide to what to make decision for diagnosis and treatments in clinical practice. Medical environment goes with the changes with social environment such as rapid increase of aging population, changes of disease pattern, formation of new area of experts except doctors, government intervention for the medical system, medical insurance of the charges of medical treatment, a increased desire for human rights. These trends should be adopted rapidly to the education system for the students of medical school. The learning objectives of the preventive medicine was developed in 1995 and underwent necessary revision of the contents to create the first revision in 2006. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum and the 2006 revision does not satisfy these needs. We formed a task force which surveyed all the Western and Traditional Korean medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. With these results, for the good education for preventive medicine, each Traditional Korean medicine schools need more preventive medicine faculties and teaching assistants and opening of some required subjects such as Yangsaeng and Qigong. And future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.53-69
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• 2021

Objectives : The purpose of this study is to analyze the effects of treatment between Western medicine and Korean medicine on Allergic rhinitis patients using national population-based claim data from the Health Insurance Review and Assessment Service. Methods : The subjects of the study were 30,024 patients in the Korean medicine group and 30,024 in the Western medicine group who were diagnosed with Allergic rhinitis from September 1, 2018 to December 31, 2018. Propensity score analysis was used for matching age, sex, etc. at a ratio of 1:1. Cox regression and subgroup analysis were used to estimate the adjusted hazard ratio of recurrence, Asthma, and Atopic dermatitis in Korean medicine group and Western medicine group. In addition, the total treatment period, total treatment cost, and average cost per day of visit were compared and analyzed. Results : Compared to Korean medicine, Western medicine had a significantly higher risk of recurrence at 1.701 times, Asthma occurrence risk at 1.609 times and Atopic dermatitis occurrence risk at 1.098 times. Compared to Western medicine, the total treatment period of Korean medicine was 14.27 days longer, the total treatment cost was 53,591 won more, and the average cost per day was 7,539 won more. Conclusions : This study is a retrospective cohort study using the propensity score matching in Korea to compare the outcomes of Allergic rhinitis between Western medicine and Korean medicine. Further research is needed by considering patients characteristics, and linking with additional data.

• The Journal of Korean Medicine
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• v.23 no.4
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• pp.91-97
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• 2002

Objective: This study was conducted to know the survival probability of the patients with cerebrovascular disease. Method: 1,341 patients who were suspected of having cerebrovascular disease clinically were investigated by telephone and NHIC (National Health Insurance Corporation) data. Conclusion: 1. The study population was grouped as 'Negative Brain CT findings' (11.8%), 'Hemorrhage' (12.4%) and 'Infarction' (75.7%). 2. The survival probabilities calculated by the Life Table method were statistically significant among brain CT finding groups (P<0.01). 3. The mean survival time calculated by the Kaplan-Meier method were also statistically significant among brain CT finding groups (P<0.01). 4. The result of Cox regression model was that sex (OR=0.7), age (OR=1.07), diabetes mellitus (OR=1.38), and heart disease (OR=1.69) affected the survival of the patients with cerebrovascular disease.

• Korean Journal of Oriental Medicine
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• v.16 no.1
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• pp.119-134
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• 2010

Objectives & Method：Based on the statistic from January 2008 to December 2008 include 66-year-old 375 people (159 men, 216 women) who got examined in National Health Insurance Corporation, this study set a goal to establish a new health index by analyzing the relation between the cardio-cerebra vascular disease and risk factor such as obesity, smoking, exercise, alcohol consumption, blood pressure, blood sugar and cholesterol. Results：1) Examine results, health status according to gender；People who are diagnosed as abnormal health status have higher risk for both men and women. As for the detailed diseases, high blood pressure was highest followed by hyperlipidemia and obesity. In case of the women, 96.3% in bone mineral density was highest. 2) Correlation of disease and health risk factors based on gender；Correlation of disease according to gender in the obesity(p<0.001), lipid abnormalities(p<0.001), kidney diseases(p<0.001), chest diseases(p<0.05), osteoporosis(p<0.001) showed a statistically significant difference. The analysis showed that the men have more obesity and lipid abnormalities as well as thoracic disease than the women, but the women have more kidney disease than the men. As for the osteoporosis examine which is conducted only for the women, most of the women were abnormal even though it cannot compare the result according to gender. Obesity(p<0.001), alcohol(p<0.001), smoking(p<0.001) and LDLcholesterol(p<0.001) showed statistical correlation between gender and health risk factor. And only high blood pressure(p<0.001) showed a statistical correlation between gender and risk of cardio-cerebra vascular disease. 3) Risk of cardio-cerebra vascular disease related to health risk factor characteristic；Obesity assessment(p<0.001), alcohol(p<0.05), smoking(p<0.05), blood pressure(p<0.001), glucose(p<0.001) showed correlation between health risk factor and stroke. Drinking(p<0.001), smoking(p<0.05), exercise(p<0.001), blood pressure(p<0.001), LDL cholesterol(p<0.001) showed health risk factor and myocardial infarction. Obesity assessment(p<0.001), smoking(p<0.05), blood pressure(p<0.001), glucose(p<0.001) and showed correlation between health risk factor and diabetes. Obesity assessment(p<0.001), blood pressure(p<0.001) showed correlation between health risk factor and high blood pressure. Conclusion：Therefore, we have to take one step farther after the health examination. In order to prevent and reduce the risk of disease, people have to understand their health status exactly first, and correct their habit with recognizing the amount of risk related to cardio-cerebra vascular disease.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.2
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• pp.38-52
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• 2021

Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

• Herbal Formula Science
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• v.16 no.1
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• pp.95-107
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• 2008

Objectives : Hwangnyeonhaedok-tang(HNHDT) is the one of well-known traditional herbal formula and has been widely used for the treatment of various diseases in Korea. For the quality improvement of commercial traditional herbal formula, we investigated the quality of prepared HNHDT. Methods: We measured the contents of baicalin, berberine and geniposide in the HNHDT Ex preparations on the market by HPLC and compared with the official notice of ingredients. Results: In 3 preparations of HNHDT covered with the national health insurance(NHI), the content of baicalin was various from 32.83mg to 185.05mg, the total berberine was $12.0{\sim}50.75mg$ and geniposide was $12.57{\sim}44.84mg$. Contents of marker ingredients in NHI Preparations were below the standard and showed a large variation. In 7 non NHI Preparations of HNHDT and the standard(STD) HNHDT manufactured in laboratory, the content of baicalin was $37.16{\sim}115.69mg$, the total berberine was $5.62{\sim}28.43mg$ and geniposide was $10.98{\sim}113.47mg$. But, because composition of non-NHI preparations is different from NHI preparations, every maker's contents were up to the notice for baicalin and berberine. There was newly enforced standard regulations of geniposide in non-NHI preparations, so contents of geniposide was up to that standard only in JI and STD. Conclusions: There was a large variation of contents in the HNHDT Ex preparations on the market and the quality differences were existed between NHI and non-NHI preparations of HNHDT. Further studies for evaluation of efficacy differences and standardization of manufacturing processes are necessary.

• Journal of agricultural medicine and community health
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• v.13 no.1
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• pp.3-18
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• 1988

The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

• Journal of Society of Preventive Korean Medicine
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• v.17 no.2
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• pp.105-127
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• 2013

Objectives : We examined the use of the moxibustion through survey on Korean Medicine Doctors (KMDs) on preparation of universal moxa product standard by fully reflecting opinions of practitioners and the industry. Methods : The questionnaire is composed of 25 questions including use of indirect moxa, side effects, complaints and improvements, general characteristics and so on, and were responded by 1,588 KMDs. For statistics, frequency analysis, chi-square analysis, T-test and ANOVA were conducted using SPSS 12.0 for windows, and the significance level was 0.05. Results : In this research, 91% of the responded KMDs was using moxibustion, and the proportion of using mediate moxibustion was shown as 63.2%. They used mediate moxibustion for side effects of direct moxa method such as risk of burn, ease of use, control of stimulation and so on. And it was mostly being conducted to women and 40 ages. Most respondents gave moxibustion treatments for the purpose of thermal stimulation on acupoint to musculoskeletal diseases. Most respondents were treating 1~2 pieces of moxibustion to patients by moxibustion points to those of 1~2 regions every time within 10 minutes. Regarding the frequency of side effects of mediate moxibustion, within 3% of respondents had experienced side effects, and the types were burn, flare and itchiness, odor and smoke. The dissatisfaction of mediate moxibustion products was moderate(2.00 out of 5 point scale), and went up public health doctors, the younger ages and the shorter clinical experience. Complaints on mediate moxibustion products were serious odor, poor attachment, risk of burn etc. Regarding ways to improve mediate moxibustion, the expansion of moxibustion's insurance cost carne out highest, followed by preparation of manual on efficacy, strengthening of training, acquiring evidence on efficacy, diversification of specifications, safety improvement, quality improvement of mediate moxibustion products. Conclusions: Many KMDs use for ease of use and give moxibustion treatments for thermal stimulation but they complain about safety, efficacy and quality of mediate moxibustion. After this it is considered that we have to elevate therapeutic effect through the improvement of mediate moxibustion products.

• The Journal of Korean Medicine
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• v.18 no.2
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• pp.187-198
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• 1997

The degree of KAP study on Chinease traditional medicine and doctor was examined with some chinease living yenbian district(延邊) from July 1st to August 30th in 1996. The result of the study for predicting health and ill patterns runs as fellows. 1. It is understand to strength and variety about role of chinease traditional medicine doctors and the curable disease. 2. Although most patients go to chinease traditional medicine clinic for the purpose of medicine herbs in package, acupuncture and industry-made pharm, they think the medical fee a little high(70.6%). 3. The 66.7% of respondents recognize chinease traditional medicine doctors as a profession and others think them only abundant works ; therefore it is rather low to ink chinease traditional doctors a profession. 4. Most respondents think that chinease traditional medicine should improved in the inside ; such as scientific reinforcement of theory, lack of univerality, improvment and enlargement of insurance, unkindness, shortage of publicity, dropped equipment, system of medical specialist, lack of integration with westem medicine, exact diagnosis and confidence of remedy, and low efficacy, etc. 5. Chinease likes more experienced-traditional doctor than beginner(78.3%) 6. The policy of korean government against 100 herbal prescription right by western pharmacy has taken the negative recognition(74.6%), 7. The degree that acknowleges of chinease traditional medicine through thease basic contents is average 47.3 mark. To be brief, although the step of the recognition and attitude of oriental medicine is less or very affirmative aspect, actully considerable positive factors is in the last chosen step. In conclusion KAP study connected chinease traditional medicine and doctor has very much postive factors.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.