• 대한한의학원전학회지
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• 제24권6호
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• pp.101-110
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• 2011

There are not a few cases in Oriental medicine where a different prescription should be given to some of the patients whose symptoms are similar to each other. In other words, there might happen a misdiagnosis due to an extremely delicate difference in symptoms of the same diseases, causing a patient's condition to get worse or to be even on the brink of death. In such a context, the records in "WooJam JabJeo(愚岑雜著)" are worthwhile to do in-depth research on. Jang-Taegyung described his first-hand experience in major medical treatment very vivaciously during his ages between 25 and 42. Particularly, most of the prescriptions recorded in this book include not only his empirical prescriptions on the patients who life was almost on the brink of death but it also so plentifully contained the process of overcoming the side effect caused by other clinics' misdiagnosis; thus, that this book is drawing attention in that it could be indispensable materials not only in the research on medical history but also for clinical treatment. Particularly, as regards two cases of insanity, this book mentions the reason for using totally different prescription on one case from the other case even though the two cases had a similar symptom, through which we can acquire somewhat concrete experience in curing scenes though indirectly during the period of the Joseon Dynasty. We were able to get the result from the analysis of the two cases of insanity as follows: 1. WooJam, in treating the two cases of insanity due to the severe exacerbation of yang energy, managed to treat the one case by inducing a bowel movement and the other case by inducing urination. Such a different treatment seems to be greatly attributable to the constitutional factor of the two patients. Such an Oriental-medicine-based method of diagnosis and prescription as WooJam's is rarely found in Western medicine-i.e., that's why more thorough research on Oriental medicine is deeply required. 2. In case of the second patient, the patient arrived at insanity due to another clinic's treatment on perspiration on the patient with severe mouth thirst. This medical story once again highlights the importance of a diagnosis in today's Oriental medicine and at the same time it's a good example showing how big the side effect caused by the abuse of medicinal herbs is. The second patient's body fluids ran dry and finally his yang energy got exacerbated all the more due to the treatment by perspiration.

• 동의생리병리학회지
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• 제23권6호
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• pp.1521-1528
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• 2009

This study aimed to know the association between health practices(Alameda 7) and health state according to Sasang Constitution. We recruited 204 subjects whose age were between 10 and 80, excluding individuals who have physically or psychologically serious diseases, and women in pregnancy among Korean population in Traditional Korea Clinics. They were diagnosed by Sasang constitution specialists and confirmed clinically with Sasang constitution drug response with past medical records. We used the 36-Item Short Form Health Survey(SF-36) to estimate health state related with quality of life. We statistically analyzed association using SPSS 17.0K for window. According to Sasang Constitution, smoking and exercising were associated with health degree in Tae-eumin, smoking, drinking, diet and snacking in So-eumin, and past smoking, drinking, sleeping and exercising in So-yangin. These results suggest that there are different health practices for health promotion according to Sasang constitution. Therefore we have to consider the differences of Sasang constitution in health care plan.

• 보건행정학회지
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• 제17권3호
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• 대한한의학방제학회지
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• 제16권2호
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• pp.71-90
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• 2008

東醫寶鑑(DongEuiBoGam) is considered as one of the most valuable medical books for Korean traditional medicine. Since 許浚(Heo Jun), the best physician on his day, wrote 東醫寶鑑(DongEuiBoGam), it has been not only a guidebook for basic medical studies, but also a field manual for clinicians. 東醫寶鑑(DongEuiBoGam) is a medical encyclopedia which integrated more than 81 medial classics. And its contents is well organized according to the symptoms of each disease. So today most clinics refer to 東醫寶鑑(DongEuiBoGam). But if we just read 東醫寶鑑(DongEuiBoGam) and use the prescriptions without understanding, the effect of medicine will be reduced by half. We should totally understand recipes in 東醫寶鑑(DongEuiBoGam) and be able to change the recipes according to the symptoms of each patient's disease. So finding the common traits of the recipes in 東醫寶鑑(DongEuiBoGam) is very important. In this research, the recipes of the fire part(火門) of Various Disease vol. Ⅲ(雜病篇 卷之三) are analyzed according to the traits of each herb in the recipes. And new classification of prescriptions according to the community of their traits is also suggested.

• 동의신경정신과학회지
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• 제34권1호
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• pp.1-12
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• 2023

Objectives: To standardize treatment, improve quality of medical service, and reduce medical costs of patients with depression by developing a clinical pathway (CP) of Korean medicine. Methods: CP was developed based on clinical practice guideline (CPG) for depression. To consider the degree of economic burden and satisfaction, the current status of management for patients with depression was examined. After CP was primarily developed, contents of the CP were supplemented by referring to previously developed CPs. Results: Based on CPG, current status survey and previous CP, four types of CP (Korean medicine clinics, Korean medicine hospitals, Western-Korean medicine collaborative hospitals, public medical center) were developed and shown in the algorithm version. However, in the case of Korean medicine hospitals and Western-Korean medicine collaborative hospitals, CPs were detailed according to different clinical scenes of outpatients and inpatients. This study also shows six different time task matrix version. Conclusions: CP for depression is expected to not only reduce financial burden of patients and health insurance, but also increase the quality of treatment and satisfaction.

• 대한예방한의학회지
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• 제24권2호
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• pp.31-41
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• 2020

Background : The introduction of policies expanding the coverage of uninsured Korean Medicine (KM) services have requires an understanding of the following components of the service : current financial expenses, degree of financial burden on the patient, and financial effect of the coverage expansion. Objectives : This study aims to determine the annual trend of outpatients' characteristics and the category of out-of-pocket spending in KM. Methods : This study uses data from the Korea Health Panel to analyze use of KM in the Korean population. Using the user characteristics and behavior drawn from the Korea Health Panel data, out-of-pocket spending trends of KM were analyzed by year. The diagnosis and prescription of out-of-pocket spending were also analyzed. Results : The proportion of patients receiving uninsured medical treatment and the number of uninsured medical treatment in outpatient clinics have increased. However, the average out-of-pocket spending per person and out-of-pocket spending per visit are consistent or have decreased. Meaningful trends are the increase of R00-R99 (unclassified symptoms) and the decrease of K00-K93 (digestive system disease) and J00-J99 (respiratory system disease). Conclusions : Expansion of KM medical service and insurance is influenced by uninsured medical treatment of KM. Hence, research to increase medical treatment categories for out-of-pocket spending or explore diseases where KM diagnosis has been proven effective should be further developed.

• 사상체질의학회지
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• 제22권4호
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• pp.40-48
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• 2010

1. Objectives Herbal Extracts are used in Korean Oriental Medicine clinics. The sixty eight kinds of single herbal extracts and fifty six kinds of mixed herbal extracts has been using since the first year of execution of Korean medicine national insurance policy in 1987. This paper was performed to make a guideline of using herbal extracts. Single herbal extracts and mixed herbal extracts were discussed and classified according to Sasang constition. 2. Methods The sixty eight single herbal extracts were classified into four categories according to Sasang Constitution and fifty six mixed herbal extracts were classified by six Korean oriental medical doctors. Mixed herbal extracts were considered in terms of drug roles[sovereign, minister, assistant and courier(君臣佐使)] or most included ingredient herb. 3. Results Sasang constitutions which were suitable for fifty six mixed herbal extracts were Soeumin(46.4%), mixed constitution(39.2%) and Soyangin(8.9%), Taeeumin(5.3%). Sasang constitutions which were suitable for sixty eight single herbal extracts were Soeumin(47.1%), Soyangin(32.4%) and Taeeumin(20.6%). 4. Conclusions The rate of Soeumin herbal extracts was the most highest among all constitutions. It is regarded that warming and enforcing herb medicine were most used in all prescriptions.

• 동의신경정신과학회지
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• 제21권3호
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• pp.95-103
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• 2010

가족 간의 갈등으로 인해 발생한 두부진전이 4-5년간 지속된 환자에게 한약물과 한방정신요법을 시행하여 증상의 유발과 악화인자에 대한 통찰을 하고 조절할 수 있는 통제력을 가지게하여 증상을 완화되었고, 수개월이 지난 지금까지 호전상태가 지속되는 것을 경험하였다. 심인성 운동장애는 전체 운동장애 중 2-3% 정도로 드물게 일어나며, 진전이 가장 흔한 형태이기는 하나 상하지에 많이 발생하고, 두부에만 국한적으로 일어나는 경우는 드물다. 이에 상기 증례는 다른 신경학적 증상을 동반하지 않고 두부에만 국한적으로 진전이 발생한 환자에게 한의학적 치료를 하여 유효한 결과를 얻었기에 보고하는 바이다.

• Journal of Acupuncture Research
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• 제17권2호
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• pp.153-168
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• 2000

Introduction : In spite of the use of Bee Venom aqua-acupuncture in the clinics, the scientific evaluation on effects is not enough. Bee Venom aqua-acupuncture is used according to the stimulation of acupuncture point and the chemical effects of Bee Venom. The aims of this study is to investigate the analgegic effects of the Bee Venom aqua-acupuncture, through the change of writhing reflex and the change of c-fos in secondary neurons in the spinal cord. Materials and Methods : Pain animal model was used acetic acid method. The changes of writhing reflex of the mice which were derived pain by injecting acetic acid into the abdomen, after stimulating Bee Venom aqua-acupuncture on Chungwan(CV12) were measured. We used Fos immunohistochemical technique to study the neuronal activity in the spinal cord. Results : 1. Expression of c-fos in superficial dorsal horn(SDH), nucleus proprius(NP) and neck of dorsal hom(N) on 6~9th thoracic spine decreased significantly at $2.5{\times}10-4$g/kg Bee Venom aqua-acupuncture, compared with saline-acetic acid group. 2. The numeral change of Fos-LI neurons on the NP, N, and ventral gray(V) on 6-9th thoracic spine, SDH on 9-11th thoracic spine, and SDH and V on 11~13th thoracic spine decreased significantly at Chungwan(CV12) Bee Venom aqua-acupuncture, compared with saline-acetic acid group. 3. The correlation between the numbers of writhing refleax and Fos-LI neurons in T6-13 segment was statistically statistically significant at Chungwan(CV12) Bee Venom aqua-acupuncture. Conclusion : This study shows that the Bee Venom aqua-acupuncture on Chungwan(CV12) decreases the numbers of Fos-LI neurons. As the analgegic effects of Bee Venom aqua-acupuncture is recognized. Bee Venom aqua-acupuncture treatment is expected for pain modulation. In order to use it in many ways, more researches are needed for the dose and stability of Bee Venom aqua-acupuncture.

• 융합정보논문지
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• 제12권2호
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• pp.184-191
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• 2022

본 연구는 자동차보험 이용환자들의 효율적 관리방안을 모색하는데 필요한 기초정보를 제공하고자 보건의료빅데이터개방시스템에 등록된 2016년부터 2020년까지 5개년 자동차보험 진료비 심사자료를 대상으로 분석하였다. 분석결과, 자동차보험 입원진료비 내역 구성비율 1순위는 상급종합병원은 처치 및 수술료, 종합병원·병원·의원은 입원료, 한방의료기관(한방병원, 한의원)은 처치 및 수술료, 치과병원은 처치 및 수술료 이었다. 외래진료비 내역 구성비율 1순위는 양방의료기관(상급종합병원, 종합병원, 병원, 의원)은 진찰료, 한방의료기관(한방병원, 한의원)과 치과의료기관(치과병원, 치과의원)은 처치 및 수술료 이었다. 자동차보험 입원 건당 진료비에는 투약료, 마취료, 특수장비 비율이 영향요인이었으며, 외래 건당 진료비에는 이학요법료 비율이 영향요인으로 확인되었다.