• 한국병원경영학회지
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• 제9권2호
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• pp.76-101
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• 2004

The primary purpose of this study was to provide the basic information for improving collaborating care of Korean traditional medicine and western medicine by surveying utilization and attitude on it among cerebral apoplexy(CA) patients hospitalized at a general hospital with both the western and Korean traditional medical department in Busan metropolitan city, Korea. The survey was conducted on 170 patients, 80 from Korean traditional medical department, and 90 from western medical department. The major results of this study were as below: First, CA patient's medical utilization patterns including selecting medical institution, term of treatment and type of medical institution at first-aid were significantly variated by their socio-demographic characteristics such as religion and job. Second, the perceptions of collaborating care, such as effectiveness and reduction of treatment period, were better at respondents who were hospitalized at oriental medical department and had been experienced with collaborating care. Third, the major contents of collaborating care which utilized by respondents in side of western medicine were physical therapy, x-ray, pathologic diagnosis, and medication, and in side of Korean traditional medicine were acupuncture, herbal medication, moxa cautery, cupping a boil therapy. Fourth, overall satisfaction on collaborating care was good(3.5 of 5.0) and was significantly variated by age and religion. Fifth, respondents perceived that collaborating care was most helpful for rehabilitation and the major problem of current duplicate medical system was increasement of medical expenditures, and the major obstacle of collaborating care was prejudice against each other medicine. The results of this study imply that effective marketing for collaborative care suitable for age and religion of customers and patient satisfaction strategy is needed to activate collaborating care.

• 대한예방한의학회지
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• 제7권1호
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• pp.17-28
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• 2003

We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

• 대한한의학원전학회지
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• 제9권
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• pp.555-652
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• 1996

Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

• 대한한의학방제학회지
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• 제23권2호
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• pp.209-224
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• 2015

Objective : The main purpose of this study is to find a reasonable solutions for utilization of herbal formulas based on the medical classics. Methods : We used official Ten 'Selected Korean Medical Classics(SKMC)'. For input of formulas from SKMC, we had to select proper editions of them. After consultations with experts of 'The Korean Medicine Society for the Herbal Formula Study' and 'Korean Society of Medical History', we chose the proper editions of SKMC, and according to those books, we built formulas database using microsoft office excel sheets, respectively. Results : After whole input procedures, we requested several experts to inspect the results and also, to correct errors in them. Input categories were name of formula, name of classic, classification, original source, composition herb, weight, unit of weight, weight conversion index, converted weight, basic formula, indications, reason for modification, preparing method, taking method and contraindications. Final number of whole formulas in DB was 32,882. Conclusions : We used SKMC and built database using excel program. Through this procedure, we can provide a developmental ways to make a foundation for herbal formulas from the medical classics, so that we can make herbal formulas be standardized or industrialized more efficiently.

• 대한예방한의학회지
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• 제4권2호
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• pp.119-141
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• 2000

The current industrial health service is shifting to health improvement business with 1st primary prevention-focused service from secondary and tertiary prevention-focused business, and Oriental medicine can provide such primary prevention-focused service due to the characteristics of its science. In particular, the advanced concept of health improvement can match the science of health care of Oriental medicine. Notably, what is most important in health improvement is our lifestyle, This does not underestimate the socio-environmental factors, which have lessened their importance due to modernism. The approach of Oriental medicine weighs more individuals' lifestyle and health care through self-cultivation. This matches the new model of advanced health business. Oriental medicine is less systemized than Western medicine, but it can provide ample contents that enhance health. If we conceive health-improvement program based on the advantages provided by these two medical systems, this will influence workers to the benefit of their health. Also, health Program needs to define factors that determine individual lives, and to provide information and technologies essential to our lives. The Oriental medicine approach puts more stress on a subject's capabilities than it does on the effect his surrounding environment can have. This needs to be supported theoretically by not only defining the relations between an individual's health state and his lifestyle, but also identifying the degree to which an individual in the industrial work place practices health improvement lifestyle . This is the first step toward initiating health-improvement business . In order to do this, this researcher conducted a survey by taking random samplings from workers, and can draw the following conclusions from it. 1 The sampled group is categorized into', by sender, female 6.6%, and male 93.4%, with males dominant; by marriage status , unmarried 43.9% and married 55.6%, with both similar percentage, and, by age, below 30, 48.4%, between 30 and 39, 27.4%, between 40 and 49, 18.2%, and over 50, 6.0%. The group further is categorized into; by education, middle school or under 1.7%, high school 30.5%, and junior college or higher 65.8% with high school and higher dominant: and by income, below 1.7 million won 24.2%, below 2.4 million won 14.8%, and above 2.4 million 6.3% Still, the group by job is categorized into collegians with 23.9%, office worker with 10.3%, and professionals with 65.8% , and this group does not include workers engaged in production that are needed for this research, but mostly office workers . 2. The subjects selected for this survey show their degree of practicing health-improvement lifestyle at an average of 2.63, health management pattern at 2.64, and health-related awareness at 2.62 The sub-divisions of health-improvement lifestyle show social emotion (2.87), food (2.66). favorite food (2.59), and leisure activities (2.52), in this order for higher points. It further shows health awareness (2.47) and safety awareness (2.40), lower points than those in health management pattern . 3. In the area of using leisure time for health-improvement, males, older people, married, and people with higher income earn higher marks. And, in the area of food management, the older and married earn higher marks . In the area of favorite food management, females, lower-income bracket, and lower-educated show higher degree of practice , while in the area of social emotion management, the older. married, and higher-income bracket show higher marks. In addition, in the area of health awareness, the older, married, and people with higher-income show higher degree of practice. 4. To look at correlation by overall and divisional health-improvement practice degree , this researcher has analyzed the data using Person's correlation coefficient. The lifestyle shows significant correlation with its six sub-divisions, and use of leisure time, food, and health awareness all show significant correlation with their sub-divisions. And. the social emotion and safety awareness show significant correlation with all sub-divisions except favorite food management.

• 한국보건간호학회지
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• 제15권1호
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• pp.182-201
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• 2001

This Study has attemped to compare the health care systems of South and North Korea. There has been a wide difference in the health care System between the South and North of Korea. In this paper, I have also shown that each health care system has its own unique response to the social, political, and economic conditions of the country. Therefore the author analyzed and summarized the important difference of health care system between the South and the North of Korea as follows. 1. Compared with the Laissez-faire health care system of South Korea, North Korea has the state socialistic health care system which provide health care services to the people free of charge. And the North Korea is marking positive efforts toward the scientification and systemization of Oriental Medicine which is called Dongui-Hak in the North-on the basis of Ju-Che idea. 2. North Korea's health care system appears to be strongly geared toward extensive and preventive treatment and launched the massive sanitary propagation campaign. which have resulted in a great success. North Korea has a system of universal comprehensive care for its population. The government has a central role in planning and regulating health care. 3. The government also employs physicians, nurses, and other professionals to provide health care to patients at public expense. In North Korea, health professionals are government employees. They work for a salary and the system is funded through general taxation. 4. In the North Korea, health services area system of the cities and countre's unit is strictly conducted along with the doctor's area responsibility system. And so without referal card, patients can not use the upper-grade medical facilities. The health care delivery system of North Korea is made up of the fourth level procedue unlike South Korea. 5. General office of Oriental Medicine, Academy of Oriental Medical Science and Guidance Bureau of Oriental Medicine are established in the organization of the Department of Health in the North Korea. And nowadays much emphasis are equally placed on the Oriental Medicine as well as Western Medicine. Both South and North Korea have faced with a critical moment of developing a mutually agreeable and acceptable system of health care for the unified nation.

• 동의생리병리학회지
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• 제24권3호
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• pp.373-379
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• 2010

There has been a need for establishing operational curriculum for chinese characters and chinese writing used by traditional korean medicine (TKM), but it was not carefully recognized so far. We analysed the frequency of unicode chinese characters from five medical textbooks and showed prerequisite chinese characters for TKM beginners. It was found that 之, 者, 不, 也, 而, 氣, 陽, 陰, 下, 其, 病, 爲, 人, 以, 中, 則, 於, 脈, 上, 故 are the most frequently used 20 chinese characters. We also showed that adequate prerequisite chinese character should be designated for the more efficient education of TKM. This study was the first systematic approach to get essential and prerequisite chinese characters for the education of TKM. The prerequisite characters by this study will be used for the development of KEET (Korean Medicine Education Eligibility Test), entrance exam to the Colleges of Oriental Medicine and textbooks, and educational curriculum of premed students.

• 대한예방한의학회지
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• 제16권3호
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• pp.15-26
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• 2012

Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

• 한방안이비인후피부과학회지
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• 제4권1호
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• pp.89-98
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• 1991

Clinical study on the 114 facial paralysis patients, visited Won Kwang University Oriental Medical Hospital in Kwang ju from July 1990 to Jun 1991, was carried out. The results obtained are as follows. 1. Prevalence was almost same in both sexes and high in the age of 3 and 4 decades but distributed in an age group. 2. Majority of the patients were nomotensive, which meant blood pressure did not affect the incidence. 3. The incidence distributed in every occupations but high in housewife as 37 cases ($32\%$) and decreased gradually in office employee, labor worker, student and merchant in order. 4. Overwork, wind and cold, emotional stress, and numerous implicated agents were etiological factor. 5. The paralysis mostly occured in summer and winter as 40($35\%$) and 37 cases($32\%$) respectively, 18($16\%$) and 19cases($17\%$) were recorded respectively in spring and autumn. 6. The majority of patients showed only facial muscle paralysis without other complications, whose cure rate was $60\%$ (47 cases). The patients with auditory impairment or taste loss was less common and cure rate was low. 7. The number of the patients with migraine or mastoid pain was 81($71\%$), which was more than 33 patients($29\%$) with such pain. The cure rate was high in the patients without migraine than with migraine as a raito of 64 to $46\%$. 8. Most of duration from attack to admission were in a week as 86 cases($75\%$) and the patients with duration over 4 weeks 11 cases($10\%$). The cure rate of the patients in a week, was 54 cases($60\%$) and the patients over 4 weeks was none($0\%$), which meant shorter the duration was, the beter the result was. 9. Response on electro acupuncture on initiating therapy showed good in 39 cases($34\%$) the majority group, moderate in 37 cases, exellent in 29 cases and poor in 5 cases. 10. The results of treatment were as follows : asymptomatic in 58 cases($51\%$), improved n 40cases($35\%$), effective in 10 cases($9\%$) and ineffective in 6 cases($5\%$). 11. Cure rate according to the response on electro acupuncture showed $72\%$ in exellent group, $59\%$ in good group, $27\%$ in moderate groop, and $0\%$ in poor group. These show the better the response on the electro-acupuncture is, the higher the cure rate is, which will be able to indicate the prognosis of facial paralysis.

• 대한예방한의학회지
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• 제16권2호
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• pp.1-15
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• 2012

Objectives : The aim of this study is to analyze satisfaction with clinical training in the department of oriental rehabilitation medicine and the related factors. Methods : All the students in the graduating class of school of Korean Medicine, Pusan National University must be trained for 2 weeks in the department of oriental rehabilitation medicine according to clinical training guideline including Objective Structured Clinical Examination(OSCE) and Clinical Performance Examination (CPX). After completing clinical training, we distributed questionaries to them about a reflex of the object of study, usefulness, difficulty, satisfaction and preference. And then, we analyzed the related factors including descriptive statistics, frequency analysis and correlation analysis by SPSS 18.0. Results : In general, a reflex of the aim of study($7.88{\pm}1.31$), satisfaction with contents($8.17{\pm}1.20$) and difficulty($5.53{\pm}0.99$) were evaluated respectively. The better a reflex of the aim of study is, the higher satisfaction with contents is(P<0.01, r=0.836). Chuna was highly estimated, whereas pharmacopuncture was not. In OSCE, a reflex of the aim of study($8.07{\pm}1.07$) and usefulness($8.13{\pm}1.16$) were highly evaluated. The preference for physical examination of the lumbar spine was highly estimated, whereas applying splint was not. Facilities and equipment($7.88{\pm}1.11$), contents of clinical training($7.25{\pm}1.79$), the handout($7.00{\pm}1.59$) and time scheduling($5.48{\pm}1.71$) were evaluated respectively in general composition of clinical training. There is no difference related to specialty, sex and age among students. Conclusions : Clinical training program in the department of oriental rehabilitation medicine can be highly estimated from the viewpoint of difficulty and satisfaction.