After providing the purpose, scope and methods of present study in the first chapter. the second chapter discusses a theoretical overview on the social implication of medical expenditure and the medical insurance program for the aged population. In conclusion, to realize the reduction of aged population's medical expenditures, some possible plans are conceivable. Firstly, the payment level of medical insurance should be upgraded and the insurance coverage in oriental medicine treatment and the drug-store protection program need to be implemented. Secondly, the medical facilities and man-power have be expanded for the sake of reducing the social and geographical distances the aged population has to overcome to receive the medical benefits. Thirdly, the expansions of medical services for the home-stay aged are all the more required. Finally, a wide range of programs needs to be augmented to promote health for the aged population.
Objective : In order to understand the changes in domestic approval regulations applicable to traditional Korean medical device companies, this article will explain the major amendments 「Regulation on Medical Device Approval Report Review, etc.」 from 2005 to the present on a year-by-year basis, and provide a counter plan to the recent changes in approval regulations. Methods : We analysed the changes in approval regulatory amendments related to the traditional Korean medical devices from 2005 to the present. Results : The Ministry of Food and Drug Safety is continuously improving medical device approval regulations to ensure the global competitiveness of domestic medical devices and contribute to the improvement of public health. Recent major approval regulatory amendments include the establishment of a review system for software medical devices and digital therapeutics, the recognition of real world evidence materials, the introduction of a biological evaluation of medical devices within a risk management process and a medical device approval licence renewal system. Conclusions : It is expected that the range of medical devices available to Korean medicine doctors will continue to expand in the future through the provision of non-face-to-face medical services and the development of advanced and new medical devices, as well as wearable medical devices and digital therapeutics. In order to increase the market entry potential of traditional Korean medical devices that incorporate advanced technologies such as digital technology and AI-based diagnosis and prediction technology, it is urgent that the government provide significant support to traditional Korean medical device companies to improve approval regulatory compliance.
Objectives: Asari Herba comes from the dried perennial herbaceous plant, Asarum sieboldii $M_{IQ}$., A. heterotropides $F_R$. SCHMIDT var. mandshuricum($M_{AXIM}$) $K_{ITAG}$. and A sieboldii $M_{IQ}$ var. seoulense $N_{AKAI}$., family Aristolochiaceae. This medicine is pungent in flavor(味辛), warm in nature(性溫), mildly toxic and affects the lung, kidney, and heart meridians. It is able to repel wind dispel cold(祛風散寒), remove the obstruction of the nose(宣通鼻竅), relieve pain(止痛) and warm the lungs to remove the retention of fluids(溫肺化飮). In a clinic it is prescribed for exterior syndrome of wine-cold type(風寒表證) manifested as headache and general pain. It is indicated for headaches, toothaches, bisyndrome of wind-cold-dampness type(風寒濕痺), etc. For many generations medical books have warned doctors that the dosage of Asari Herba should not be excessive because the pungent flavor has the effect of dispersing exopathogens from superficies of the body. The principle, 'Asari Herba should not exceed Jeon(錢, Qian, 3.0 gram)' is still considered to be relevant. Methods : Extensive research of several ancient medical texts has lead to the following conclusion. Results : The statement 'Asari Herba should not exceed Jeon' is a dosage which is used to prepare single recipe and powder. Conclusion : The definition of Jeon is not 1 Jeon(3.0 gram), but 1 Jeonbi(錢匕, Qianbi, 1.0 gram), moreover, the usage, collection. and refinement process are not in accordance with the contents of the ancient medical texts. A deeper study of Asari Herba's dosage in the future is expected to have interesting results.
Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.
The purposes of this research were to investigate home care rehabilitation services in rural areas and to collect basic data about disabled persons necessary when for carrying out rehabilitation services. Respondents were selected from six of a total of eight townships (Myon) and one town (Eup) in the Wonju city area. Wonju is in Kangwon Province (Do). Of a total of 338 names provided by the Myon offices, 298 persons were located and included registered and non-registered persons. Conditions included stroke, spinal cord injury, and cerebral palsy in addition to disabilities classified as first, second or third degree, in the case of registered cases. Respondent demographic characteristics, medical characteristics, rehabilitation service needs, willingness to receive rehabilitation service and individual opinions regarding rehabilitation services were analysed by frequency and percentage. The results were as follows: 1) Rehabilitation services received by disabled persons living at home in the rural areas surrounding Wonju city were medical rehabilitation (41.7%), diagnosis (36.5%), rehabilitation assistive devices (7.6%), social assistance (7.1%), rehabilitation counseling (3.0%), vocational rehabilitation (1.8%), educational rehabilitation (1.6%) and housekeeping services (0.5%). The majority of rehabilitation services were medical rehabilitation provided at hospitals and oriental medicine hospitals. 2) Sixty point eight percent of respondents expressed their willingness to receive home care rehabilitation services. Needs expressed were highest for medical rehabilitation (27.0%), followed by social assistance (19.4%), medical examination (12.4%), physician-generated diagnosis in the home setting (11.6%), sociopsychological rehabilitation (9.3%), vocational rehabilitation (7.6%), rehabilitation engineering (6.0%), educational rehabilitation (3.3%), and housekeeping services (3.3%). 3) Rehabilitation service needs were analyzed by severity classification: 65.8% of first degree, 62.7% of second degree and 55.6% of third degree disability classification, and 62.7% of non-registered disabled individuals responded that rehabilitation service was necessary. 4) Rehabilitation service needs were also analyzed by diagnosis: 62.6% of stroke, 85.5% of amputation, 60.0% of spinal cord injury and 52.4% of traumatic brain injury respondents answered positively that they were willing to receive rehabilitation service if it were to be provided. Rehabilitation service utilization data of disabled individuals living at home in rural areas were investigated and their rehabilitation needs analyzed. This critical information can be used when community-based rehabilitation programs for disabled persons living at home are planned for provision out of a public health center or when community-based rehabilitation welfare policy is formulated.
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.
Objective: To check the status of traditional Korean medical doctors' medical services amid the continual increase in the number of traditional Korean medicine clinics. Methods: A survey of traditional Korean medicine clinics based on questionnaire sheets mailed to 4,200 out of 10,895 clinics, of which 465, or 11.0%, responded, in the June 1, 2008 to December 9, 2008 period. Results: 1. 65.6% of the traditional Korean responding clinics are doing business in a rented space; 92.1%of them are one-person institutions; 24.4% of them, i.e., the largest group of those surveyed, operate in a space sized 41 (123 $m^2$)~50 pyeong (150$m^2$). The number of sick beds installed in their facilities comes to 7.9 on average. 2. Concerning support staff, 190 of them (or 40.9%), i.e., the largest group of those surveyed, employ two people in this capacity. They generally comprise assistant nurses (48.7%) and others (47.6%). 3. The size of the space used by the clinics is showing a tendency to increase. The number of sick beds and support staff, including assistant nurses, reached a peak in 2006, and has been on the decrease since then. 4. The average number of on-days comes to six days a week among 92.6% of those surveyed. Their average daily service hours come to 9 hours and 33 minutes (from 9:17 am to 6:50 pm). 5. Per-patient service time: 14 minutes on average; per-patient acupuncture time: 18.8 minutes; per-patient moxa cautery time: 10.1 minutes per-patient; boil-cupping time: 5.7 minutes; per-patient physical treatment: 28 minutes. Conclusion: Periodical studies should be carried out concerning desirable ways of developing traditional Korean medicine clinics with the focus on the facilities, doctors' service hours, and types of service.
The information relating to the health of person has been increasing. The information is such as medical information and personal health record and the information collected by utilization and dissemination of mobile devices. Therefore, the interest and demand for systems that can integrate and manage the Personal Health Record(PHR) is increasing. Quantity and quality of information that is collected from the patient can have a major impact on the diagnosis and treatment of Korean Medicine(KM) in clinical practice. Because closely observe the usual clinical symptoms of patients to utilize the treatment. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. Therefore, the personal health care services that can record and manage and own is necessary based on KM. In this paper, we propose Korean Medicine Personal Health Record Platform(KM PHR Platform). We have selected the significant symptoms that mean to the personal records from symptom information required for diagnosis in KM. And classifying and scoring as the symptoms were used as personal health care indicators. And significant symptoms were easily configure a screen that can be recorded. simple operation is recorded as a symptom. It was designed to reflect these functions. So KM PHR Platform helps to Personal health care. Doctor may be able to help in the diagnosis and prognosis observation by reference to shared symptom. We look forward to a variety of health services based on KM using a symptom, a medical record, personal health device information.
Objective : We proposed fundmental rules of prospective on legal and institutional position and role of Korean medicine doctors working at public health center. Methods : By the result of this research on the current situation, the grade and allowance given to the Korean medicine doctors working at public health center were different every self-governing body. Results : The reason the Korean Medicine Doctor can't serve as a regular order of 5th grade is that the 'The Enforcement Regulation about Administrative Organization and the Standard of Pixed Number of person of Self-Governing Body(지방자치단체의 행정기구와 정원기준등에 관한 규정 시행규칙)' prescribes the number of regular order of 5th grade is regulated within 7% among the number of regular order officials. But not appointing to office as the regular order of 5th grade infringes on the Constitution, the highest law. The reason the Korean Medicine Doctors can't be appointed to office as the regular order officials by the self-governing body is that 'The Enforcement Order of the Law of Preservation of good health of Local Area(지역보건법시행령)' prescribes the Korean Medicine Doctors are not indispensable to Public Health Center. But in fact, the Korean Medicine Doctors can execute many kinds of work such as medical examination or instructing house nursing. Conclusion : The Korean Medicine Doctors working at Public Health Center serve at low positions as daily use or common use, not receiving a regular order. All laws including the Constitution(헌법), the Medical Services Law(의료법), the Law of Preservation of good health of Local Area(지역보건법), the National Public Service Law(국가공무원법), the Local Public Service Law(지방공무원법) and the Law of Higher Education Law(고등교육법) describe that the Korean Medicine Doctors and the Western Medicine Doctors are equal to their position and right.
Objectives : The new health technology assessment (nHTA) involves evaluating the safety and efficacy of the new health technology under the Medical Services Act by the New Health Technology Assessment Project Division from 2007. The purpose of this study is to understand the status of applications and recent trends of the results, and suggest strategies for the development of new health technologies in Korean Medicine. Methods : We investigated and analyzed the results of evaluation of new health technology of whole conventional medical and the list of new health technologies in Korean Medicine provided by the New Health Technology Assessment Project Division from 2007 to 2016. Results : The number of applications for new health technology of Korean medicine was low as 41 items in the whole number of 2,013 items. The evaluation method of new health technologies in both, the whole medical and Korean medicine fields was the same, but the tendency in results was very different. Most of the new health technology items in Korean medicine were classified as existing technology (20 items), early stage technology (7 items), and Only 2 items were evaluated as research stage technology. Conclusions : In order to develop new health technology in the Korean medical field, we have made suggestions about the health technology assessment systems, R&D infrastructures, and corporation with conventional medicines.
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