• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.19-40
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• 2002

The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

• Journal of Sensor Science and Technology
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• v.21 no.4
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• pp.241-248
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• 2012

Recently healthcare industry such as pharmaceutical, medical device and healthcare service technology is growing significantly. Mobile healthcare has attracted big attention due to IT convergence technology. Paradigm of healthcare has been changed from the 1st generation(communicable disease prevention) and the 2nd generation(treatment of disease due to extended life expectancy) to the 3rd generation(extended life expectancy due to prevention and control). In our study, we suggest the 3rd generation mobile healthcare system using Bluetooth based wearable ECG monitoring system and smart phone technology. The mobile healthcare system consists of wearable shirts with Bluetooth communication module, ECG sensor, battery, and mobile phone. The ECG data is obtained by a miniaturized sensor and the data is transferred to a mobile phone using Bluetooth communication. Then, user can monitor his/her own ECG signal on an application using Android in mobile phone. The Bluetooth communication device is used due to highly reliable data transmission property and the Bluetooth chip is embedded in every mobile phone. The wearable shirts with chest belt of Bluetooth ECG module is designed with a focus on convenience in the daily life of a wearer. The ECG signal evaluation software in Android based mobile phone is developed for the health check and the ECG signal variation is tested according to the activities of the wearer such as walking, climbing stairs, stand up and sit down, and so on.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.288-295
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• 2014

Background: The pharmacy education system in South Korea has changed from four-year degree program to two-year pre-pharmacy program plus four-year professional degree program (a total of six years) since 2009. Objectives: The purpose of this study is to assess final year student's satisfaction on this new pharmacy education system and to explore factors related to student satisfaction. Methods: A paper-and-pencil survey instrument was administered to all final year pharmacy students at four universities located in South Korea during September of 2014. The self-administered questionnaire contained 39 items. In part 1, the quality of education with regards to school utilities, education system, human resources, and communication domains were measured. In part 2, overall satisfactions with the new education system were asked to students. Responses were recorded on a seven point Likert scale. Results: A total of 207 students were participated in this study. Students showed low satisfaction on school utilities and standardization of education while they displayed high level of satisfaction on the quality of the faculty members and preceptors at clerkship sites. Factor analysis showed that education service was the most significant factor that affects students' satisfaction followed by facilities, standardized education, communication, administration, pharmacy practice (p<0.05). Conclusion: The qualification of faculty and preceptors ranked number one in students' satisfaction and it was the most significant factor. School facilities were found to be the second most significant factor in students' satisfaction while students displayed poor satisfaction. The study results might need to be reflected in future education planning to improve students' satisfaction.

• Health Policy and Management
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• v.23 no.3
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• pp.210-223
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• 2013

Backgrounds: Escalating pharmaceutical expenditure has threatened the sustainability of National Health Insurance system in Korea. Generic medicines allow patients to access safe, effective, high-quality medicines at low cost, thus insurers could achieve significant financial savings by promotion of generics, if they are priced much lower than the originator. The purpose of this study was to review generic pricing as well as promotion policies in other countries and assess the implication of those policies. Methods: We reviewed the main measures adopted by the developed countries such as Austria, Belgium, Denmark, Finland, France, Germany, Italy, Japan, Netherlands, Norway, Sweden, United Kingdom, especially in countries where governments are the largest third-party payers or insurance finance resource is the national health insurance. Results: The foreign countries's experience with generic medicine policy shows that demand-side policies such as physician budgets, international nonproprietary name prescribing, generics substitution, patients co-payment as well as supply-side policies relating to pricing and reimbursement seems to play a critical role in developing the generic medicines market. Conclusion: Various strategy should be implemented to promote generic drug use.

• YAKHAK HOEJI
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• v.58 no.3
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• pp.200-207
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• 2014

This study aimed to assess the quality of outpatient antibiotic consumption in Korea compared with other countries. We used the National Health Insurance claims data for outpatient services in March, June, September, and December in 2012 and calculated nine indicator values based on the 12 European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators. Indicator values in this study reflect the yearly use of antibiotic expressed in defined daily doses for 1,000 inhabitants per day (DID) and the use of main subclasses of antibiotics expressed in DID and as percentage of the total antibiotic use. Korea showed lower quality in the consumption of total antibiotics (J01), especially in the use of Cephalosporins (J01D) expressed in DID. Korea also showed low quality with regard to the use of narrow/broad spectrum antibiotics. The percentage of the use of narrow-spectrum Penicillins (J01CE) was lowest in Korea. The quality on the use of the third- and fourth-generation cephalosporin (J01(DD+DE)) was the fourth lowest among 26 countries. High rates of antibiotic resistance and payment system based on fee-for-service might have influenced on the high consumption of the broad spectrum antibiotics in Korea. It needs to further investigate the use of broad-spectrum antibiotics to identify the target of strategies promoting quality use of antibiotics in Korea.

• YAKHAK HOEJI
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• v.56 no.2
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• pp.126-135
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• 2012

Purpose: To develop therapeutic duplication criteria for the drugs used for respiratory diseases. Method: Therapeutic duplication was defined as "more than 2 drug ingredient-usage in which each has the same therapeutic effect and combination therapy does not confer additional therapeutic benefit". Respiratory system drugs approved in Korea were examined for the study. The WHO's Anatomical Therapeutic Chemical Classification System was used for grouping of the corresponding drug ingredients. The principles and recommendations on combination usage or multiple drug regimens were reviewed by using the clinical practice guidelines, textbooks, product labelings, and clinical articles. Clinical expert group consultation was performed and expert opinions were incorporated into the final criteria. Results: Nine hundred sixty two drug products with Korean Food and Drug Administration classification codes of 141, 149, 222, and 229 were evaluated, of which 87 active ingredients were composed. The drug ingredients were classified into 12 groups (antihistamines, oral nasal decongestants, leukotriene receptor antagonists, inhaled anticholinergics, inhaled corticosteroids, oral ${\beta}2$-agonists, long-acting ${\beta}2$-agonists, short-acting ${\beta}2$-agonists, xanthines, antiallergics, mucolytics and cough suppressants). The use of more than 2 drug ingredients including the same group was therapeutic duplication, and thus combination should be recommended not to be used. Conclusion: Twelve drug groups were identified as therapeutic duplication criteria. Combination therapy within each group should not be used otherwise therapeutic benefits outweigh potential risks.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.123-164
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• 2014

Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.712-728
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• 2022

World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.1061-1074
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• 2008

Objectives : Recently, the number of cancer patients who use complementary and alternative medicine (CAM), including oriental medicine, are increasing. Also, evidence for efficacy and safety of cancer CAM is reported continuously. This study was designed to evaluate the quality of the published papers for clinical studies about oriental medical cancer treatment in Korea. Methods : We searched for clinical research papers on the websites of the Korean oriental medical society and subsidiary academies, Korean traditional knowledge portal. Koreanstudies information service system (KISS), etc. We used the reference words 'cancer', 'malignant tumor', 'leukemia', 'lymphoma', 'multiple myeloma', 'melanoma', etc, We then chose studies that had been presented between 1991 and 2008 and analyzed them by publication year, design, cancer type, intervention, subject and journal. Results : There were 86 clinical research papers that were published between 1991 and 2008. The number of clinical studies has increased in a time-dependent manner. Case reports and case series studies account for 78% of total clinical research. Studies of lung cancer account for 17%. Studies of cancer-related symptoms of cancer patients account for 38%. Studies of Hang-Am-Dan account for 33%. Studies published in the journal of the Korean Society of Oriental Internal Medicine account for 35%. Conclusion : The clinical research papers about oriental medicine are increasing over time, but most of the studies are retrospective case reports or case series. Well-designed and prospective clinical trials would be recommended to provide more reliable evidence.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.29-34
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• 2016

Nowadays, real-time devices that provide health care for a companion animal is being developed by IoT technology and its demand such as smart puppy tag is increasing. However, it is difficult for IoT devices of companion animals to process complex nature due to miniaturized hardware and constructive nature. There is a clear limit to custom advanced features like health care implementation. This paper designs an integrated platform with statistical analysis which makes it possible to customized services such as feed production, pharmaceutical production, and health care for each companion animal. Middleware that collects sensor information, customer's spending pattern and information from Social Network Service is also designed by making use of IoT devices which companion animals wear. Furthermore, the paper designed data analyzer which analyzes and refines data from collected information that can be applied to personalized services.