• 한국식품위생안전성학회지
• /
• 제23권3호
• /
• pp.276-283
• /
• 2008

국내 외 선행연구결과에 의한 어린이 출생 전 후 건강에 영향을 미칠 수 있는 주요 유해물질은 inorganic arsenic, BPA, 2,4-D, dichlorvos, methylmercury, PCBs, pesticide, phthalate, PFOA/PFOS, vinyl chloride 등으로서 국내에서도 이들을 포함한 확인 연구가 수행되어져야 할 것이다. 또한 어린이들의 행동발달과 연관된 생활환경에서의 다양한 인체노출이 확인됨에 따라 탁아소, 유치원과 같은 경우 어린이 활동공간을 대상으로 환경모니터링 및 위해관리활동도 병행되어야 할 것이다. 또한 어린이 건강에 영향을 미치는 유해물질을 중심으로 독성평가, 인체영향연구, 환경 및 인체모니터링과 위해평가를 수행하므로 유해물질의 원인-상관관계를 확인하고 사실자료에 근거한 관리정책을 반영하는 것이 바람직하다.

• 보건행정학회지
• /
• 제16권2호
• /
• pp.117-134
• /
• 2006

Korean health care system introduced the reform for separation between prescribing and dispensing of drugs (SPD reform) in the latter part of the year 2000. The objective of this paper is to look at what change this reform has brought about in the financial situation of Korean public health insurance scheme, particularly in terms of insurance benefit outlay. Since the inception of the reform is a development of more than five years ago, its impact on the finance situation would now start to become apparent. Hypothesis is set in this study for each of three components of drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. In terms of the classification of health care services by mode of production, the impact of the SPD reform is confined mainly to the last two among three drug reimbursement fields including inpatient department, out-patient department and pharmacy. Pure impact of the SPD reform was estimated to be more or less than 1.7 trillion won, 13.1% of the total outlay of the Nation Health Insurance in 2001, and more than 2.0 trillion won, 14.9% of the total outlay of the Nation Health Insurance in 2003. Both dispensing fees for the pharmacists, which had been newly introduced on occasion of the SPD reform, and larger share of expensive drugs in the medicines prescribed by doctors were confirmed to be main drivers of the augmentation of drug reimbursement.

• 보건행정학회지
• /
• 제23권1호
• /
• pp.52-58
• /
• 2013

This study was conducted to investigate the responsiveness and its related factors of public health center for novel influenza A (H1N1) epidemic. The data was collected through a web-based survey conducted during February to April 2011. The 182 respondents were team leaders or persons who were responsible for H1N1-related work at public health centers during the H1N1 prevalence. The related factors affecting the responsiveness were different by urban or rural area. In the level of gu (urban) area, cooperation with the public organizations, preparing its own response plan were the significant factors. But, in the level of si or gun (rural) area, cooperation with private organizations (clinic or pharmacy), physical (facilities, equipments, and medicines), and human infrastructures (public health professions, education and knowledge, and motivation) were more important factors. Therefore, how to cope with H1N1 prevalence in the future should be different by local characteristics. As a result, there are several challenges that public health centers should prepare for the further emerging infectious diseases. First, it is needed to make standard manuals which could strengthen education and training in order to respond appropriately, as well as to prepare enough physical infrastructures for the crisis. Next, the public health center should prepare correct media response and cooperation system with public and private organizations.

• 한국병원경영학회지
• /
• 제18권2호
• /
• pp.15-32
• /
• 2013

Few public health researchers have paid research attention to the location of medical institutions in Korea. Previous studies were published in geography journals, and relied on limited data in terms of geographic regions and the type of medical institutions. This study utilized nationwide data covering 8 types of medical institutions. We obtained data from Health Insurance Review and Assessment Service and National Population and Housing Census. The correlation coefficients of resident, daytime, university-graduate population, and the population of different age groups (fewer than 15, 15~64, 65 or more) were compared to understand their relative association with the location of medical institutions. Medical clinic, dental clinic, oriental medical clinic, and pharmacy, all of which are almost completely operated by private sector, showed strong positive correlation with population. Hospital-level medical institutions, which are operated by both public and private sector, had moderate positive correlation. Daytime population and university-graduate population, rather than resident population, were more correlated with the location of medical clinics. The correlation coefficients of the population of 15~64 age group and the location of medical institutions were greater than that of other age groups. The results showed that daytime and university-graduate population are more important than resident population to explain the location of medicalrelated facilities. The results also suggests that the population of age groups (especially, 15~64) might be one of important influence factors in the location of medical institutions.

• Journal of Preventive Medicine and Public Health
• /
• 제48권3호
• /
• pp.170-177
• /
• 2015

Objectives: The goal of this study was to examine the association of various demographic and socioeconomic factors with risk factors for chronic kidney disease (CKD). Methods: We used nationally representative pooled data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2007-2013. We estimated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease equation. We defined CKD as a GFR <60 mL/min/$1.73m^2$, and 1304 of the 45 208 individuals included in the KNHANES were found to have CKD by this definition. The outcome variable was whether individual subjects adhered to the CKD prevention and management guidelines recommended by the Korea Centers for Disease Control and Prevention. The guidelines suggest that individuals maintain a normal weight, abstain from alcohol consumption and smoking, manage diabetes and hypertension, and engage in regular exercise in order to prevent and manage CKD. Results: This study found that individuals with CKD were more likely to be obese and have hypertension or diabetes than individuals without CKD. In particular, male and less-educated CKD patients were less likely to adhere to the guidelines. Conclusions: Although the prevalence of CKD, as indicated by the KNHANES data, decreased from 2007 to 2013, the prevalence of most risk factors associated with CKD fluctuated over the same time period. Since a variety of demographic and socioeconomic factors are related to the successful implementation of guidelines for preventing and managing CKD, individually tailored prevention activities should be developed.

• 보건행정학회지
• /
• 제15권3호
• /
• pp.40-59
• /
• 2005

The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.

• 보건의료산업학회지
• /
• 제13권3호
• /
• pp.115-125
• /
• 2019

Objectives: Korea has been practicing the separation of dispensary from medical practice since 2000 as a national policy to prevent misuse or overuse of medicines. This study aimed to investigate prescription patterns from except pharmacies in order to determine the appropriateness of drug usage among those patients. Methods: Thirty-two pharmacies in the Yeongdong area of Gangwon Province were examined in this study. The same simulated patient complaining of cold symptoms for 3 days visited each pharmacy to obtain a prescription for medication. Results: At pharmacies prescribing medicine, steroids (53.1%) and antibiotics (50.0%) were used to treat the common cold. Duplicate prescriptions of drugs, such as antihistamines (47.0%) and decongestants (31.3%) were common. The average number of drug prescriptions was 6.59, and 53.2% of pharmacies had prescribed more than seven drugs. The average total cost of the prescriptions was 6,093 won, and the daily cost was 2,544 won. Conclusions: Steroids and antibiotics were frequently abused among patients whose medications had been prescribed by pharmacies. Also, there were a considerable number of drugs and duplicate prescriptions. The prices of the drugs were somewhat high.

• 셀메드
• /
• 제11권4호
• /
• pp.20.1-20.23
• /
• 2021

Background: The pandemic COVID-19 caused by a novel coronavirus SARS-COV-2 has spread like a forest fire. This disease may have serious consequences for pregnant women. Presently, no specific drugs or vaccines exist to battle this disease and researches are underway. Unani medicine has a unique role in prevention and management during epidemics. Here, we reviewed the overview of COVID-19 infection and pregnancy, concept and practices in Unani medicine for flu-like epidemics in general and pregnancy, and safety of Unani drugs for the prevention and treatment of mild symptomatic cases of COVID-19 during pregnancy. Methodology: Unani classical texts and pharmacopoeia were meticulously explored for concepts and practices for flu-like epidemic diseases. Further, we browsed scientific databases such as PubMed, Scopus and others for an overview, epidemics and Unani medicine, effectiveness and safety of Unani drugs in COVID-19 and pregnancy. Results: Unani medicine includes prevention and management of flu-like epidemic include quarantine and isolation, aromatic herbal drugs fumigation and spraying for environmental disinfection, ilaj bid tadbir for health promotion and use of health-protecting drugs and symptom-specific drugs in general and related to pregnancy. Lahsun, asalussus, behidana, banafsha, zanjabeel, unnab, etc are in use since antiquity for the prevention and treatment of asymptomatic and mildly symptomatic pregnant women during infectious and epidemic diseases. Conclusion: Currently, the aforementioned plants are proven for antiviral, antioxidant, immunomodulatory and anti-inflammatory activities, probably useful in the COVID-19 pandemic. Additionally, scientific studies have provided new insight into the mechanism underlying the therapeutic effect of Unani medicines that are safe in pregnancy.

• 보건교육건강증진학회지
• /
• 제29권2호
• /
• pp.1-12
• /
• 2012

Objectives: Several practice guidelines recommended both medication and behavior modification to control hypertension. The objective of this study was to analyze ambulatory care utilization pattern and related factors. Methods: A retrospective cohort study was conducted among 45,267 new users who initiated treatment with hypertensive drugs in 2003. Korean National Health Insurance Claims Data was used to study the medical care utilization behavior and related factors after treatment initiation for up to four years. Taking prescription was considered as medical care utilization. Results: More than 20% of patients discontinued visiting physicians for prescription after initiating antihypertensive drug therapy. The average number of institutions visited by patients was about 1.3 annually. Clinic was the most frequently visited institution by patients. In GEE analysis, probability of continuous visit one institution after initiating antihypertensive drug treatment increased in patients who were women, old, have comorbidity, visited clinic or hospital mainly in previous year. Conclusions: Young hypertensive male patients who have no major comorbidity showed high possibility to discontinue medical service utilization. It is necessary to educate these targeted patients about importance of hypertension management in early stage after treatment initiation.

• 동국한의학연구소논문집
• /
• 제11권
• /
• pp.41-51
• /
• 2008

Dietary supplements are used by more than one-half of the adult US population. By contrast, herbal products in Germany are carefully regulated by the same standards as drugs, and efforts are under way to standardize their regulation in the entire European Union. Most herbal users do not inform their physicians that they are taking these supplements, and most physicians do not inquire. Although some herbal products have clinically proven benefits, it is increasingly apparent that many contain potentially toxic substances, particularly in relation to interactions with drugs. Hence, it is essential that practicing physicians develop a working knowledge of herbals-specifically, about claims for their usage and potential or proven efficacies and toxicities-and that they incorporate such knowledge into the evaluation and management of their patients. By contrast, functional foods-integral components of the diet that are understood to contribute added health benefits-are the subject of intense and widespread research in food and nutritional science. Examples include many polyphenolic substances, carotenoids, soy isoflavones, fish oils, and components of nuts that possess antioxidant and other properties that decrease the risk of vascular diseases and cancer. Practicing physicians are advised to stay abreast of these emerging findings in order to best advise their patients on the value of health-promoting diets in disease prevention.