• 대한예방한의학회지
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• 제19권3호
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• pp.11-19
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• 2015

Objective : This study aimed to develop and preliminary validate the Mibyeong Questionnaire (MQ) based on Deficiency-Stagnation pattern, which was report of a person's health condition that comes directly from the person. Method : The first phage of developing a MQ was to generate and exhaustive list of all MQ issue that are relevant to the domain of interest, using literature research and expert group discussions. Through those steps, we established MQ with 33 items divided into two parts: 21-item deficiency pattern and 12-item stagnation pattern. The second phage, we examined the preliminary tests of reliability and validity including the 16-item Deficiency of MQ (16D-MQ), with data (n=1,890) already collected on the Korean medicine data center in KIOM. Results : Exploratory factor analysis revealed three factors of the 16D-MQ. These factors were fatigue(Qi, 氣); psychic and physical elements(Shen, 神); and skin and hair(Jing, 精). Cronbach's coefficient alpha was 0.876 and the intraclass correlation coefficients was 0.368-0.538. In support of criteria validity, the 16D-MQ was weakly correlated with EQ-5D and physicians's opinion, but it was acceptable. Conclusion : The MQ shows that it has an appropriate level of internal consistency and validity. We think further study to reveal its reliability and validity, including stagnation pattern as well as deficiency pattern, is needed.

• 보건행정학회지
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• 제32권1호
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• pp.73-93
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• 2022

Background: Appropriate physician workforce projection through reasonable discussions and decisions with a broad view on supply and demand of the workforce, thus, is very important for high-quality healthcare services. The study expects to provide preliminary research data on the workforce diagnosis standard model for Korean physician workforce policy decision through more flexible and objective physician workforce projection in reflection of diverse changes in healthcare policy and sociodemographic environments. Methods: A low flow rate through the causal map was developed, and an objective workforce demand projection from 2019 to 2040 was conducted. In addition, projections by scenarios under various situations were conducted with the low flow rate developed in the study. Lastly, the demand projection of the physician workforce by region of 17 cities and provinces was conducted. Results: First, demand of physicians in 2019 was 110,665, 113,450 in 2020, 129,496 in 2025, 146,837 in 2030, 163,719 in 2035, and 179,288 in 2040. Second, the scenario for the retirement of baby boomers led to a decrease in the growth rate due to time delay. Third, Seoul and Gyeonggi-do account for a high percentage of demand, a very high upward trend was identified in Gyeonggi-do, and as a result, the projection showed that the demand of the physician workforce in Gyeonggi-do would worsen over time. Conclusion: This study is meaningful in that rational and collective physician workforce supply and demand and its imbalance in workforce distribution were verified through various projections by scenarios and regions of Korea with System Dynamics.

• 지역사회간호학회지
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• 제11권2호
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• pp.513-525
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• 2000

This study was to investigate medication management and the level of awareness about separation of prescribing and dispending at small-to-medium sized workplaces which have less than 300 employees in Korea. The data were collected by questionnaires from May to June in 2000. The number of subjects were 127 workplaces and 130 employees. The SAS PC Program was used for the descriptive statistics. The results are as follows; 1. The over the counter(OTC) drug was provided sufficiently(91.1 %). but medication management was not performed systematically. 2. On drug-providing rate and drug-using rate, the latter was high in the workplace and Health care management's nurses consume all of the over the counter drug provided. 3. When the separation of prescribing and dispending starts, employees shall be medically examined, treated and prescribed by physicians and drugs shall be dispended by pharmacists. It is necessary to make it possible to visit health care institutions whenever they want to. (eg. lunch time or after work) They should change their drug-dependent behaviour. We should focus on strengthening Health Promotion Program to prevent disease by making habitual of health promotion behaviour.

• 한국임상약학회지
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• 제10권1호
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• pp.30-37
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• 2000

Adverse drug reactions (ADR) may result in increased hospital admissions, morbidity and mortality, adding extra cost to healthcare expenditures. Thus, it is critical to activate ADR monitoring and reporting program in tertiary hospitals in developing countries such as Korea. This study was performed to identify the types of ADR being reported in a tertiary hospital, Samsung Medical Center, and to find out the ways to improve current ADR monitoring system. Of 464 ADR reports submitted to the pharmacy department during the 6-month survey period, $97.8\%$ of the reports were from out patient and $48.5\%$ were from patients aged between 50 and 60. The medical department with the highest frequency in ADR reporting was Internal Medicines $(35.6\%)$. The most common ADR manifestations were gastrointestinal complaints $(43.4\%)\;and\;75\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $32.8\%$. In terms of causality assessment, $85.1\%$ of the reports were probable cases by WHO causality assessment criteria. In regards to sources of report, $75.6\%$ of ADR were reported by physicians and $24.4\%$ by nurses. There were no ADR reported by pharmacists. In conclusion, there is an urgent need to improve ADR monitoring system for inpatient and to motivate pharmacist involvement in ADR monitoring and reporting in Korea.

• 대한예방한의학회지
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• 제1권1호
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• pp.137-148
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• 1997

The Serial Securities and the Social Welfare, as the national policy aimed at securing generals' lives, are the policies or systems for the stabilization in lift; especially of law-incomers and workers, for which the povernment has to establish the Social Security System. No wonder the Social Insurance System is a part of the Social Security System and the most important. The Social Insurance System, along with Public Assistance, is underlying the Social Security System. Social Security System includes medical insurance, industrial accident Compensation insurance, national pention insurance and employment insurance. The study is on 'The Oriental Medical Insurance and the Industrial Accident Compensation in the Social Security System' . The rate of industrial accident in Korea marks the highest rank in the world. for laborer, industrial accident do not merely mean the loss of health but the question of the right to live in terms of their loss of opportunity of life. The industrial accident compensation system should be established as the es post facto remedy system to guarantee the injured worker and his/her family's life. The oriental medical insurance system which began to operate in 1987 in Korea is based on unionism and divided into 3 parts; one part for the worker, a second part for the community inhabitants, and a third part for the public service personnel and private school personnel. Today the medical problem must be the most important social assignment to be considered. The medical system of contemporary industrial society has began greatly stood out in relief as a part of social welfare not emphasized on gainings of physicians. Accordingly systematization of the oriental medical insurance was strongly Pursued and it was developed to to the extent of entire nation insurance. Though the history of it is very short, most of the people are getting benefit from the insurance system by the social security system method. This study develops the Oriental Medical Insurance, the Workmen's Accident Compensation Insurance, the Pension System in relation to the industrial accident compensation of Employees, along with the ideas and principles of social insurance.

• 대한예방한의학회지
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• 제21권1호
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• pp.41-48
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• 2017

Objectives : The aims of the current study were to assess the reliability and validity of the CoRe-Ditec-BS Questionnaire-II (BSQ-II; Blood stasis questionnaire-II) with 8 items including 5 items related women added to BSQ-I that was consisted of 36 items and developed in 2013. Methods : Between May 2014 and November 2014, 411 patients from 3 traditional Korean medical hospitals were asked to complete the BSQ-II. Each patient was independently diagnosed with BSS by two traditional Korean medical physicians from the same site. We estimated the internal consistency using Cronbach's ${\alpha}$ coefficient, the discriminant validity using the means score of BSS, and the predictive validity using logistic regression (sensitivity and specificity). Results : The BSQ-II had satisfactory internal consistency (Cronbach's ${\alpha}$ coefficient=0.765) and validity, with significant differences in the mean scores between the BSS($63.60{\pm}9.56$) and non-BSS groups($48.36{\pm}5.93$). The area under the receiver operating curve was about 98%, and the sensitivity and specificity were 91.4% and 94.9%, respectively. Conclusions : These results suggest that the CoRE-Ditec-BSQ-II is more reliable and valid instrument for estimating BSS than BSQ-I.

• 대한한의학회지
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• 제28권2호통권70호
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• pp.205-212
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• 2007

Objectives : Combined treatment (CT) of oriental herbal medicine and prescribed drugs is now being increasingly used among cancer patients around the world. However, in Korea, clinical information on the frequency, efficacy and safety of CT among cancer patients has not yet been thoroughly reported. This study aimed to identify the status and adverse effects of CT for the management of cancer patients. Methods : A questionnaire and medical record survey by oriental medical doctors or physicians were performed at two oriental medical hospitals and one general hospital. Of the initial 400 in-patients, 368 participated in this survey, representing a response rate of 92.0%. Results : Among cancer patients in oriental medical hospitals, the proportion of CT was 45.9%. In contrast, the proportion of CT in the general hospital was only 0.6%. The proportion of CT among breast cancer patients (20) and gastric cancer patients (35) were 85.0% and 51.4%, respectively. The proportion of CT among cancer patients was high in younger, female or married patients groups. 10 respondents (11.1%) among 90 cancer patients experienced several adverse effects including nausea, fatigue, etc. Conclusions : This study suggests that many more patients in oriental medical hospitals than general hospitals use combined treatment of oriental herbal medicine and prescribed drugs for management of cancer. Therefore, medical professionals should provide comprehensive and up-to-date clinical information about potential benefits and risks of CT to cancer patients in Korea.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.31-38
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• 2022

Background: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21-September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21-September 8, 2019) and control period 2 was set as July 1-19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results: During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

• 대한한의학회지
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• 제41권2호
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• pp.137-149
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• 2020

Background: Opioids are a class of drugs found in the opium poppy, and used primarily as a pain reliever. About 130 people die every day from opioid abuse in the U.S., and the number of deaths was 6 times higher than it was 20 years ago. Objectives: To derive the implications on Korean Medicine(KM), this study aimed to investigate the current state of opioids abuse in the U.S. and analyze cases to solve opioids abuse using acupuncture. Methods: Literature on opioids abuse in the U.S. were searched through the websites of government, agency, and research institute. Results: There were several cases using acupuncture on opioids abuse. First, the Act on the use of acupuncture was enacted. Second, the clinical practice guidelines by the American College of Physicians recommended using acupuncture. Third, a large clinical study was conducted on whether acupuncture could replace opioids. Fourth, Vermont and Washington State conducted pilot projects on insurance coverage of acupuncture. Conclusions: As opioids issues are also valid in Korea, KM can serve a critical role in pain management to pursue expanded insurance coverage. In order to do so, building the discourses of KM in opioid issues is critical by defining its medical advantage, conducting large-scale clinical researches and implementing pilot projects to tackle social problems.

• Journal of Hospice and Palliative Care
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• 제23권2호
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• pp.93-102
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• 2020

Purpose: The Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life came into force in February 2018 in Korea. This study reviews the practices of end-of-life care for patients who withdrew or withheld life-sustaining treatment at a tertiary care hospital, addresses the limitations of the law, and discusses necessary steps to promote patient-centered self-determination. Methods: We retrospectively analyzed the medical records of patients who died after agreeing to withhold life-sustaining treatment in 2018 at our university hospital. The cause of death, the intensity of end-of-life care, and other characteristics were reviewed and statistically analyzed. Results: Of a total of 334 patients, 231 (69%) died from cancer. The decision to stop life-sustaining treatment was made by family members for 178 patients overall (53.3%) and for 101 (43.7%) cancer patients, regardless of the patient's wishes. When the patient decided to stop life-sustaining treatment, the time from the authorization to withhold life-sustaining treatment to death was longer than when the decision was made by family members (28.7±41.3 vs 10.5±23.2 days, P<0.001). Conclusion: In many cases, the decision to discontinue life-sustaining treatment was made by the family, not by the patient. In order to protect human dignity based on the patients' self-determination, it is necessary for patients to understand their disease based on careful explanations from physicians. Ongoing survey-based research will be necessary in the future.