• Title/Summary/Keyword: prescription services

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Development of a Mini-OCS System for Voluntary Medical Services in the Challenged Regions

  • Park, Junghun;Oh, Dongik;Shin, Wonhan
    • Journal of Internet Computing and Services
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    • v.19 no.5
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    • pp.97-105
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    • 2018
  • In this paper, we present our recent effort on the development of a portable OCS system (SCH-mOCS), which provides minimal but essential functionalities of conventional OCS systems. SCH-mOCS is targeted for the environment where Internet connection is not available and fast processing of essential patient information is needed. The main usage could be found at the outdoor environment, such as voluntary medical services at challenged regions. The target of the first usage of the system is in the rural area of Cambodia where medical service and ICT infrastructure is poor. We have been conducting voluntary medical services for 15 years in Cambodia, where the services usually run for 3 days and include outpatient diagnosis/consultation, medication, and simple surgeries. This medical service started in 2002, where about 20 SoonChunHyang University Bucheon Hospital staffs (doctors, nurses, and pharmacists) participated. We realized that a system like SCH-mOCS is needed: we have to consult many patients in a short period, so that a prompt response and prescription to the patients are very important. However, the conventional OCS system is not suitable, because the service is usually conducted outdoor environment where Internet connected computers cannot be installed. Moreover, since the service needs only a subset of the conventional hospital information system and fast system response, application of a full OCS is not practical. The adequate system is a bare minimal OCS system, with very simple and quickly manageable patient admission, consultation, and prescription functionalities. In this paper, we describe hardware as well as the software aspect of a mini-OCS we have developed for the purpose. We named the system SCH-mOCS (SoonChunHyang mini-OCS). We also describe the usage scenario of SCH-mOCS in order to demonstrate that the system is general enough to apply for other similarly challenged regions.

Outpatient Antibiotic Prescription Patterns for Respiratory Tract Infections of Infants (소아 호흡기감염 외래환자에 대한 항생제 처방양상)

  • Kim, Yejee;Lee, Suehyung;Park, Sylvia;Na, Hyen Oh;Tchoe, Byongho
    • Health Policy and Management
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    • v.25 no.4
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    • pp.323-332
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    • 2015
  • Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

Prescription Drug Use Behavior and Influence Factors in Veteran Patients from the Perspective of Veterans (보훈환자 시각에서의 처방의약품 사용 행태와 영향요인)

  • Kim, Jin;Lee, Iyn-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.185-195
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    • 2020
  • Objective: This study aimed to explore a veteran patients' behavior of prescribing drug use and of which influencing factors from the veteran patients' perspective through qualitative interviews. Methods: We recruited veteran patients through purposive sampling and interviewed 30 veteran patients aged 20 and over who had been taking prescription drugs. We developed and utilized an interview guide consisting of three themes for data collection. We made verbatim transcripts and analyzed data using the framework analysis. Results: Participants were aware that they had large amounts of prescribing medicines and discarded the medicines. They often used improperly by the person himself or his family or acquaintances. The factors that influenced these inefficient prescription drug usage were grouped into 'factors procuring more drugs than necessary' and 'factors being prescribed more drugs than necessary'. Anxiety about downgrading from the upper class to the lower among reward classes for veterans, and suspicion or dissatisfaction with the veteran policy caused the participants to procure more drugs than necessary. Additionally, they received too many medicines due to long-term prescriptions and lack of communication with their doctors, and poor quality of veteran health services. Conclusion: To improve the medication use behavior of veteran patients, providing information or introducing interventions for the proper medication use is not enough. Efforts should be made to improve their negative recognition over relevant policies and health care services.

The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication (소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석)

  • Kim, Dong-Sook;Park, Choon-Seon;Jang, Sun-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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Legal Bases for the Termination of a Contract under Common European Contract Law (유럽공통매매법(CESL)상 계약의 종료단계에서의 법적 기준 - CISG와의 비교를 중심으로 -)

  • SHIM, Chong-Seok
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.67
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    • pp.23-47
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    • 2015
  • European Commission drafted and proposed the Common European Sales Law(CESL) to the European Parliament for the realization of a uniform set of international private law rules within the EU internal market. Since its purpose is for free international commercial activities for the sale of goods, for the supply of digital content and for related services, it was proposed to enable EU Member States to adopt or supplement as their substantive law according to their options. This study is relate to the legal bases on termination of a contract under CESL, they are composed of three parts: damages and interest, restitution and prescription. Damages and interest are divided into damages, general provisions on interest on late payments, and late payment by traders. Damages are explained by dividing into right to damages, general measure of damages, foreseeability of loss, loss attributable to creditor, reduction of loss, substitute transaction, and current price. Restitution is described by dividing into restitution on revocation, payment for monetary value, payment for use and interest on money received, compensation for expenditure and equitable modification. Prescription is explained by dividing into general provisions, periods of prescription and their commencement and extension of periods of prescription. General provisions explain right subject to prescription into a right to enforce performance of an obligation and any right ancillary to such a right. Regarding period of prescription, the short one is two years and the long one is ten years. However, in the case of a right to damages for personal injuries, period of prescription for such right is thirty years. Regarding commencement, the short one begins to run from the time when the creditor has become, or could be expected to have become, aware of the facts as a result of which the right can be exercised, while the long one begins to run from the time when the debtor has to perform. However, in the case of a right to damages, the CESL clarifies that it begins to run from the time of the act which gives rise the right.

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The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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A Diet Prescription System for U-Healthcare Personalized Services (유헬스케어 개인화 서비스를 위한 식단 처방 시스템)

  • Kim, Jong-Hun;Park, Jee-Song;Jung, Eun-Young;Park, Dong-Kyun;Lee, Young-Ho
    • The Journal of the Korea Contents Association
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    • v.10 no.2
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    • pp.111-119
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    • 2010
  • U-Healthcare provides healthcare and medical services, such as prevention, diagnosis, treatment, and follow-up services whenever and wherever it is needed, and its ultimate goal is to improve quality of life. This study defines the figure of U-Healthcare personalized services for providing U-Healthcare personalized services and proposes a healthcare model. A diet prescription system for personalized services can draw customized calories and rates of nutrition factors and represent a personalized diet through analyzing the personal preference in foods. This system changes the personal preference by monitoring the diet selection behavior of users. Also, this system is designed to be interactively operated with some sensors and devices in various environments using Java-based OSGi middleware.

Research Design for the Verification of Constitutional Prescription Determinants (체질처방 결정요인 확인을 위한 연구설계)

  • Jin, Hee-Jeong;Kim, Sang-Hyuk;Baek, Young-Hwa;Jang, Eun-Su;Ryu, Jong-Hyang;Lee, Si-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.2
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    • pp.222-230
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    • 2015
  • 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.