• Health Policy and Management
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• v.22 no.4
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• pp.561-578
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• 2012

This study was performed in order to compare a change in pharmaceutical expenditures per outpatient of clinic and to analyze factors relevant to a systems as part of evaluating policies for the incentive scheme to reduce total prescribed drug expenditure and for the drug utilization review system("DUR system" hereafter). For this, it had finally analytical subjects as 21,320 clinics nationwide without a change in location, clinics symbol and signed subject during both terms of the first half of 2010 and the first half of 2011. As a result, the odds ratio with reduction in pharmaceutical expenditures of clinic was statistically higher significantly in the shorter year number of opening clinic, in the larger number of doctors, when the classification of establishment is other, not individual, and when the signed subject is surgical division. Also, the odds ratio was significantly higher in the less patient number of clinic and in the lower ratio of patients aged over 65. Finally, the odds ratio was significantly high when a clinic had been located in DUR system demonstrative project area. Through this, a case of policy for improvement in doctor's autonomous prescription behavior like DUR system can be known to be effective for reduction in pharmaceutical expenditures. A future research on evaluation of policy for pharmaceutical expenditure management system will need to be performed in-depth analysis in consideration of diverse characteristics on the participatory entities.

• Journal of Preventive Medicine and Public Health
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• v.9 no.1
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• pp.139-146
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• 1976

This survey attempted to determine the overall health situation in Kyunggido in terms of sickness prevalence, sickness distribution, demand for medical care by type, and utilization of medical care. The survey was conducted on 766 households, or 4,065 people, from July 1-31, 1975. The findings from the survey are as follows: 1) In terms of age distribution, 28.7% of the sample was from 10-19, the 40-49 age group was the next largest group, and those over 60 made up 7% of the sample. 2. The education distribution is as follows, 30.4% completed primary school, 22.4% had no formal education, 20.6% attended but did not onplete primary school, and 1.8% attended unversities or higher. 3) In terms of occupation, 55.9% were unemployed or family employees, which represents a large dependent population, 30.4% of the workers were employed in farming or fisheries. 4. The marital status is as follows, 58.8% of the women were married, 32.3% unmarried, and 7.5% divorced. 5) The prevalence rate of mouthy illness was 19.7% of 100 infant, 42.8% became fatally ill within the first year of life. This is a very high percentage compared with more developed nations. 6) Of those reportion on illness, 54.6% sought treatment. The rate of treatment was highest in infants at 77.7%. Us age increased, demand for treatment decreased to 43.1% for those in the aldest age group. The oldest age group also had the highest rate of non treatment at 56.8%. 7) The demand for medical care showed that 65.6% utilized drug stores, 20.2% utilized hospitals and clinics, 5.4% used herbdrug-stores and herb clinices, and 3.9% relied upon folk medicine and withch craft. 8) The utilization of medical facilties by sex is as follows, 65.1% of the men and 66.0% of the women used drug stores, and 19.2% of the men and 20.2% of the women used hospitals and clinics. However, more men (3.5%) were hospitalized than women (1.8%) 9) In terms of out-patient care, the largest age group of males was 10-19 (28.2%), and the largest age group of females was 0-9 (30.8%). There was no sex difference in the use of western pharmacies. Menaged 30-39 and women aged 50-59 were the most frequent users of herb clinics. 10) The rate of receiving treatment at drugstore hospitals went towards declining level in the second case of what While increaing much more at herb clinics and folk medicines in the second case than the first one. 11) After primary utilization of hospitals, 32.7%. of the adults aged 20-59 used drug-stores as a secondary source of care, and 12.8% of children and youth under age 20 continued receiving care at hospitals. 12) After primary utilization of drug-stores, 32.5 % of the adults continued to seek care at drug stores and 1.8% used hospitals. 4.2% of those over age 60 utilized folk medcine and witch craft.

• Journal of Preventive Medicine and Public Health
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• v.14 no.1
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• pp.65-74
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• 1981

This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.27 no.1
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• pp.117-129
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• 2014

Objective : To study current status on characteristics of allergic rhinitis patients by using the electronic medical record (EMR) data and to explore the feasibility of clinical studies using the EMR data in three different Korean medical hospitals. Methods : We studied allergic rhinitis patients who visited the department of ophthalmology, otolaryngology and dermatology in the three different Korean hospitals from January 1, 2012 to December 31, 2012. We retrospectively collected medical history and characteristics of study subjects using data of EMR. Results : In hospital A, we were able to collect data of 18 years of age or older. In hospital C, we could only collect data after July 1, 2012. Therefore, each hospital's data had different settings in measuring them. Men and women were accounted for similar percentage, and teens were the highest in the age group. J30.4, unspecified allergic rhinitis, was the highest in diagnosis of the allergic rhinitis. Most of the patients have received acupuncture treatments. Moreover, 74.6 percent of the total patients were prescribed with Chinese medicine. Conclusions : Based on this exploratory study, further studies were needed on clinical studies using data of systematic EMR.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.26 no.2
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• pp.10-18
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• 2013

Objectives : We performed a pilot study to investigate inter- and intra-rater reliability of pattern identification using nasal endoscopy for allergic rhinitis(AR). Methods : Eight experts of ophthalmology, otolaryngology and dermatology of Korean medicine evaluated 20 nasal endoscopy photograph cases of AR patients with pattern identification index using nasal endoscopy for AR including the nasal membrane color(pale / hyperemia), nasal membrane humidity(dryness / dampness), rhinorrhea(watery / yellow), and membrane edema (atrophic / edematous) on nasal endoscopy. Results : Intra-rater agreement(%) and Kappa coefficient was generally from 'moderate' to 'good'(% agreement: 73.13-90% / Kappa coefficient: 0.547-0.748). Inter-rater agreement(%) and Kappa coefficient was also from 'moderate' to 'good' (% agreement: 65-85% / Kappa: 0.475-0.778) except 'humidity(dryness / dampness)' item (% agreement: 55.98% / Kappa: 0.340). In findings of subgroup analysis according to affiliation of raters, Inter-rater agreement(%) and Kappa coefficient of raters in same affiliation was higher than inter-rater agreement(%) and Kappa coefficient of raters in different affiliation except 'dryness / dampness' item. Conclusions : It is necessary to improve objectivity and reproducibility of pattern identification using nasal endoscopy for allergic rhinitis(AR) through the development of detail-oriented criteria and enhanced training of clinicians with development of standard operating procedures(SOPs).

• Journal of Preventive Medicine and Public Health
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• v.41 no.2
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• pp.80-83
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• 2008

An economic evaluation is required in order to apply to the Health Insurance Review and Assessment Service (HIRA) for a listing in the national drug formulary. To assist companies in preparing the necessary documents, HIRA published guidelines for the economic evaluation of pharmaceuticals in 2006. The guidelines are composed of two parts: guidance and explanatory notes. Each guideline reflects the best practice which meets both the theoretical consensus within the academic community and local situations, like data availability. To enhance the transparency of evaluation, guidelines emphasize the reproducibility of data and analysis result. That is, all evaluation processes are required to be described in enough detail to be replicated by reviewers. With growing experience and theoretical development in this area, HIRA guidelines will be revised periodically.

• The Journal of Korean Medicine
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• v.29 no.2
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• pp.41-46
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• 2008

Objective: To build a basis of strategy for development of herbal drug as a preventive medicine during dynamic innovation of Korean Oriental medicine. Methods: Via telephone interview, 101 subjects prescribed with deer antler were asked to provide us their reflections about five topics: points of satisfaction, physical improvement, improved symptoms, annual times of taking restorative herbal medicine, and aspect of complaints about taking the herbal drugs. Results: Around 68% of subjects usually take a restorative herbal medicine with deer antler less than once per year. 63% of subjects were satisfied with herbal restoratives. They answered the physical energetic feeling (52%) as the most benefit while expensive price (43%) as the most frequent complaint. Conclusion: Scientifically designed restorative herbal medicine needs to be developed for competitiveness of Korean Oriental medicine as a preventive medicine. In addition, more reasonable price and confirmative data for safety and quality control should be equipped in Korean Oriental medical market.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.245-250
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• 1988

For the evaluation of change of FVC and $FEV_1$ after discontinuance of bronchodilator in the coal workers' pneumoconiosis patients, 17 pairs of patients were selected. They were matched by the age(${\pm}5$ y.o.) and the type of ventilatory impairment. Pulmonary function was measured 2 times bimonthly before and after the drug discontinuance discontinued after measurement of PFT for 2 times. In case group the bronchodilator was discontinued after measurement of PFT for 2 times. In control group there was no interruption of medication. FVC, $FEV_1$ decreased in both group as measurement progress. Simple linear regression coefficients against the month of measurement were calculated in both group and tested for parallelism between two groups. The results of test revealed that both regression coefficients were parallel. So in conclusively, discontinuance of medication of bronchodilator for coal workers pneumoconiosis patients has no effect on the decreasing rate of FVC, $FEV_1$.

• Journal of Preventive Veterinary Medicine
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• v.42 no.4
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• pp.177-181
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• 2018

Disulfiram is a drug used to treat alcohol dependence. Recent studies have shown that disulfiram also has anti-cancer effects. Considering that many anti-cancer agents have side effects, including immunosuppression, it is important to check if disulfiram has some cytotoxicity to immune cells. In this study, mouse spleen cells were treated with disulfiram and the metabolic activity was measured. Disulfiram increased the cell death of spleen cells according to annexin V-FITC/PI staining analysis. In addition, disulfiram decreased the mitochondrial membrane potential of spleen cells. The toxicity of disulfiram was concentration dependent. Interestingly, disulfiram affected the population of lymphocytes and the subset of spleen cells was altered. This study provides clinicians and researchers with valuable information regarding the toxicity of disulfiram to mouse spleen cells, particularly lymphocytes.

• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.23-56
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• 1994

Recent criticisms of the conduct and use of risk assessment by regulatory agencies have led to a wide range of proposed remedies, including changes in regulatory statutes and the development of new methods for assessing risk. The mandate to this Committee was more limited. Our objective was to examine whether alterations in institutional arrangements or procedures, particularly the organizational separation of risk assessment from regulatory decision-making and the use of uniform guidelines for inferring risk from available scientific information, can improve federal risk assessment activities. Before undertaking to determine whether organizational and procedural reforms could improve the performance and use of risk assessment in the federal government, the Committee examined the state of risk assessment and the regulatory environment in which it is performed. In this chapter, we define risk assessment and differentiate it from other elements in the regulatory process, analyze the types of judgments made in risk assessment, and examine its current government context. Because one chronic health hazard, cancer, was highlighted in the Committee's congressional mandate and has dominated public concern about public health risks in recent years, most of our report focuses on it. Furthermore, because activities in four agencies--the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA), the Occupational Safety and Health Administration (OSHA), and the Consumer Product Safety Commission (CPSC)--have given rise to many of the proposals for changes in risk assessment practices, our review focuses on these four agencies. The conclusions of this report, although directed primarily at risk assessment of potential carcinogens as performed by these four agencies, may be applicable to other federal programs to reduce health risks.