• Health Policy and Management
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• v.11 no.4
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• pp.70-87
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• 2001

The purpose of this study was to identify health care providers' perceptions about the goal achievement and benefit/loss caused by the separation policy of drug prescribing and dispensing after the policy implemented on July 1, 2001. Uslng stratified sampling method based on the administration area, Ku, 315 physicians and pharmacists were sampled from the rosters of physician and pharmacist association in the city of Busan on 2001. There were 122 and 115 responses from physician and pharmacist sample, respectively. 78.3% of physicians and 50.4% of pharmacists evaluated that the goal of the policy was not achieved. Moreover, 75.3% of physicians and 40.7% of pharmacists did not support the policy. Most physicians and pharmacists considered preventing the citizens with drug abuse and misuses as the most important benefit derived from the policy. However, physicians and pharmacists concerned over raising health care cost that could be patients' burden. The most important physicians' benefit derived from the policy was free choice of all possible medicine that might result in effectiveness of medication. In physicians' the most important loss, most physicians worried about that breaking traditional patient and physician relationship might cause physicians' authority in treating diseases to be damaged. Pharmacists considered the most important policy benefit as hiked social status resulted from enforcement of profession due to the policy whereas they considered the most significant loss as expected financial problems of small pharmacies compared to that of large pharmacies or pharmacies adjacent to hospitals. In the current problems of the policy, physician and pharmacists blamed the government for inadequate preparations of the policy implementation. Physicians and pharmacists also considered citizens' mature attitudes toward the policy as a crucial success factor.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.3
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• pp.31-44
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• 2018

Objectives : The aim of this study was to investigate the Korean medicine doctor's perception of the extension and activation of herbal medicine preparations insurance benefits. Methods : The sample of Korean medicine doctors' panel pool which is extracted by examining the square root quota of city location of Korean medicine clinics was used. In case of a vacancy in some participants, the number of Korean medicine doctors were supplemented and placed for investigation. Results : It has 54.0% awareness of the separation of prescribing and dispensing herbal preparations, 87.0% agreed on the need to be insured, but the separation as a necessary condition for being insured was only 60.3% agreed. When a large number of herbal preparations are being insured, it was expected that 30% to 50% of patients(30.3%) will be prescribed herbal preparations and the number of new patients will increase by 5 to 15 for the purpose of prescriptions only(49.3%). Increase amount of medical expense(?3,000) as a result of the separation of prescribing and dispensing herbal preparations are insufficient(54.3%). Conclusions : From the results of this study, extension of national health insurance to cover herbal preparations must be needed to activate herbal medicine preparations and improve Korean medical services.

• Health Policy and Management
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• v.12 no.4
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• pp.91-113
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• 2002

We report and analyze the Korean physicians' recent general strike over the implementation of the Separation of Prescribing and Dispensing Practice (SPDP) in which more than 18,000 private clinics and 280 hospitals participated. Utilizing game-theoretic models of bargaining we explain why the Korean physicians were so successful in organizing intense collective action against the government and securing very favorable policy outcomes. In particular, we highlight the role of distributional conflict among social actors in shaping the details of institutional reform. The introduction of the SPDP was a necessary first step in the overall reform of health care system in Korea. However, the SPDP was perceived to be a serious threat to the economic viability of their profession by the vast majority of Korean physicians who had long been relied on the profits from selling medicines to compensate for the loss of income due to the low service fee under the previous health care system. The strong political coalition among heterogeneous physicians enabled them to organize an intense form of collective action, the general strike. Thus, physicians were successful not only in dragging the government to a bargaining table, but also winning in the bargaining and securing an outcome vastly favorable to them. On the other hand, the lack of an overall reform plan in the health care policy area, especially the finance of the National Health Insurance and the need for maintaining an image as a successful reform initiator, motivated the government to reach a quick resolution with the striking physicians.

• Korea Journal of Hospital Management
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• v.7 no.4
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• pp.1-23
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• 2002

This study examined the influence of the separation of prescribing and dispensing roles(SPD) policy implemented in Korea in July 2000, especially on the change in the net profit of medical institutions. Using the data set from the Korea's National Health Insurance and the previous research, this study elicited the following main results. First, tertiary care institutions was estimated to lose about 631 billion won after the SPD policy. Second, general hospitals and hospitals gained about 557 billion and 564 billion won, respectively. Third, it is shown that clinics also gained 389-659 billion won. Finally, however, the change in net profit of medical institutions after the SPD policy largely depends on different estimation models. Moreover, it also varies from the assumptions on the price differential of a reimbursable drug which worked as cross-subsidy to insufficient physician's fee before the SPD policy. Despite such limitations as lack of data outside of the National Health Insurance's coverage, this study differs from others. This is the first research to explore the effect of the SPD policy on different types of medical institutions and to attempt to purely focus on the SPD policy. In this study, we can draw the policy implication that preparing for a policy change, the government should set up the policy evaluation system to collect the concerned data and develop the methodologies in advance to the policy implementation.

• Korea Journal of Hospital Management
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• v.8 no.2
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• pp.93-110
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• 2003

Fiscal crisis in the medical insurance has put the pressure upon hospitals by increasing the rate of curtailment, since the implementation of the separation between prescription and dispensing of Drug. The purpose of this study is to analyze the curtailment for antibiotics, injected drug and other drugs expenditure before and after the system of separation between prescribing and dispensing. Data were gathered from 13 general hospitals and used for analysis of trends on antibiotics and injected drug expenditure, and curtailment in 2000-2001 at three months intervals. The results were as follows; The curtailment rate of antibiotics expenditure has been increased in outpatient and inpatient since 2000. The curtailed antibiotics cost and injected drug cost in outpatient under the prescription within the hospital and in inpatient increased. The ratios of curtailment versus expenditure had increased in antibiotics, injected drugs, anticancer drugs, antiulcer drugs, albumine, antiinflammatory drugs. These results suggest that claim review system in social health insurance were over-focused mainly to control the cost and it might to impede the validity of claim review function in health insurance system. Therefore, it's needed to develope the scientific and reasonable parameter & criteria for claim review of drug expenditure.

• Proceedings of the PSK Conference
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• 2003.10b
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• pp.71.2-72
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• 2003

This presentation is to enhance the pharmacist's role in Over-The-Counter(OTC) drug selection and patient counseling for diversification of pharmacy management after the separation of prescribing and dispensing practice in Korea. Self-medication by OTC drugs may be viewed as one element of the broader self-care treatment. The patient may use a OTC drug to manage a minor ailment, a process that may be supported by counseling from a pharmacist. Pharmacists involved in self-medication decisions have a greater involvement with patients and an enhanced professional role. (omitted)

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.226-226
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• 2002

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.62-84
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• 2001

The purpose of the study was to compare patient's satisfaction on the pharmacy services after introducing the new system of separation of dispensing from prescribing medicines, between those filling their prescriptions from the pharmacy nearby hospitals and those from the pharmacy in their resident areas. To measure patient's satisfaction, a questionnaire survey was conducted with 354 outpatients who received prescriptions from any of the three university hospitals located in In-Cheon city. Study results showed that geographic accessibility to pharmacy was a main attribute to select pharmacy. Size of the pharmacy and availability of prescription drugs are the second major reasons for pharmacy selection for the patients from the pharmacy nearby hospital, whereas patronage is the second major reason for those from the pharmacy in resident areas. Overall satisfaction was higher among the patients from the pharmacy in resident areas than those from the pharmacy nearby hospitals, mainly due to better facilities(waiting area, public telephone, etc), kindness, cleanliness, shorter waiting time, and pharmacist's concern about patient's health. On the other hand, the patients of the pharmacy nearby hospitals showed low satisfaction because of long waiting time and the lack of pharmacist's knowledge and information about patients' health status and medication history. Patients visiting the hospital that has pharmacy-hospital cooperation system showed higher satisfaction as compared to those visiting the hospital without such system. This study provided an empirical evidence that it would be more advantageous for patients to receive pharmacy services from pharmacies located in their living areas than from pharmacies nearby hospitals. This implies that there is a strong need for adequate strategies to enhance the role of pharmacies in resident areas under the new system of separation of dispensing from prescribing medications.

• YAKHAK HOEJI
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• v.52 no.6
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• pp.507-513
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• 2008

The purpose of this study is to analyze the factors affecting financial performance of community pharmacies after the implementation of the new drug policy in Korea: separation of drug prescription and dispensing (SPD). The online survey questionnaires were sent to the active pharmacists of the total 20,633 community pharmacies in Korea and 1,147 pharmacists responded to the survey (the response rate was 5.5%). The questionnaire asked simple financial data in order to compare their financial performances before and after the policy. With the SPSS package (version 12.0), two levels of data analysis were used: 1) descriptive statistics to see the financial status of the pharmacies; and 2) multiple regression analysis to find the factors. {or A multiple regression method was used for the data analysis.} The finding illustrated that the average net benefit of the pharmacies was 4,870 thousand won in August 2006, and the major factors affecting the net benefit were the location of pharmacy (geographical proximity to medical institutions), number of prescriptions, drug management services for patients, chain pharmacy membership. The findings of this study suggest that service improvement for patients, revitalization of non-prescription drug sales, professional management will contribute to promote community based pharmacy business.

• Health Policy and Management
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• v.12 no.1
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• pp.54-83
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• 2002

Korea's recent attempt to separate prescription and dispensation of pharmaceuticals suffers serious, negative side effects. The interned-based prescription delivery system is being considered a supportive tool to alleviate such side effects. This paper conducts an economic evaluation of the system. We consider all possible types of pecuniary costs and benefits, from societal perspective, to conclude that nationwide adoption of the system would raise net social benefits by 5,892 billion won for the coming five years. Specifically, the net benefits would be distributed among consumers (5,667 billion won), pharmacies (216 billion won) and medical institutions (8 billion won). Net social benefits would be far mere enhanced by deregulation policies, such as removal of restrictions on electronic type prescription and home-delivery of dispensed drugs.