• Quality Improvement in Health Care
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• v.12 no.2
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

• YAKHAK HOEJI
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• v.53 no.3
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• pp.138-144
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• 2009

The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

• Asian-Australasian Journal of Animal Sciences
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• v.14 no.3
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• pp.395-401
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• 2001

A review of present understanding of the dietary nutrient utilization in ruminant animals is presented. For increasing the utilization of dietary nutrients and reducing environmental contamination, highlighting the development and use of nutritional manipulation technique is suggested.

• YAKHAK HOEJI
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• v.55 no.3
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• pp.173-184
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• 2011

The purpose of this study was to review foreign retrospective Drug Utilization Review(DUR), and so to suggest a development plan suitable for use with domestic situation. Literature review of foreign retrospective DUR program and domestic project such as DUR and prescribing analysis project were reviewed. To improve prescribing quality, developed countries such as US, Canada, UK, France, and Australia have implemented various forms of policy. Based on the review of foreign retrospective DUR program, we suggested to apply practical implementation of retrospective DUR program.

• Health Policy and Management
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• v.24 no.2
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• International Commerce and Information Review
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• v.12 no.4
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• pp.3-24
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• 2010

This study aims to identify the determinants on the implementation level of e-Trade of Chinese exporters in Shandong Province, China. From the review of previous studies, a research model and six hypotheses were set up and tested by the multiple regression analysis with total 127 effective survey data. Among the company characteristics, the company size was statistically significant to the utilization range and the utilization level. But unlike former studies in Korea, the utilization range showed the (-) mark. On the other hand, the innovative attitude of CEO didn't show statistical significance to both the utilization range and the utilization level. Among the information characteristics, the IT infrastructure was not statistically significant to both the utilization range and the utilization level. On the other hand, the education and training of technical personnel didn't have a significant effect on the utilization range, but it had a statistically significant effect on the utilization level. Among the external environment, the intensity of competition had a statistically significant effect on both the utilization range and the utilization level. In summary, the implementation level of e-Trade of Chinese exporters in Shandong Province, China is still behind that of Korea. But the fact that the small and medium-sized Chinese exporters are using Internet more actively than large companies suggests some implications for those of Korea.

• Journal of the Korean Society for Marine Environment & Energy
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• v.11 no.1
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• pp.55-62
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• 2008

This study investigated the status and problems of marine-related environmental impact assessment and a utilization-consultation system in Korea and suggested improvement of the review organization. Also, it conducted SWOT analysis based on evaluation of functions, roles and performance of the marine environmental impact assessment center and proposed development strategies of the center through introduction of expert opinions and advanced systems. The performance statement-review by the center in 2007 included 358 cases in total; 165 (46.1%) for consultation on utilization of sea area, 104 for environmental impact assessment (29.0%), and 89 (24.9%) for prior environmental review. The consultation on utilization of sea area can be divided into that for public water surface-use (41%) and reclamation (32%), and sea aggregate extraction process (21%). Although bad impacts on marine environment are reducing under the current system, there are some limits and problems to supplement it in terms of content, system and operation. Review system on sea area utilization-impact(marine environmental impact assessment center) by marine environmental management law needs to obtain expertise, fairness and efficiency and, to do so, have operational supports and institutional improvement to maximize its own functions and roles. At the same time, it is necessary for the center to establish identity and the status as a professional review organization by setting active development strategies inside the center. Finally, it should strengthen an consultation system of marine environmental impact assessment led by the related ministry to achieve effective coastal management.

• Korean Journal of Clinical Pharmacy
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• v.29 no.1
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• pp.25-32
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• 2019

Objective: South Korea made a list of potentially inappropriate medications (PIMs) for elderly patients in 2015 and has prompted medical professionals to prescribe proper medication by using the drug utilization review (DUR) system. It has been three years since the system was introduced, but related studies have rarely been conducted. This study aimed to evaluate the effect of the DUR system on the prescription of PIMs for elderly patients. Methods: The data on the prescription of PIMs for elderly patients (${\geq}65$ years) who received medical treatment between March 1st and May 31st in 2015 (before introduction of the DUR system) and who received medical treatment between March 1st and May 31st in 2018 (after introduction of the DUR system) were retrospectively collected from electronic medical records. Results: The prescriptions of PIMs decreased from 3,716 (7.7%) to 3,857 (6.9%) (p < 0.001). The prescription of escitalopram and paroxetine, among selective serotonin reuptake inhibitors, increased significantly, and that of short-acting benzodiazepines also increased significantly from 454 (0.93%) to 624 (1.2%). Conclusion: Prescription of PIMs for elderly patients significantly decreased (p < 0.001) after the DUR system was introduced. Further expanded studies of PIMs need to be conducted for the safety of elderly patients.

• The Journal of the Korea Contents Association
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• v.19 no.1
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• pp.234-241
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• 2019

The side effects of using drugs can greatly threaten the health of the public. The reality is that there are very few reports of current side effects. This can be activated by linking adverse drug reactions reporting to the Drug Utilization Review (DUR) currently used by pharmacies. A study of the U.S. medication management system, where drug use assessment is activated, can find ways to activate adverse drug reactions reporting. In 'Pharm IT 3000', which is used as a medication management program in pharmacies, we examined how to enable reporting of adverse drug reactions. The literature study and research on actual program operation have found a convenient way to report side effects by linking the Pharm IT 3000 prescription preparation assessment to the item.

• Health Policy and Management
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• v.25 no.3
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• pp.207-220
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• 2015

Background: The purpose of this exploratory study is to explain where, when and how the introduction of user fee system works in low and middle income countries using context, mechanism, and outcome configuration. Methods: Considering advanced research in realist review approach, we made a review process including those following 4 steps. They are identifying the review question, initial theory and mechanism, searching and selecting primary studies, and extracting, analyzing, and synthesizing relevant data. Results: User fee had a detrimental effect on medical utilization in low and middle income countries. Also previous and current interventions and community participation were critical context in user fee system. Those contexts were associated with intervention initiation and recognition and coping strategies. Such contexts and mechanisms were critical explanatory factors in medical utilization. Conclusion: User fee is a series of interventions that are fragile and dynamic. So the introduction of user fee system needs a comprehensive understanding of previous and new intervention, policy infrastructure, and other factors that can influence on medical utilization.