• 한국의료질향상학회지
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• 제12권2호
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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.

• 약학회지
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• 제53권3호
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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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• 제14권3호
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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.

• 약학회지
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• 제55권3호
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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.

• 보건행정학회지
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• 제24권2호
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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.

• 통상정보연구
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• 제12권4호
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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.

• 한국해양환경ㆍ에너지학회지
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• 제11권1호
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• pp.55-62
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• 2008

본 논문에서는 현재 시행되고 있는 우리나라의 해양관련 환경영향평가와 협의제도의 현황과 문제점을 파악하여 관련 제도의 개선방향을 연구하였다. 또한 해양환경관리법상 해역이용영향 검토기관(이하 검토기관이라 함)의 기능과 역할 및 수행실적을 조사하여 SWOT 분석을 실시하였고, 나아가서 운영상 개선사항과 발전방향을 제안하였다. 2007년 검토기관에서 수행한 실적은 총 358건으로, 해역이용협의서가 165건(46.1%)으로 가장 많았고, 환경영향평가서 104건(29.0%), 그리고 사전환경성검토서가 89건(24.9%)이었다. 해역이용협의의 내용별로는 공유수면점 사용, 공유 수면매립과 바다골재채취 관련이 각각 41%, 32%와 21%를 차지하였다. 그러나 이러한 제도시행으로 해역이용개발 행위가 해양환경에 미치는 악영향을 최소화하고 있지만, 사전예기능으로서의 한계와 여러 가지 내용적 그리고 제도상운영상 측면에서 보완하고 개선해야 할 문제점이 지적되었다. 검토기관의 전문성, 공정성과 효율성을 확보하는 것이 매우 중요하고, 이를 위해서는 고유 기능과 역할을 극대화시킬 수 있는 제도적 개선과 운영상 지원이 필요하며, 동시에 자체적으로 적극적인 발전전략을 수립함으로써 전문적인 검토기관으로서의 정체성 확보와 위상을 정립시켜야 할 것이다. 연안관리의 실효성을 확보하기 위해서는 효율적인 해역이용협의제도를 지향하고, 주무부처의 해양환경관리에 대한 구동력과 능동성을 강화 확립해 나가야 할 것이다.

• 한국임상약학회지
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• 제29권1호
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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.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.234-241
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• 2019

의약품을 사용할 때 나타나는 부작용은 국민의 건강을 크게 위협할 수 있다. 현재 의약품 부작용에 대한 보고가 매우 미흡한 것이 현실이다. 이에 현재 약국에서 사용하고 있는 의약품 사용평가(DUR:Drug Utilization Review)에 의약품 부작용 보고를 연계하게 된다면 활성화될 수 있다. 의약품 사용평가가 활성화되어 있는 미국 의약품 관리 체계 연구를 통해 의약품 부작용 보고 활성화 방안을 찾을 수 있다. 약국에서 의약품 관리 프로그램으로 사용되는 'Pharm IT 3000'에서 의약품 부작용 보고의 활성화 방안을 연구해 보았다. 문헌연구와 실제 프로그램 운영 방식 연구를 통해 Pharm IT 3000 처방 조제 현황 항목에 의약품 사용평가를 연동시켜 부작용 보고가 편리하게 되는 방안을 찾게 되었다.

• 보건행정학회지
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• 제25권3호
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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.