• Title/Summary/Keyword: western medical care

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Health Care Utilization of Outpatients in the Oriental Hospital (모 한방병원 내원 환자의 의료이용실태)

  • 김지용;김경호;김장현
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.129-137
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    • 2000
  • Objectives: The aim of this study was to investigate the attitude toward the oriental hospital among 1,234 outpatients. Methods: A questionnaire about the general characteristics of patients, the decision-maker of use and the reason of choice or alteration was implemented. Results: The results of this survey as follows: Among outpatients 56.4 % were female in sex, 25.6 % were below 9 years of age; in educational level, 50.1 % were college graduates. Among outpatients, 33.6% chose the oriental hospital as their first choice and the rest were recommended by other persons. The recommenders were mostly relatives(73.9 %), female(73.4 %), young(30-39 years old, 40.1 %), high educational level (above the college, 54.9 %) people. 37.8 % among outpatients were secondary selection after the western medical clinic for the same symptom and sign. 7.0 % were the concomitant users of both therapies. 62.8 % among the concomitant users did not notify the western doctor about the dual therapies. The reasons they did not notify their Western doctors were 'be afraid of western doctor s bias' (42.6 %), 'no special reason' (29.6 %). Conclusions: The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and doctors who practice both kinds of medicine.

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A Literature Study on Usage of and Satisfaction Levels with Combined Treatment Including Oriental and Western Medicine

  • Lim, Jung-Hun;Lim, Sung-Min
    • Journal of Pharmacopuncture
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    • v.15 no.3
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    • pp.7-12
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    • 2012
  • Objective: This study aimed to summarize and analyze the usage of and the satisfaction levels with combined treatment including Oriental and Western medicine. Methods: We searched studies on the usage of and the satisfaction levels with combined treatment including Oriental and Western medicine over the past 10 yrs (2001-2011) from 3 Korean databases (National Assembly Library, Research Information Service System, and National Discovery for Science Leaders). The reviewers also conducted a summarizing analysis by sampling the literature according to the type of study, study period, region, study subjects, sample size, type of sampling, research method, data analysis, study instruments, main results, etc. Results: When the main results of six studies on combined treatment usage and satisfaction levels were considered together, the most important decisive factor in determining the usage of combined treatment was the illness of the patient, followed by the patient's occupation, sex, age, education, marital status, religion, treatment cost, and treatment results. In addition, the most important factor that determined satisfaction levels with combined treatment was age, followed by education, religion, income, health status, treatment procedures, staff attitude, and cleanliness. Conclusions: Elderly patients with musculoskeletal, cerebro-vascular, and circulatory system illnesses are more likely to prefer combined treatment over independent Oriental or Western treatment and are more likely to request specialized, adjusted medical care.

Review of 2013 Major Medical Decisions (2013년 주요 의료 판결 분석)

  • Lee, Dong Pil;Jeong, Hye Seung;Lee, Jung Sun;Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.263-302
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    • 2014
  • The court handed down meaningful rulings related to medical sectors in 2013. This paper presents the ruling that the care workers could be the performance assistants of the care-giving service although the duties of care worker are not included in the liability stipulated in the medical contract signed with the hospital for reason of clear distinction of duties between care workers and nurses within the hospital in connection with the contract which was entered into between the hospital and patients. In relation to negligence and causal relationship, the court recognized medical negligence associated with the failure to detect the brain tumor due to the negligent interpretation of MRI findings while rejecting the causal relationship with consequential cerebral hemorrhage. The court also recognized negligence based on the observation on the grounds of inadequate medical records in a case involving the hypoxic brain damage caused during the cosmetic surgery. In terms of the scope of compensation for damages, this paper presents the ruling that the compensation should be estimated based on causal relationship only in case the breach of the 'obligation of explanation' is recognized, however rejecting the reparation for de factor property damages in the form of compensation, and the ruling that the lawsuit could be instituted in case that the damages exceeded the agreed scope despite the agreement that the hospital would not be held responsible for any aftereffects of surgery from the standpoint of lawsuit, along with the ruling that recognized the daily net income by reflecting the unique circumstances faced by individual students of Korean National Police University and artists of Western painting. Many rulings were handed down with respect to medical certificate, prescription, etc., in 2013. This paper introduced the ruling which mentioned the scope of medical certificate, the ruling that related to whether the diagnosis over the phone at the issuance of prescription could constitute the direct diagnosis of patient, along with the ruling that required the medical certificate to be generated in the name of doctor who diagnosed the patients, and the ruling which proclaimed that it would constitute the breach of Medical Act if the prescription was issued to the patients who were not diagnosed. Moreover, this paper also introduced the ruling that related to whether the National Health Insurance Service could make claim to the hospitals for the reimbursement of the health insurance money paid to pharmacies based on the prescription in the event that the hospitals provided prescription of drugs to outpatients in violation of the laws and regulations.

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Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

  • Wang, Feng-Liang;Chen, Fei;Yin, Hong;Xu, Nan;Wu, Xiao-Xiang;Ma, Jing-Jing;Gao, Shen;Tang, Jin-Hai;Lu, Cheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2277-2282
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    • 2013
  • Purpose: Mammography has been confirmed as the only effective mode to improve the prognosis of patients with breast cancer in Western developed countries, but might not be a good choice in other areas of the world. One of the major challenges in China is to determine an optimal imaging modality for breast cancer screening. This study was designed to clarify the sensitivity of ultrasonography compared with that of mammography in rural China. Methods: We retrospectively studied the sensitivity of mammography and ultrasonography based on 306 breast cancer patients detected by the program of "screening for cervical cancer and breast cancer" performed in Chinese rural areas between January 2009 and December 2011, and analyzed the effects of age, breast density and volume on the sensitivity. Results: Stratified analysis showed that the sensitivity of breast ultrasonography was significantly higher than that of mammography in premenopausal patients (81.4% vs. 61.1%, p=0.02), in women ${\leq}$ 55 years of age (82.2% vs. 63.4%, p<0.01), in the high breast density group (American College of Radiology [ACR] levels 3-4) (85.9% vs. 60.6%, p<0.01) and in the small breast volume group (${\leq}$ 400 ml) (87.1% vs. 66.7%, p<0.01). Age had a significant effect on sensitivity of mammography (breast density and volume-adjusted odds ratio, 6.39; 95% confidence interval, 2.8-14.4 in age group > 55 compared to age group ${\leq}$ 45), but not that of ultrasonography. Neither breast density nor volume had significant effect on sensitivity of mammography or ultrasonography. Conclusions: Ultrasonography is more sensitive than mammography in detecting breast cancer in women under 55 year-old Chinese, especially in those with high-density and relatively small breasts.

A Study on the Architectural Planning of Plan Type and Area Composition in Medical Emergency Center (지역응급의료센터의 평면유형 및 면적구성에 관한 건축계획적 연구)

  • Kwon, Yongtaek;Roh, Jihwa
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.18 no.2
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    • pp.55-64
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    • 2012
  • Recently, our country is caused with economic growth and development and city intensive brazier being caused by industrial accident, crime accident and suicide of traffic facility, it is caused by with Western dietary life and the emergency patient is to an increase tendency. And the life increases with medical development and the medical emergency demand of the old people are increasing. Approximately 80% of the patients are non-emergent patients who receive ambulatory care and the rest 20% of the patients are serio us- emergent patients Emergency patients because non-strategy it is doing with function as imported medical treatment and provides, equipment, the operation is being impossible with manpower tribal etc.

Effect of Steroid Administration Ex Vivo on the IκB/NF-κB Pathway in Human Peripheral Blood Monocytes (스테로이드의 투여가 말초혈액 단핵구에서 IkB/NF-κB경로에 미치는 영향)

  • Yoon, Ho Il;Lee, Hee-Seok;Lee, Chang-Hoon;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.5
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    • pp.542-550
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    • 2003
  • Background : Synthetic glucocorticoids are widely used in many chronic inflammatory diseases because of their excellent anti-inflammatory activity. Enhancing the transcription of $I{\kappa}B$ and preventing activated NF-${\kappa}B$ from binding to ${\kappa}B$ sites are thought to be the underlying mechanisms. But these data are largely derived from in vitro studies using cell lines. In this study, after administrating a steroid to volunteers, we evaluated the effect on the NF-${\kappa}B$ system. Methods : Prednisolone(0.5mg/kg/d) was orally administered to 5 healthy volunteers for 7 days. Before and after the administration, we sampled their peripheral blood monocytes, and performed western blot analysis both with stimulation, using IL-$1{\beta}$, LPS, TNF, and without stimulation(baseline). We also performed EMSA after stimulation with LPS. Results : After ingestion of the steroid, baseline expressions of $I{\kappa}B{\alpha}$ were increased in two of the subjects, while suppressed degradations of $I{\kappa}B{\alpha}$ to stimulations were observed in all five. In addition, the binding capacity of NF-${\kappa}B$ after the administration was decreased. Conclusion : Steroid plays such roles as enhancing the transcription of $I{\kappa}B{\alpha}$, suppressing the DNA binding capacity of NF-${\kappa}B$, and suppressing the degradation of $I{\kappa}B{\alpha}$.

Economic Evaluation of Eastern, Western and Collaborative Treatments for Patients with Frozen Shoulder Pain (견비통의 한${\cdot}$양방 진료 및 협진의 경제성 평가)

  • Jang, Hye-Jung;Hong, Sang-Min;Park, You-Seon;Nam, Dong-Woo;Lim, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.72-86
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    • 2007
  • Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.

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A Study on Sickness and Utilization of Medical Care in a Rural Area of Kyunggido (일부(一部) 농어촌주민(農漁村住民)의 상병(傷病) 및 의료이용도(醫療利用度)에 관(關)한 조사연구(調査硏究))

  • Chang, Yong-Tae
    • 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.

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An Implementation of Intefrated Database for Electronic Medical Record System in East-West Medical Collabration (${\cdot}$양방 협진 전자의무기록 시스템 구축을 위한 통합 데이터베이스 구축)

  • Ahn, Yo-Chan;Oh, Sang-Bong
    • Journal of Information Technology Applications and Management
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    • v.12 no.2
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    • pp.129-143
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    • 2005
  • In recent years, two major streams in medical information systems are:1) system integration among OCS(Order Communication System), EMR(Electronic Medical Record), PACS(Picture Archiving and Communication System), and ERP(Enterprise Resource Planning) and 2) system integration through medical collaboration between East and West medical service providers. One of the characteristics which differentiate the Korean medical industry from the western medical industry is the East-West medical collaboration. In many respects there are many differences between East and West medical treatment. Although East and West medical treatment have developed from different medical philosophies and standards, we assume that the better medical care can be provided by integrating their medical procedures effectively. The two possible approaches to the integration of East and West medical information systems are suggested in this paper:One is loosely coupled model and the other is tightly coupled model. EMR improves the quality of medical record which reflects the quality of clinical practice. It provides more efficient and convenient way of input, retrieval, storage, communication and management of medical data. We abstracted the standard medical procedures from the two medical procedures performed in Daejeon Oriental Hospital and Hehwa Clinic at Daejeon University and also abstracted database schema by analyzing the characteristics of information needed in East-West medical collaboration. Our EMR is composed of two types of data:one is structured data and the other is unstructured data, which are formalized by SOAP(Subjective, Objective, Assessment, Plan) format. Currently the integrated system is implemented and operated successfully for six months.

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Determinants of Utilization of Oriental Medical Services and Policy Implications (한방의료이용의 결정요인과 정책개선방안)

  • Byun Jin-Suk;Lee Sun-Dong;Kim Jin-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.2
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    • pp.1-23
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    • 1999
  • The purpose of this paper is to survey the current status of service utilization in oriental medicine, to identify the determinants of consumers' decision in the service utilization, and then suggest policy implications for promoting the consumers' utilization. A multiple regression model was adopted to analyze the factors that influence consumer's decision in purchasing the oriental medical services. Data used in this research relied on National Survey Data conducted by Korea Institute of Health and Social Affairs, and sampling survey. The results could be summarized as follows.: 1. the number of visits to oriental medical institutions has shown an overall increase during the last decade since the inception of health insurance for oriental medical services. It still, however, revealed a relatively iow figure to western medical services. 2. the main factors, after controlling demographic variables, that determine consumers' selection between oriental medical services and western medical services are considered to be price, belief in effectiveness of services, waiting time for service. Implications for policy recommendation include 1. to reduce a barrier to service utilization by discounting dramatically the price of herb medicine, which is believed to be crucial in expanding market share, 2. to encourage consumer's belief in clinical effectiveness through a specialization in competitive services compared with wertern medicine, 3. to keep the affirmative image among consumers alive through an active participation of oriental medical doctors in community activities, 4 to change the health care system in favor of oriental medicine in the long run.

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