• Title/Summary/Keyword: 의료분업

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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Vertrauen und Misstrauen in der horizontal arbeitsteiligen Medizin (수평적 분업의료에 있어서 신뢰와 불신)

  • Kim, Min-Joong
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.159-172
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    • 2010
  • Viele medizinische Ma$\ss$snahmen erfordern ein Zusammenwirken verschiedener $\ddot{A}$Arzte. In der arbeitsteiligen Medizin wird deutlich zwischen vertikaler und horizontaler Arbeitsteilung unterschieden. Mit dem Begriff vertikaler Arbeitsteilung geht es darum, ob ein Arzt einem anderen Weisungen erteilen kann oder nicht. Bei der Horizontalen Arbeitsteilung handelt es sich um selbst$\ddot{a}$andig t$\ddot{a}$atige Mediziner, in gleichen oder aneinander sto$\ss$senden Gebieten, bei denen man sich auf die Angaben oder die T$\ddot{a}$atigkeiten des anderen verlassen kann. Die wirkliche arbeitsteilige Medizin wird horizontal geleistet. In der arbeitsteiligen Medizin, insbesondere in der mehr und mehr spezialisierten Medizin, ist ein gewisser Grad des Vertrauens notwendig, schon aus Zeitgr$\ddot{u}$unden. Die Wiederholung aller m$\ddot{o}$oglichen diagnostischen, aber auch pr$\ddot{a}$aoperativen Untersuchungen, w$\ddot{a}$are zeitaufwendig und kostenreich. Es gibt aber auch Verh$\ddot{a}$altnisse, in denen die Kontrolle oder sogar die Wiederholung dieser Tests notwendig ist. Dann ist, insbesondere wenn sie in einer gewissen Zeitfolge t$\ddot{a}$atig werden, die Problematik des Vertrauens und Misstrauens angesprochen. Der Arzt, der von einem anderen Arzt in herk$\ddot{o}$ommlicher Weise Mitteilungen bekommt oder jedenfalls erwarten kann, darf sich grunds$\ddot{a}$atzlich auf den Vertrauensgrundsatz berufen. Das gilt insbesondere, wenn der mitteilende Arzt in einer personell und apparativ $\ddot{u}$uberlegen ausgestatteten Klinik t$\ddot{a}$atig ist. Wenn sich allerdings Zweifel an der Richtigkeit der Mitteilung aufdr$\ddot{a}$angen, etwa zahlreiche Nachl$\ddot{a}$ssigkeiten vorgekommen sind, ist f$\ddot{u}$r Vertauen kein Platz.

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학회순례 - 창립 53돌 회원 8백여명 "대한예방의학회"

  • Kim, Jun-Yeon
    • The Science & Technology
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    • v.33 no.9 s.376
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    • pp.82-83
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    • 2000
  • 1947년 조선보건학회로 출범한 대한예방의학회는 해마다 "예방의학지"를 4회 발간하고 4차례의 학술대회도 개최한다. 또한 "에방의학회 50년도록 "을 비롯 "한국보건의료문제 - 진단과 처방"등 의료참고서를 꾸준히 발간하고 있다. 앞으로 대한예방의학회는 예방의학 뿐만 아니라 의약분업 및 통일대비 의료제도 등 미래지향적인 과제에 대한 연구도 적극 수행해 나갈 것이라고.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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의료서비스와 건강보험 : 무엇이 왜 문제인가?

  • Choe, Gwang
    • Journal of the Korean hospital association
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    • v.31 no.3 s.277
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    • pp.14-19
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    • 2002
  • 우리 국민의 의료서비스에 대한 불만은 매우 높다. 더더욱 최근 건강보험의 통합과 관련한 정치권과 행정부의 정책혼선과 의약분업 정책에 의해 야기된 불안과 불만은 정권자체의 불신을 초래하는 단계에까지 이르고 있다. 혼선과 불만이 야기된 근본적 원인은 정책담당자들의 무지, 일부 학자들의 잘못된 이념적 선동, 그리고 일반국민의 허황된 기대에서 찾아진다. 이 과정에서 얻는 중요한 교훈은 어떠한 정책이든 뜨거운 가슴으로 되지 않으며 무엇보다도 냉철한 머리가 정책의 중심을 차지하여야 한다는 것이다.

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A Study on the Selection of Inducement Industry in Hinterland of Busan New Port - According to Analysis on the Structure in International Division of Labor among Korea, China and Japan and the Export-Import Structure of Busan Port against China and Japan - (부산 신항 배후단지 유치산업의 선정에 관한 연구 -한.중.일 국제분업구조와 부산항의 대 중.일 수출입구조 분석에 따른-)

  • Kim, Jeong-Su
    • Journal of Korea Port Economic Association
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    • v.25 no.4
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    • pp.107-130
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    • 2009
  • Future of Busan New Port may depend even on the efficient use of the port hinterland. Accordingly, selection of which industry according to which standard in the port hinterland is another task. In order to solve this problem, it analyzed the structure in international division of labor with China and Japan, which are possessing considerable portion in the trading volume with our country, and the export-import structure of Busan Port against China and Japan, by using RCA index and GL index as well as export-import results. In addition to this, the proper industry was selected on the basis of 10 strategic industries for development in Busan. According to the analytical results, the industries, which will be induced in the hinterland of Busan New Port, include textile clothing, pulp printing matter, jewelry, basic metal nonmetallic product, machine lectric product, automobile, shipbuilding, optics accurate machinery medical treatment musical instrument, nano material, fuel battery, aerospace and intelligent robot.

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