• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.88-104
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• 2002

According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

• The Korea Journal of Herbology
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• v.27 no.2
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• pp.1-16
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• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• The Journal of Korean Physical Therapy
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• v.15 no.1
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• pp.82-95
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• 2003

Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

• Journal of Nutrition and Health
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• v.45 no.5
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• pp.470-478
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• 2012

This study was conducted to investigate dietary factors, bone status, and bone loss in postmenopausal women in rural areas. A total of 189 women participated in the follow-up study after two years. Radius, Tibia, and Phalanx SOS (Speed of Sound) was measured on two occasions 2 years apart by ultra-sonic-metry, and % body fat was measured by bioelectrical impedance analysis at the baseline and after 2years. Dietary intake data were collected 4 times at different season by 24-hour recall method, and then calculated as average. Bone density of radius decreased by 4.2% during the two year period. When the subjects were divided into three groups, by bone decline level during two years, the lowest bone loss group had higher potassium and vegetable intake than other groups. Age and calcium intakes showed significant correlation with bone decline rate at tibia. In multiple regressions, the baseline SOS, vitamin A, vegetables and eggs intakes were found to be significant factors for tibia bone decline. In conclusion, dietary factors, such as higher vegetable intake, seem to affect the changes in bone mineral density in more favorable way. Therefore, efforts are needed to enhance the access to nutritional care for rural elderly postmenopausal women.

• Journal of the Korea Furniture Society
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• v.26 no.1
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• pp.77-91
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• 2015

The appeal of sauna is caused by the fact that through that, one can feel Korea's unique temperament and culture; however, because of its being a public facility and flooding of businesses due to excessive supplies of various additional features such as washing, playing, eating, sleeping and health care functions, issues of social resources and environment come to the fore, so it has reached a situation of red ocean that it is difficult to enter the market anymore. Taking these into account, this study focused on developing a thermal technology and design of the housing of an environment-friendly mobile home sauna, making the most use of the sauna's fundamental purpose and settling it as a tourist product, analyzing the marketing research on the existing sauna and considering the recent housing trends and lifestyles for a new concept sauna. Thus, regarding its characteristics and utilization, it was designed smaller than $10m^2$ (3 pyeong) so that it would be easy to install in any space and convenient to move. It can be installed in separate buildings and rest spaces such as country houses, resorts, pensions, camping grounds as well as outdoor houses, custom produced for a measure of pyeong that customers want so as to match up with the Enforcement Ordinance of the Agricultural Land Act in a concept of the farmer's hut and kitchen, bathroom and bathroom can be installed inside according to an option. In addition, regarding its efficacy, in order to give environment-friendly healing effects, materials such as Hinoki Cypress, red clay and hardwood charcoal were used, a fixed indoor temperature of $70{\sim}100^{\circ}C$ was maintained by heating methods such as electromagnetic wave free, energy saving and low-power boiler, and it was made to have excellent effects on fatigue recovery, relieving stress, skin care and diet through far-infrared emission.

• The Korean Journal of Pain
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• v.30 no.3
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• pp.183-191
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• 2017

Background: Current therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin was more for low-dose unit packs than that of the high-dose unit packs, raising the belief that these drugs are prescribed at a lower dose than is actually recommended in the guidelines. To test this hypothesis, a survey was conducted across speciality throughout the country to observe the prescription pattern of these drugs amongst the health care providers in India. Methods: Three hundred fifty survey forms were distributed of which 281 forms were included for analysis. Results: It was observed that the commonly used initiation and maintenance dose for amitriptyline, pregabalin, and gabapentin was 5-10 mg/day, 50-75 mg/day, and 100-300 mg/day, respectively. The reason to select the lower dosages was to have a balancing effect to achieve good efficacy with minimum side effects. Care-givers reported no side effects/not many side effects as a reason in 22.2%, 16.88%, and 23.86% patients with amitriptyline, pregabalin, and gabapentin, respectively. Sedation and giddiness were commonly reported with all three drugs. Conclusions: Commonly prescribed drugs for management of neuropathic pain, such as amitriptyline, pregabalin, and gabapentin are preferred at lower doses in Indian clinical settings. Acceptable efficacy and low tolerance to the standard dosage is believed to be the reason behind the prescribed dose.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.209-220
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• 2001

Objectives : The aim of this study was to investigate the attitude toward the oriental hospital among 100 pediatric outpatients. Methods : A questionnaire about the general characteristics of patients. the reason of choice or alteration was implemented. Results : 1. In distribution of sex & age, 60% was men and 40% women was between 2 and 6 years old. 2. In determinant factor for using Oriental medicine, 43.8% was tolerance increase of the western medicine and 33.0% was recommened by others. 3. In distribution of disease & therapeutic method, 62.5% was respiratory disease and 11.7% gastrointestinal disease, 64.3% was treated with oriental after Western medical therapy and 20.9% only Oriental medical care. 4. The changing causes for using Oriental after Western medicine, 35.9% was ineffective affect and 26.5% side effect. 5. The preference for using Oriental medicine, 41.6% was respiratory disease and 21.0% gastrointestinal disease. 6. The peculiarity of Oriental medicine compared with western medicine, 36% was effectiveness on the cronic disease and 14% for fundamental remedy. 7. The prodominance disease in Western medicine compared with Oriental medicine, 28% was operation, 18% common cold and 15% inflammatory disease 8. The questions about Oriental medicine, 22% was medical material's sanitation and place of origin, 18% harmness or not administered during long time. 9. The controversial point of Oriental medicine, 33.5% was expensive price and 27.7% difficulty of taking medicine. 10. In satisfaction degree of Oriental medicine, 69% was satisfied and 19% was very satisfied. Conclusions : Considering the above results, we have concluded that proper recognition about Oriental Pediatric medicine will be needed among patients.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.2
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• pp.25-32
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• 2018

Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

• The Journal of Korean Medicine
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• v.17 no.2 s.32
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• pp.34-47
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• 1996

We have seen a sharp increase in the utilization rate of medical services since the launch of Nation Health Insurance system in 1989. However, the market share of oriental medicine in the Korean health sector has been gradually diminished mainly due to low insurance coverage and high price. Especially high price as an entry barrier to oriental medical services has played a major role in decreasing market share. This paper investigated the effects of price discount on the financial condition and market share of oriental medical institutions. Microeconomic theory and multiple regression analysis were used as a methodology in testing the alternative hypothesis: price discount of enveloped herb drug will result in increases in both the revenue and market share of oriental medical institutions. Data was collected from the statistical yearbook and sample survey. The price elasticity of demand for enveloped herb drug was estimated at 5.8 during 1987-1995 period, which means that a 1% decrease in price will bring about a 5.8% increase in the utilization of oriental medical services. The empirical result shows that a drastic price discount for the enveloped herb drug will eventually improve the financial status of the oriental medical institutions and enlarge the market share of oriental medicine in the Korean health care sector.

• The Journal of the Convergence on Culture Technology
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• v.1 no.4
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• pp.87-101
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• 2015

This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.