Objectives : Health cooperative movement is of increasing concern among medical consumers and professionals in Korea. Most health cooperative clinics provide Western Medicine and Korean Medicine(KM) to patients. This study aimed to evaluate the primary care level of health cooperative KM clinics and compare it with local KM clinics in Korea. Methods : Face to face survey was performed at the 3 health cooperative KM clinics and 5 local KM clinics with the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of 5 domains (21 items): first contact (5), coordination function (3), comprehensiveness (4), family/community orientation (4), and personalized care (5). Subjects were patients or guardians who had visited KM clinics five times or more during the last 3 months. We compared primary care scores of each domain between health cooperative KM clinics and local KM clinics. Results : Data were collected from 200 respondents (100 patients from health cooperative KM clinics and 100 local KM clinics). Total average scores of the KPCAT for health cooperative clinics and local KM clinics were $81.1{\pm}12.0$ and $75.4{\pm}9.5$, respectively. Among primary care domains, personalized care was the highest ($89.2{\pm}12.0$, $89.6{\pm}8.4$, respectively), and comprehensiveness function was the lowest ($68.5{\pm}22.5$, $54.5{\pm}22.0$, respectively). Significant differences between two groups were noted in comprehensiveness function (68.5 vs. 54.5, P=0.000), family-community orientation (79.5 vs. 73.0, P=0.004), first contact(89.2 vs 84.0, p=0.001) and coordination function(74.0 vs 68.7, p=0.025). Conclusions : Based on the patients assessment, health cooperative KM clinics provide more primary care-oriented services than local KM clinics. This means that health cooperative clinic can be one of alternatives to strengthen the primary health care in Korea. Future researches are recommended to measure patients satisfaction and treatment effectiveness in the health cooperative clinics.
Objectives: To compare Korean medicine (KM) and traditional Chinese medicine (TCM) psychotherapy for anxiety. Methods: Databases including MEDLINE (via PubMed), EMBASE (via Elsevier), Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Oriental Medicine Advanced Searching Integrated System were comprehensively searched. Prospective clinical studies on KM or TCM psychotherapy for patients with anxiety disorder or individuals with elevated anxiety levels published up to August 3, 2022 were reviewed. Psychotherapy was divided into counselling, art therapy, and meditation according to its characteristics. Results: A total of 12 clinical studies were reviewed, including nine randomized controlled trials. The most common disorder investigated was post-traumatic stress disorder. Ten studies used TCM psychotherapy and two used KM psychotherapy. As for differences between TCM psychotherapy and KM psychotherapy, TCM psychotherapy utilized pattern identification in the procedure more actively than KM psychotherapy. In addition, some TCM studies have attempted to directly converge Western psychotherapy (i.e., hypnosis) and Eastern psychotherapy (i.e., Taoin qigong therapy). In the case of KM psychotherapy, there was an attempt to incorporate psychotherapy with Sasang constitutional medicine. Reported effects of TCM psychotherapy and KM psychotherapy on anxiety were positive. Conclusions: Research status of KM psychotherapy and TCM psychotherapy for anxiety was investigated, revealing some of their characteristics, commonalities, and differences. Findings of this review have the potential to provide a clue to the development of conventional KM psychotherapy and new medical technology for KM psychotherapy.
Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.
Objectives : The purpose of this study was to investigate the real status of the utilization of Korean medicine (KM) treatment among children with cerebral palsy (CP). Methods : In a prospective observational multicenter study for children with CP aged from 6 months to 78 months, we analyzed 69 questionnaires of children currently receiving or have received KM treatment such as acupuncture and Korean herbal medicine for CP. Results : Of all the 170 participants, 32 children was currently getting KM treatment and they were getting acupuncture therapy 2.5 times per week on average. The mean expenditure per month for acupuncture and herbal medicine was respectively 32,000won and 501,000won. 37 children have discontinued KM treatment. The most frequent reason for quitting acupuncture therapy was 'inconvenience' (40.7%), followed by 'suffering of children' (33.3%). The average duration of taking Korean herbal medicine was 3.78 months and the highest reason of stopping medicine was 'rejection of children' (32.3%), followed by the 'cost burden' (22.6%). 75% of currently KM using group answered they have experienced positive effect of KM and the rate was 48.6% among the group who have ceased KM. There was a significant difference between the two groups(p=0.025). Conclusions : Further study will be required to increase the therapeutic effect and utilization of KM among the children with CP. More efforts should be made to develop less invasive acupuncture method and various shape of KM herbal medicine and to expand the insurance coverage of KM for children with CP.
Objectives : The concurrent use of Korean Medicine (KM) and Western Medicine (WM) for the management of disease are increasing. In this study, the factors determining the choice of concurrent use of KM and WM was investigated based on national survey data for the public. Methods : Survey data from 1239 people with experience treating diseases with KM were utilized for this study. The national survey data were gathered using e-mail and face-to-face interviews between December 2007 and January 2008. Results : Among people who had been treated with KM, 819 (66%) used both KM and WM to the treat same disease. Multivariable analysis revealed that concurrent users of KM and WM were significantly associated with age 40-69 (OR=1.43, 95% CI=1.12-1.82), university education or higher (OR=1.34; 95% CI=1.05-1.71), enhanced health status (OR = 0.47, 95% CI=0.35-0.62) and unsatisfied with WM (OR = 1.71, 95% CI=1.02-2.87). The respondents that reported KM was more effective than WM among concurrent users of KM and WM were significantly associated with being an office worker (OR=1.78, 95% CI=1.25-2.53), age 40-69 (OR = 0.62, 95% CI=0.44-0.86), unsatisfied with WM (OR=2.61, 95% CI=1.51-4.50) and overall satisfied with KM (OR=8.38, 95% CI=5.65-12.44) Conclusions : This study showed that two-thirds of KM user were concurrent user of KM and WM, and some influential factors determined the choice of a concurrent use of KM and WM. Therefore, Korean Medicine Doctors should consider the possibility of concurrent use, need to know the information on the benefits and risks of concurrent use.
Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.
Objectives: The purpose of this study was to analyze the aspects of the Korean medicine (KM) treatment among children with cerebral palsy (CP) according to the disease characteristics. Methods: In a prospective observational multicenter study for children with CP, we analyzed 78 baseline questionnaires of children having experience of KM treatments such as acupuncture and Korean herbal medicine and 43 follow-up data of children who have received KM during the one observation year. Results: Of all the 182 participants, 38 children were currently getting KM treatment and 40 children have discontinued KM treatment. Children with non-spastic CP and more health problems tended to use KM. The most frequent reason for quitting acupuncture therapy was 'suffering of children' and the highest reason of stopping herbal medicine was 'rejection of children'. Among the 133 participants finished one year follow-up, 43 children have received at least one KM treatment. The average number of acupuncture therapy was twice a week and the average monthly cost of acupuncture therapy and herbal medicine were 65,922 won and 476,003 won, respectively. Children under 32 month old have received significantly more acupuncture and children with non-spastic CP have taken significantly more herbal medicine. Conclusions: Further study will be required to confirm the effectiveness of KM and increase the utilization of KM among the children with CP. More efforts should be made to increase the convenience of acupuncture therapy and herbal medicine and to expand the insurance coverage of KM for children with CP.
Objectives: The aim of this study was to identify the complementary and substitute relationships between the use of Korean medicine (KM) and that of Western medicine (WM) in the treatment of musculoskeletal disease. Methods: We analyzed the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. Logistic regression, negative binominal regression, and Tobit regression analysis were used to identify the relationships between the use of KM and the use, visit frequency, and expenses of WM, respectively. Results: In the treatment of musculoskeletal disease, KM use and non-herbal treatments with Korean medicine significantly reduced WM use. Herb medication use significantly increased WM visit frequency. There were no significant relationships between KM use and WM expenses. Conclusions: There are substitute relationships between WM use and KM use, especially non-herbal treatments in KM. Therefore we need to develop the clinical protocols of KM and WM treatments in the treatment of musculoskeletal disease for proper distribution medical resources.
Aims: This study aimed to analyze the tasks of Korean Medicine (KM) nurses. Methods: The definition and job description of KM nurses were developed through a "developing a curriculum" (DACUM) workshop. DACUM committee consisted of nine nurses from eleven Korean medicine hospitals, two DACUM facilitators and four DACUM coordinators. Twenty five nurses from nine Korean medicine hospitals validated job description established through the workshop. 235 KM nurses from 9 traditional Korean medicine hospitals participated in evaluating frequency, importance and difficulty of the duties and tasks. Questionnaires were sent to those nurses and 225 responses were included for final analysis due to missing data. The data were analyzed using descriptive statistics. Results: The jobs of a KM nurse were analyzed into 11 duties and 86 tasks on the DACUM chart. The 11 duties were KM nursing assessment, KM nursing intervention, fundamental nursing intervention, KM therapy management, support for KM therapy, KM nursing education, nursing administration, material management, environment management, professional development, and collaborative role between Korean medicine and Western medicine. Conclusion: We identified various roles of KM nurses and developed a DACUM chart based on their duties and tasks. Phased education programs for KM nurses should be developed by considering frequency, importance and difficulty. In addition, it is necessary to promote unique KM nursing interventions for expanding the roles of KM nurses in the future.
Objectives: This study was conducted to reflect the public's perspective when developing Korean Medicine (KM) Clinical Practice Guideline (CPG) for nausea and vomiting of pregnancy (NVP). Methods: 317 respondents who had experienced nausea and vomiting during current or past pregnancy completed the questionnaire online, and we analyzed their answers. Results: 1. 24% of all respondents had received KM treatment. The most common reason for choosing KM treatment was "it would be relatively safe for pregnant women and fetuses", and the reason for not choosing KM treatment was "they did not know much about it". 2. Respondents who had experienced KM treatment for NVP had felt the effects of KM treatment (79%), and chose herbal medicine as the most effective and preferred treatment. 3. 64.1% of respondents who had not experienced KM treatment for NVP preferred cooperative treatment with Western medicine. They answered that herbal medicine would be the most effective treatment, but preferred acupuncture. 4. The most important factor when treating NVP was "the safety of treatments". 59% of all respondents perceived KM treatment is safe for NVP. The treatments perceived as safest were herbal medicine and acupuncture, while the treatments with the least safety information were pharmacopuncture and electro-acupuncture. 5. Treatments that medical consumers were comprehensively interested in were acupuncture, KM treatment & Fluid, herbal medicine, moxibustion, and acupressure, in order. Conclusions: This study revealed the public's experience of using medical care, preference and perception of KM treatment for NVP. Therefore we would reflect the patients' clinical needs in the CPG.
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