• 보건행정학회지
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• 제5권1호
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• pp.31-58
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• 1995

The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

• BMB Reports
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• 제46권1호
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• pp.17-24
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• 2013

Transcutaneous immunization refers to the topical application of antigens onto the epidermis. Transcutaneous immunization targeting the Langerhans cells of the skin has received much attention due to its safe, needle-free, and noninvasive antigen delivery. The skin has important immunological functions with unique roles for antigen-presenting cells such as epidermal Langerhans cells and dermal dendritic cells. In recent years, novel vaccine delivery strategies have continually been developed; however, transcutaneous immunization has not yet been fully exploited due to the penetration barrier represented by the stratum corneum, which inhibits the transport of antigens and adjuvants. Herein we review recent achievements in transcutaneous immunization, focusing on the various strategies for the enhancement of antigen delivery and vaccination efficacy.

• 보건행정학회지
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• 제30권3호
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• 산업진흥연구
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• 제1권1호
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• pp.79-89
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• 2016

본 연구는 사회복지의 발전추세에 따라 향후 공적 사회복지 전달체계가 더욱 중요함을 인식하고 여기에 나타난 조직운영 상의 실태분석을 통해 극복요인을 파악하고자 하였다. 극복요인으로는, 첫째, 전달체계의 속성에 대한 극복이다. 둘째, 업무의 비효율성에 대한 극복이다. 셋째, 전달체계 및 인력상의 부조화에 대한 극복이다. 넷째, 사회복지통합관리망의 관리부실에 대한 극복이다. 결론적으로 본 연구를 통해 위와 같은 극복요인이 해결될 때 비로소 공적 사회복지 전달체계가 원활히 이루어질 수 있음을 알 수 있다.

• 한국임상수의학회지
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• 제36권4호
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• pp.212-218
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• 2019

This study evaluates the drug delivery and biocompatibility of latanoprost imbedded disk in rabbit eye by assessing pharmacokinetics (PK), clinical signs, and histopathologic findings. During 84 days of experimental period, 48 New Zealand Rabbit (NZW) eyes were divided into control group which received no treatment and test material group which latanoprost were implanted intrasclerally. Pharmacokinetic assessment was performed to evaluate the drug delivery for 3 months. For biocompatibility, clinical signs were observed and histopathological analysis was done at 3 months post-operatively. The concentration of latanoprost in the iris tissue was maintained during the experimental period and the highest level of latanoprost was found at 4 weeks. However, the latanoprost was not found in the aqueous humor. Macroscopically, there was no evidence of clinical signs except for temporary hyperemia, neovascularization and edema immediately after surgery. On histopathological examination, there were no abnormal findings such as hyperemia, neovascularization, and edema in the eye tissues. The latanoprost imbedded disks has effectively released the drug into the adjacent tissue with high compatibility. Therefore, this study suggests that the drug delivery system with intrascleral latanoprost imbedded implants might be a novel approach as a treatment option for glaucoma.

• 한국사회복지학
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• 제47권
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• pp.107-147
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• 2001

In the 1990s, with enacting of the laws on the family violence in Korea, agencies such as helpline 1366, counseling center and shelter for the female victims have been rapidly increasing in number. Also police and medical center have been viewed as having major responsibility for delivering services and social workers in community welfare center and public social worker have been expected play a role in community-based delivery systems for the female victims. The purpose of this study is to measure the level of the inter agency coordination and to find out the factors affecting the inter-agency coordination in family violence and to make policy implications for a better delivery system. The data were obtained from a social survey of family violence agencies, counselling center/shelter/helpline 1366, police, medical center, social workers of community center and of public sector in Seoul and Kyeongi area. The major results are as follows: 1) the level of inter-agency coordination is low, specially the referal cases of police and medical center is very poor. 2) The type of inter-agency coordination is referals and information sharing among agencies. 3) the factors affecting inter-agency coordination is agency type, wills and efforts of agency, information sharing, experience of family violence education. The current findings suggest that the delivery system to promote inter-agency coordination efforts and for police and medical center, social worker in private and public agency to respond promptly and properly would be built up.

• 대한임상독성학회지
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• 제11권1호
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• pp.9-18
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• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

• 한국한의학연구원논문집
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• 제12권3호통권18호
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• pp.31-47
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• 2006

Nowadays Korean governments use Information Technology to improve the quality of life for a people. One of these tries is building the Food Tracing System based on Information Technology. Koreans have big concern about food that is good for health. The Food Tracing System means that the system can follows, traces, and records every steps of production and delivery of food and its ingredient. And this process should be identified and grouped by using tags, marks, and other methods. For example, producer of ingredient, processing steps of food, delivered place could be traced. In addition to food, medical herbs need consumer's trust in production and delivery. To trace and prosecute contaminated medical herbs, medical herbs also need this kind of Tracing System based on Information Technology. This study shows current medical herbs tracing ways and RFID(Radio Frequency IDentification) technology trend. As preceding study for future RFID based medical herbs tracing system, this study suggests the building plan and scenario of the Medical Herbs Tracing System. The determination of the main body for sticking RFID Tags is very important to design for RFID Traceability System. In this study, the starting point of information to medical herbs is an inspection agency. The Medical Herbs to product domestically or import moved to an inspection agency. An inspection agency bond the RFID Tags to packing of the Medical Herbs after examining the a basic its component. At the same time inspector give the information of production or importation to the Tags. This Tags are moved for logistical process to end point, the Korean medicine agency. The customer confirmed the traceability and certification information of the Medical Herbs. For success tracing of medical herbs, institutional support and close cooperation between related organizations is necessary besides good system design.

• 대한한방내과학회지
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• 제21권5호
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• pp.883-887
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• 2000

A clinical study was carried out 1 case of ischemic cerebrovascular accident which occurred at puerperium in a 27 year-old woman followed by vaginal delivery The results were as follows: 1. In the clinical view, it was thought that the cause of this case is intracranial venous thrombus, because the symptom-headache, foaming at the mouse, acromyotonia, hemiparesis- occurred in the postpartum and functional outcome is good. 2. In this case, the patient's functional system of spleen-stomach is usually weak, and due to delivery the functional system of spleen-stomach is more insufficient. so it can not control damp-phlegm(濕痰). In addition, vital energy of liver stagnate.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권1호
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• pp.37-46
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• 2017

Purpose: There is little information about China's medical service system and health care facilities in Korean medical architecture papers, which is inconvenient for scholars engaged in medical building research and comparison. Futhermore, the transformation of the notion of health and the ascension of the service needs show the lack of medical function, and then make functions of hospital construction are always in the state of dynamic renewal. Therefore, the purpose of this study is to analyze the Chinese medical service system and general hospital related laws and regulations for future research to provide effective analysis of data, and find shortcomings. Methods: This study was conducted by a research on law and regulation of China's medical service system and general Hospital. Results: At present hospital construction in China is in the period of rapid development and it exposes the layout of medical health facilities is not reasonable and the service does not reach the designated position and so on. Overall, it requires more detailed guidelines to enhance the quality of medical health services. Implications: It is expected that the research of this paper will provide effective reference for future research on Chinese medical architecture system and medical facilities, and can promote and perfect the construction of Chinese medical architecture theory system.