• 대한한의학회지
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• 제32권2호
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• pp.79-91
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• 2011

Objectives: The purpose was to study the market of traditional Korean medical devices and survey, list and number medical devices in traditional Korean medical clinics. Methods: we researched in three ways. 1. We investigated the list of devices regarded as traditional Korean medical devices in 'Report on production, export, and import of medical devices.' 2. We investigated the statistics of medical devices equipped in traditional Korean medical clinics through the website of the Health Insurance Review & Assessment Service. 3. We surveyed medical devices in traditional Korean medical clinics by mail. Results: 1. We could not directly investigate the market for traditional Korean medical devices because they were not categorized as such ('traditional Korean medical devices'). 2. The number of medical devices in traditional Korean medical clinics has increased alongside the increase of traditional Korean medical clinics. 3. Traditional Korean medical clinics hold over 64,962 medical devices and have below 50 percent of traditional Korean medical diagnosis devices. 4. Meridian function testing machines, pulse diagnosis devices, and yangdorak showed ranking of equipment-ratio equal to ranking of insurance fees. Conclusions: Traditional Korean medical device regulations should be enacted following definitive and concrete Korean traditional medical concepts by the Korean traditional medical society.

• 대한한의학회지
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• 제30권5호
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• pp.127-136
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• 2009

Objective: This study aimed to analyze the current status of treatments and patients with diabetic peripheral neuropathy, and then map out of a strategy for development of generalized-treatments for diabetic peripheral neuropathy in Traditional Korean Medicine. Methods: We selected research materials from various databases such as PubMed, Google, KStudy, KoreanTK, OIM, KOMS and books. Also, to understand current tendencies of medical examination and treatment related with diabetic peripheral neuropathy, we requested Health Insurance Review and Assessment Service clinical data from 2003 to 2007. Results: It is reported that the incidence of diabetic peripheral neuropathy is increasing in an aging society. The medical fees of National Health Insurance related with diabetic peripheral neuropathy show a year-on-year increase. There are no particularly effective therapies for diabetic peripheral neuropathy in Western medicine, and in some papers, it was reported that treatment of diabetic peripheral neuropathy using Traditional Korean Medicine was effective. However, patients usually visit on Western medical center rather than seek Traditional Korean Medicine. To take charge of clinical fields related with diabetic peripheral neuropathy by Traditional Korean Medicine, we need more studies and experiments of diabetic peripheral neuropathy using Traditional Korean Medicine and should make a standardized protocol. Conclusion: Various studies related with diabetic peripheral neuropathy using Traditional Korean Medicine will have to be undertaken hereafter. We expect that Traditional Korean Medicine will play a vital role in treating of diabetic peripheral neuropathy.

• 보건행정학회지
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• 제17권3호
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• pp.1-25
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• 2007

Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

• 동의생리병리학회지
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• 제27권5호
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• pp.667-671
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• 2013

The aim of this study was to know the current management status in Korean medical clinics (KMC) and the awareness of Korean medicine doctor. The simple random extraction method from the membership list of 'The Association of Korean Medicine' in 2010 was used for survey. The questionnaire which had used in 2008 was revised, and those were sent to each KMC by mail. A total of 107 data were acquired and frequency analysis was conducted. The result showed that the annual average employees working in each KMC was 2.9 persons and the number of daily outpatient was 33.8 person in 2010. The proportion of sales covered by medical insurance at KMC has been increasing annually as 42.9%, 43.5%, and 44.8% of total sales, whereas the uninsured sales was 57.1%, 56.5%, and 55.2% of total sales in 2008, 2009, and 2010 respectively. All of the responders recognized that the current situation of Korean medical service market was not good and the reason was mainly resulted from undeveloped medical technique, popularized use of functional foods for health and alternative medical care by Western medicine. To expand Korean medical service, the expansion of sales covered by public health medical insurance, government support and advertizement for public relation were needed.

• 대한한의학회지
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• 제20권2호
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• pp.27-36
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• 1999

This study was performed to investigate the supply and demand of the oriental medical doctor(OMD) based on the supply and demand analysis of OMD up to the year 1997. The baseline projection and demographic methods were considered to examine the supply of OMD. On the contrary, for the demand analysis, two different approaches were conducted with the nonlinear regression model. The findings of this study indicate that the OMD will be oversupplied before the year 2012 with decreasing rate. However, when we consider the demand of OMD in the future. it is anticipated that the demand of oriental medicine will be increased rapidly with two major aspects. The first is the expansion of insurance benefits. The second is the increasing number of adult diseases because of the aging of the population structure. Therefore, the effective cooperation system and mutual exchange between western and oriental medicine is required for the future. Also. it is necessary to make the oriental medicine of the pharmaceutical services in more scientific way for the appropriate policy of the demand and supply of OMD. For the future study, the students who study abroad, especially China should be considered. These students will be the key element for the future supply of OMD.

• 한국병원경영학회지
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• 제3권1호
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• pp.34-61
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• 1998

A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

• 대한한의학회지
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• 제17권2호
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• pp.34-47
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• 1996

전국민의료보험제도가 실시된 이후 의료 서비스에 대한 수요는 외래 진료와 입원진 모두 현저한 상승 현상을 보여주고 있다. 그러나 이에 반해 한방의료에 대한 수요는 한방의료보험제도의 부분적 시행에도 불구하고 상대적으로 저조한 실정이며, 의료시장에서의 점유율도 점차 감소하고 있는 추세에 있다. 따라서 한방의료를 국민 속으로 널리 확산시키고 양방의료에 대한 대체 기능을 제고시키려면 소비자들이 보다 쉽게 한방의료에 접근할 수 있는 장치가 마련되어야 하며, 그 중에서 가장 핵심적인 요소는 한방의료의 가격을 적정한 수준으로 유지하는 것이다. 본고에서는 한방의료기관이 현재의 경영 상태를 유지하면서도 한방의료의 대중화를 촉진시킬 수 있는 한방의료의 적정 가격을 추계하여 제시하였다. 본 연구 결과에 의하면 한방의료의 가격탄력성은 약 5.8로 높게 나타나 가격이 하락할 때 한방의료에 대한 수요가 그 이상으로 증가할 것으로 예상되어 전체적으로 경영수지는 호전될 것으로 추계되었다. 첩약가의 인하가 한방의료기관의 경영수지에 미치는 영향을 분석한 결과에 의하면 한의사의 추가공급에 별다른 제한이 없는 경우, 가격탄력성이 6일 때 첩약가를 20%, 40%, 50%씩 인하하면 수입이 각각 76%, 104%, 100% 증가하는 것으로 추계되었다. 또 가격탄력성이 5인 경우에는 수입이 각각 60%, 80%, 75% 증가하고, 가격탄력성이 4인 경우에는 수입이 각각 44%, 56%, 50% 증가하는 것으로 추계되었다. 그리고 이윤율을 첩약가 인하 이전인 50% 수준으로 유지하고자 할 때 최대로 가능한 첩약가의 인하 폭을 산정한 결과, (i)가격탄력성이 현재와 같이 6인 경우에는 최대 가격인하율이 33.3%이며, 이 때 첩약의 이용량은 200% 증가하고 수입은 2배가 되는 것으로 나타난다. (ii)가격탄력성이 5인 경우에는 가격을 30% 인하할 때 지금과 같은 이윤을 누릴 수 있으며, 이 때 한의원의 수입은 75% 증가하는 것으로 추정된다. (iii)가격탄력성이 4일 때의 최대 가격인하율은 25%로서 이 경우에 수입은 50% 증가하는 것으로 추정된다.

• 대한한방부인과학회지
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• 제23권1호
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• pp.72-82
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• 2010

Purpose: This study was conducted to estimate the annual socioeconomic costs of menopausal syndrome treated with oriental medicine in Korea 2008. Methods: Study subjects selected were patients aged 40 years or older who had national health insurance(NHI) claims record with menopausal syndrome(KCDO codes: K04, K04.0, K04.2, K04.3, K04.4) for oriental medicine treatment in 2008. Direct medical cost of oriental medicine treatment for menopausal syndrome were measured from NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting hospitals. Indirect costs were defined as patients' productivity loss associated with office visits or hospitalization. Also, the costs of unpaid-household chores were calculated. Results: The total cost for the oriental medicine treatment of menopausal syndrome in the nation was estimated to be 743,091,219 Korean won(KRW) which included direct costs at 442,971,637 KRW and indirect costs at 300,119,583 KRW. Conclusion: This study provides an important perspective of socioecnomic influence due to menopausal syndrome treated with oriental medicine. And this results can be used as elementary data for menopausal syndrome-related health policy of oriental medicine.

• 대한예방한의학회지
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• 제21권3호
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• pp.29-42
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• 2017

Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the 'Programm Evaluation $Komplement{\ddot{a}}rmedizin$ (PEK)' and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and cost-effectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.

• 척추신경추나의학회지
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• 제11권1호
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• pp.53-64
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• 2016

Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.