• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1294-1302
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• 2019

Objective: Glucagon-like peptide 1 (GLP-1), one of the gut peptide hormones, has an action to induce satiety, and its effect as an anti-obesity agent is known. Recently, it has been reported that many herbal medicines have an anti-diabetic effect through inhibition of DPP-4 enzyme and inducing of GLP-1 secretion. It is therefore suggested that GLP-1 may be effective for the treatment of obesity. In this study, we report a case of male obese patients treated with herbal medicine as a GLP-1 secretagogue. Methods: In this study, the patient took a fixed prescription of herbal medicine for 10 weeks and recorded his weight at each visit. Results: This prescription produced significant weight loss (BMI loss>5%). In the follow-up period after two weeks, the trend of weight loss was observed continuously. Conclusion: This prescription can be an alternative to ephedra herba-based obesity treatment.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.115-120
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• 2016

Background: Azithromycin has broad spectrum and is effective to treat several bacterial respiratory tract infection. It is also relatively safe and tolerable to pediatric patient. Careful use of azithromycin is also required for the prescribers because it could cause cardiovascular toxicity (QTc prolongation) and ototoxicity. There has been no study on duration of azithromycin use in pediatric patients in Korea. Methods: The outpatient sample data on the azithromycin prescription was obtained from Korean health insurance review and assessment service. The characteristics of azithromycin prescription were analyzed with two different years (2011 and 2014). Results: Total 4,215 cases were analyzed. The azithromycin was prescribed the most frequently in the children (73.2% in 2011 and 62.5% in 2014) and for the condition of bronchopneumonia (28.7% in 2011 and 21.7% in 2014) in both years. The duration of prescribed for azithromycin has significantly different between 2011 and 2014. In 2014, 94.3% of prescription were indicated less than 5 days, but 86.6% were in 2011. Acute bronchiolitis and bronchopneumonia prescriptions more longer duration of treatment compared with acute bronchitis and others. Conclusion: The pattern of prescribing azithromycin has been changed for the treatment of several infectious diseases in pediatric patients. The rate of appropriate duration of azithromycin treatment has increased.

• Korean Journal of Clinical Pharmacy
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• v.29 no.1
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• pp.1-8
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• 2019

Background: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. Purpose: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. Method: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. Results: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. Conclusions: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1281-1289
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• 2018

Objectives: This study is the first report on a case of subclinical hypothyroidism treated with Modified Er-Xian Decoction, which is rarely used in Korea. Methods: Patients were treated for 3 months with Modified Er-Xian Decoction and their therapeutic effects were evaluated through thyroid function tests and Spleen-Kidney deficiency Questionnaire. Results: Initial improvement was apparent after the administration of Modified Er-Xian Decoction. After 3 months of treatment, the patient 's Spleen-Kidney deficiency index improved significantly, and thyroid hormone levels returned to normal. Conclusions: In this case report, symptoms and biochemical improvement were confirmed based on a single herbal medicine prescription for subclinical hypothyroidism. It is necessary to verify the effect of this prescription through well - established clinical trials.

• Journal of Korean Medical classics
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• v.36 no.2
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• pp.49-60
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• 2023

Objectives : This study aims to examine the 13 diagnostic criteria symptoms of panic disorder in Korean Medicine and to establish a literature basis for treating panic disorder in the clinical setting. Methods : Symptoms in Korean Medicine corresponding to each diagnostic criterion were comprehensively reviewed based on the Uihagimmun(醫學入門) and the Donguibogam(東醫寶鑑). Treatments were investigated as well. Results : According to Korean Medicine, panic disorder is believed to be caused by the stagnation of qi, leading to the retention of phlegm and fluids. Conclusions : Yijintang(二陳湯) can serve as a fundamental prescription for treating panic disorder, and it can be easily adapted to each patient's symptoms through modification of the ingredients.

• Journal of the Ergonomics Society of Korea
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• v.31 no.1
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• pp.93-100
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• 2012

Objective: This study is to review the current state of services offered to pharmacy users, and develop a service design converging a prescription service and a smart phone application service in order to enhance patients' experience at pharmacies and home. Background: Under the new medical system; separation of prescribing and dispensing drugs, a doctor writes a prescription to their patients and patients have their prescription filled at the pharmacy. As the number of flue, allergy and atopy patients has increased, waiting lines have been longer at pharmacies. Besides, the current medical service system lacks of providing proper information on prescribed pills to patients. There are already services offered during waiting times such as offering free drinks, magazines or suggesting general drugs which you can buy without prescription, however they neither cover the current medical service's shorts nor shorten the waiting time. Method: I researched objective and perceived waiting times reduction methods, the current service status at pharmacies, and the government's policy direction in a medical service. Also, I observed a patient's journey from the hospital to pharmacy and then home. I examined the circumstance at pharmacies, patients' behaviors and their thoughts during their journey, and extracted three main goals to design a service in order to help patients have positive perception during the waiting time; (1) to reduce the perceived time by the way of visualizing time and offering readings about what patients consider necessary, (2) to educate patients what they are into and how to get through, (3) to establish trust among patients, doctors and pharmacists. Based on three goals, I designed a structure and a wireframe for a new service application of smart phones. Results: With a new service design for pharmacy users, users can track their medical record and visit the information about their current medical treatments anytime. Also the service helps patients build reliable relationships with doctors and pharmacists. Conclusion: Experience is not just an activity but series of multiple activities. The serving range of a medical service should not be determined by stakeholders but user's holistic experience. By approaching a service design with a holistic vision, it can enrich not only a temporary experience but also a whole life well being. Application: Since there are already many service applications advising patients about their illness and finding right doctors, this service design is focused on the experience from getting a prescription till feeling better. The next move is to combine those two parts medical services and design an integrated service application. As a prescription is going to be coded in numbers, we might consider to design an un-attended pharmacy which can shorten huge amount of time for filling prescriptions.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.263-302
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• 2014

The court handed down meaningful rulings related to medical sectors in 2013. This paper presents the ruling that the care workers could be the performance assistants of the care-giving service although the duties of care worker are not included in the liability stipulated in the medical contract signed with the hospital for reason of clear distinction of duties between care workers and nurses within the hospital in connection with the contract which was entered into between the hospital and patients. In relation to negligence and causal relationship, the court recognized medical negligence associated with the failure to detect the brain tumor due to the negligent interpretation of MRI findings while rejecting the causal relationship with consequential cerebral hemorrhage. The court also recognized negligence based on the observation on the grounds of inadequate medical records in a case involving the hypoxic brain damage caused during the cosmetic surgery. In terms of the scope of compensation for damages, this paper presents the ruling that the compensation should be estimated based on causal relationship only in case the breach of the 'obligation of explanation' is recognized, however rejecting the reparation for de factor property damages in the form of compensation, and the ruling that the lawsuit could be instituted in case that the damages exceeded the agreed scope despite the agreement that the hospital would not be held responsible for any aftereffects of surgery from the standpoint of lawsuit, along with the ruling that recognized the daily net income by reflecting the unique circumstances faced by individual students of Korean National Police University and artists of Western painting. Many rulings were handed down with respect to medical certificate, prescription, etc., in 2013. This paper introduced the ruling which mentioned the scope of medical certificate, the ruling that related to whether the diagnosis over the phone at the issuance of prescription could constitute the direct diagnosis of patient, along with the ruling that required the medical certificate to be generated in the name of doctor who diagnosed the patients, and the ruling which proclaimed that it would constitute the breach of Medical Act if the prescription was issued to the patients who were not diagnosed. Moreover, this paper also introduced the ruling that related to whether the National Health Insurance Service could make claim to the hospitals for the reimbursement of the health insurance money paid to pharmacies based on the prescription in the event that the hospitals provided prescription of drugs to outpatients in violation of the laws and regulations.

• The Korean Society of Law and Medicine
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• v.10 no.1
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• pp.171-211
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• 2009

Because Korea has the excellent informational technology, it was expected to be able to improve the accessibility to healthcare and compete with other nations in excellence through u-Healthcare. But we can't complete the excellent u-Healthcare because of the law to be able to use only the tele-counselling between doctor to doctor or doctor to nurse. First of all, we must complete the law to be able to use the improved u-Health containing of telemedicine between doctor to patient. Though other factors, the procurement of safe IT, the credibility to healthcare service provider containing of nutritionist and occupational therapist etc. are prepared for erecting u-Healthcare, we can get the final and decisive u-Health policy only by means of Law for supporting u-Healthcare's Activation. The important sections of Law for supporting u-Healthcare's Activation are as follows. Sec. 4 The Minister for Health, Welfare and Family Affairs and the dean of associated administrative division have to erect the combined plan for u-Healthcare's Activation. Sec. 11 Government and local autonomous entity can support the facility and equipment to be necessitated for using u-Healthcare to improve the medical accessibility of person in the region with poor medicine. Sec. 13 Doctor can support other doctor's medical action through IT and if there are not medical risk, doctor can give medical act directly to the special patients. Sec. 21 If pharmaceuticals is necessitated in u-Healthcare, remote doctor has to send the patient the electronic prescription and the pharmaceutist to receive the electronic prescription has to delivery the pharmaceuticals in accordance with patient's demand.

• Journal of Korean Society for Quality Management
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• v.46 no.3
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• pp.539-550
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• 2018

Purpose: The purpose of this study was to find meaningful patient groups of disease using foreign patients data and analyze implemented test of the patient groups. Methods: The data was collected by foreign patients' EMR data of K university hospital. The author proposed tree-form patients' characteristic diagram through statistical methods that association rule, proportion test, clustering using prescription information and questionnaire information. Results: This study's analysis process was applied high blood data and diabetes data. Analysis showed other characteristic of meaningful patient groups in high blood and diabetes. In high blood, test implementation rate of patient group showed the differences. And in diabetes, test implementation rate of patient group and implemented test list showed differences. Conclusion: The result of this study can play a role as basic data that can be clinical testing standard in preventive aspect. Eventually, 5 dimensions of SERVQUAL will be improved by this study's process.