• 보건행정학회지
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• 제23권2호
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• pp.188-195
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• 2013

Background: The separation of pharmaceutical prescription and dispensing law was implemented in July 1st of 2000. This law was initiated by government without a through consensus among related stakeholders in the process of policy decision, eventually raising contention about decision making process rather than the performance of the policy. Methods: Therefore, this study tries to identify the accomplishment of the policy goals; based on the last decade's research we assessed inhibition of unnecessary prescription, drug misuse and overuse prevention, prevention of drug-related sentinel events, reducing unnecessary drug utilization, and reducing nation's medical cost. Results: Assessment results represent that government-suggested goal of the policy lacks sufficient evidence to evaluate accomplishment. Conclusion: Unlike other studies that evaluate problems regarding drug dispensing policy in the policy decision process, this study is meaningful in that it evaluated the policy goal based on the last ten years of related study results.

• 보건행정학회지
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• 제12권3호
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• pp.23-35
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• 2002

Fiscal crisis in the medical insurance system has put the pressure upon hospitals by increasing the rate of curtailment, since the implementation of the separation of prescription and dispensing of medicine. The purpose of this study is to analyse the curtailment of mdical and drug expenditure before and after the system of separation between prescribing and dispensing and to suggest the problems about current inspection system. Data were obtained from 13 general hospitals and used for analysis of trends on medical & drug expenditure, and curtailment in 1999-2000 at three months intervals. The results were as follows; The scale of curtailment for drug expenditure has been increased on outpatient and inpatient since 2000. For the curtailed drug cost with outpatient, the ratio of curtailed drug expenditure has been increased in the case of prescription within the hospital. These results suggest that review system in social insurance were over-focused to control the cost and it might to impede the validity of review function in insurance system. Therefore, it' s needed to develope the scientific and reasonable criteria for Inspection and evaluation of durg expenditure.

• 한국병원경영학회지
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• 제8권1호
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• pp.64-80
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• 2003

The separation policy of prescription and drug dispensing which has been implemented since the 1st of July, 2000, has brought about great changes in patients flow within the healthcare delivery system. The changes in the patients flow, in turn, resulted in the change in the distribution of financial resources among the participating entities in the healthcare delivery system: pharmacies, clinics, small hospitals, general hospitals, and teaching hospitals. The purpose of this study is to shed some light in the change in the financial performance of teaching hospitals under the separation policy that has created environmental changes such as the decrease in the number of out patients visits, the increase in the capital expenditures, the rapid increase in labor costs and so on. For the purpose, this study has compared and analyzed the balance sheets, the income statements and other operational data of three teaching hospitals located in D area. The data include two periods: before(year 1999) and after(year 2001) the implementation of the separation policy. The analysis was conducted with an emphasis on the changes in the financial ratios such as liquidity, turnover ratio, performance ratio. and capitalization ratio. The results show that the financial performances of the hospitals under study were weaker than before the implementation of the separation policy, and that, while the operating expenses have increased remarkably, there was no tendency to corresponding increase in revenue. And the result of analysis of other operational indicators also show that the performance of the hospitals is getting worse. Based on the results, this study has suggested the directions of the healthcare policies. This study suggests to improve the current model of separation of prescription and drug dispensing, to grant subsidies for the training of residents in teaching hospitals, and to lower the rate of patients' out of porket payment in teaching hospitals.

• 보건행정학회지
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• 제11권4호
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• pp.88-108
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• 2001

Separation of prescribing and dispensing practice in Korea has changed the service pattern of the pharmacy. The prescription dispensing activities, however, are concentrated excessively on the pharmacies near hospitals or clinics. Thus this study was conducted to estimate the number of optimal dispensing cases for the community pharmacy. Forty-six pharmacies were selected using systematic stratified random sampling method, and ninety-five pharmacists were interviewed on their workload of dispensing and other activities at pharmacies. One hundred and seventy prescriptions were chosen based on the length of drug administration and drug dosage form, and the dispensing time was measured by time-watch method. Also pharmacy benefit claims data were analyzed to identify the characteristics of the pharmacies which performed more than optimal dispensing cases. According to the study results, the average work time per pharmacist per day was found to be 10hours 32minutes and the dispensing activities occupied 7hours 36minutes. It took 5.72minutes on average for each dispensing case. The optimal dispensing case was estimated as 75 cases under the condition of 10hours 32minutes work time and 6% allowance rate. Even though the pharmacies near hospitals or clinics participated dispensing services actively, only pharmacies near clinics dealt with more than optimal dispensing cases. For the pharmacies near hospitals they dealt with less than optimal cases, but drug administration period per prescription was almost 3 times longer than that of pharmacies near clinics. Thus the intensity of dispensing activities such as drug administration period is to be considered to estimate optimal dispensing cases more accurately.

• 한국병원경영학회지
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• 제7권4호
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• pp.102-122
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• 2002

It has been 2 years since the implementation of the separation policy of drug prescription and dispensing. This study analyzes the changes in community pharmacy operation after the implementation of the policy. The main purposes of the analysis are to determine whether the changes in community pharmacy operation have occurred and to evaluate that the changes are consistent with the intention of the policy, if the changes actually have occurred. For the study a survey on 961 pharmacies chosen by stratified sampling method has been performed. Of the 961 sample pharmacies, 438 pharmacies were responded resulting 45.6% response rate. The sample pharmacies are classified by the location that the pharmacy are operating: the pharmacies around large size hospitals, the pharmacies around clinics or medium to small size hospitals and the pharmacies with no hospitals or clinics around. Based on the classification, the number of pharmacies, number of prescriptions processed, the personnel structure, the changes in facility, and other operational characteristics are compared. The results showed that the pharmacies were tended to concentrate around hospitals and clinic since the implementation of the policy. The number of pharmacists per pharmacy was increased, the size of pharmacy was increased and the facilities were improved to accomodate the requirements of the policy. The work hours a pharmacist spent on dispensing drug have increased almost twice, however, there was no corresponding increase in the time spent on patient education and medication history management, indicating a problem in the provision of quality pharmaceutical services. Based on the results, suggestions to minimize the negative effects of the policy are provided.

• 약학회지
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• 제52권6호
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• pp.507-513
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• 2008

The purpose of this study is to analyze the factors affecting financial performance of community pharmacies after the implementation of the new drug policy in Korea: separation of drug prescription and dispensing (SPD). The online survey questionnaires were sent to the active pharmacists of the total 20,633 community pharmacies in Korea and 1,147 pharmacists responded to the survey (the response rate was 5.5%). The questionnaire asked simple financial data in order to compare their financial performances before and after the policy. With the SPSS package (version 12.0), two levels of data analysis were used: 1) descriptive statistics to see the financial status of the pharmacies; and 2) multiple regression analysis to find the factors. {or A multiple regression method was used for the data analysis.} The finding illustrated that the average net benefit of the pharmacies was 4,870 thousand won in August 2006, and the major factors affecting the net benefit were the location of pharmacy (geographical proximity to medical institutions), number of prescriptions, drug management services for patients, chain pharmacy membership. The findings of this study suggest that service improvement for patients, revitalization of non-prescription drug sales, professional management will contribute to promote community based pharmacy business.

• 한국병원경영학회지
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• 제8권3호
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• pp.118-142
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• 2003

This study is aimed at evaluating the financial structure of hospitals before and after the separation of prescription and drug dispensing policy started to be implemented in July 2000 and at making a suitable hospital managerial strategy through the verification of the factors which have effect on their profitability. This study investigated the hospitals which have passed the accredition review to be designated as a accredited training hospital each year for three years from 1999 to 2001. Those hospitals were selected from members of the Korea Hospital Association. 106 hospitals were targeted for analysis except for the hospitals whose financial statements and managerial performance were not reported faithfully. The financial indicators used in this study were stability indicators(liability to total assets, ratio of debt to fund balance, fixed ratio), liquidity indicators(current ratio, quick ratio), activity indicators(total assets turnover, fixed assets turnover), profitability indicators(net profit to total assets, net profit to net worth, operating margin), and operating expenses to patient revenues indicators(drug and supplies costs/payroll/overhead expenses). The result of this study are as follows: First, the analysis of the increase of loss-making hospitals before and after. The separation of prescription and drug dispensing policy shows that the number of loss-making hospitals increase after the separation(22.6% before the separation; 31.1% after the separation). However, there was no significant statistical difference. Second, the analysis of operating expenses to patient revenues indicators showed that the ratio of drug and supplies cost became lower in all hospitals but the ratio of payroll/overhead expenses became higher. Additionally, the factor which have the greatest effect on profitability was operating expenses to patient revenues indicators (drug and supplies costs/payroll/overhead expenses). Third, the analysis of managerial performance by four types of loss-loss, loss-profit, profit-loss and profit-profit compared the results before the separation with those after the separation revealed as follows : Reliance on liability to total assets became higher in the profit-loss type($56.2%{\rightarrow}66.4%$), lower in the loss-profit type($82.7%{\rightarrow}74.5%$). Total assets turnover became higher in the profit-profit type($1.3{\rightarrow}1.5$), but lower in the loss-profit type($0.8{\rightarrow}0.7$). Operating margin decreased to minus 5.9% from 4.3% in the profit-loss type, but increased to 7.2% from minus 7.8% in the loss-profit type. Forth, operating expenses to revenues indicators showed that the increase of payroll was the biggest in the profit-loss type($39.2%{\rightarrow}49.9%$) and that overhead cost decreased in the loss-profit type but that rather increased in other types.

• 한국병원경영학회지
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• 제7권2호
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• pp.37-51
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• 2002

It has been 2 years since the implementation of the separation of prescription and drug dispensing policy. This study analyzes the effects of the policy on the job contents and personnel structure of hospital pharmacy. The main purposes of the analysis are to determine if the policy has causes the increase of professional activities of pharmacists in hospital and to investigate whether the hospital pharmacy is equipped with enough manpower to provide high quality pharmaceutical service as intended by the policy. The level of professionality of pharmacists' activities is measured by the number of activities of direct involvement in inpatient care such as participation in patient rounding, medication consultation, the number of hospital committee the pharmacists involved and the number of continuous education pharmacists took. The adequacy of personnel structure to provide high quality pharmaceutical care is measured by the level of compliance to the governmental standard of hospital pharmacy personnel. In order to collect the data, surveys were performed for two periods: year 1999 (before the implementation of the policy) and year 2001 (after the implementation of the policy). The results show that the pharmacists' participation in inpatient rounding decreased and that the inpatient medication history management activities, operation of ward pharmacy, participation in hospital committee increased. In personnel structure, the average number of pharmacist per hospital decreased and the number of prescription processing per pharmacist increased. Based on the results this study concludes that the professional activities of hospital pharmacists has increased a little and there were structural changes in hospital pharmacy service activities to increase the professionalism in providing care. However, the pharmacy departments were understaffed hampering the strive to increase the provision of professional pharmaceutical service in hospitals.

• 보건행정학회지
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• 제11권4호
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• pp.70-87
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• 2001

The purpose of this study was to identify health care providers' perceptions about the goal achievement and benefit/loss caused by the separation policy of drug prescribing and dispensing after the policy implemented on July 1, 2001. Uslng stratified sampling method based on the administration area, Ku, 315 physicians and pharmacists were sampled from the rosters of physician and pharmacist association in the city of Busan on 2001. There were 122 and 115 responses from physician and pharmacist sample, respectively. 78.3% of physicians and 50.4% of pharmacists evaluated that the goal of the policy was not achieved. Moreover, 75.3% of physicians and 40.7% of pharmacists did not support the policy. Most physicians and pharmacists considered preventing the citizens with drug abuse and misuses as the most important benefit derived from the policy. However, physicians and pharmacists concerned over raising health care cost that could be patients' burden. The most important physicians' benefit derived from the policy was free choice of all possible medicine that might result in effectiveness of medication. In physicians' the most important loss, most physicians worried about that breaking traditional patient and physician relationship might cause physicians' authority in treating diseases to be damaged. Pharmacists considered the most important policy benefit as hiked social status resulted from enforcement of profession due to the policy whereas they considered the most significant loss as expected financial problems of small pharmacies compared to that of large pharmacies or pharmacies adjacent to hospitals. In the current problems of the policy, physician and pharmacists blamed the government for inadequate preparations of the policy implementation. Physicians and pharmacists also considered citizens' mature attitudes toward the policy as a crucial success factor.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.224-225
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• 2002