This study analyzes the effect of separation of dispensary from medical practice on hospital management performance. The results are as follow. The earning ratios of large size hospitals become deteriorated significantly after the separation of dispensary. The growth ratios of revenues from inpatient were unchanged, but the growth ratios of revenues from outpatient of large and middle size hospitals were decreased significantly. Hospitals can't sell the medicines to the outpatient after the separation of dispensary, but they can do to the outpatient. The labor cost ratios of small and large size hospitals are increased significantly after the separation of dispensary. There are two reasons for increase of labor cost ratios. One is the decrease of material cost ratio. The other is the increase of doctor's salary. The material cost ratios of every size hospital are decreased significantly after the separation of dispensary. Because medicines costs of outpatients are decreased. The labor cost and doctors' salary per patient of middle and large size hospitals are increased significantly after the separation of dispensary. And average treatment fees per day of inpatients of middle and large size hospitals are increased significantly after the separation of dispensary. But those of outpatients are decreased significantly. Average numbers of outpatients per bed of small and large hospitals are decreased significantly after the separation of dispensary. And average numbers of inpatients per bed of large hospitals are decreased significantly. In summary, as a consequence of separation of dispensary from medical practice, management performances of large size hospitals become deteriorated significantly.
Although there have been studies regarding the separating policy of dispensary and medical practice, little study have provided a concrete empirical evidence to what extent the policy objectives are achieved. In this paper, we try to provide empirical evidence whether the policy separating dispensary from medical practice achieved the policy objectives, which representatively are reducing the mis-use or over-use of anti-biotic prescriptions and medicines, and decreasing the government spending for the cost of pharmaceutical support. By comparing the average of the rate of change of the number of medicines prescribed, the rate of anti-biotics prescribed, and the government spending for the cost of pharmaceutical support between the areas where the separation policy was implemented and the exceptional areas, we concluded that it is difficult to conclude that the policy separating dispensary and medical practice achieved its policy objects, as it first announced to achieve in the introduction of the policy in 2000. However, the limitation of this study is that the data, that can thoroughly analyze the effect of separating policy of dispensary from medical practice, cannot be collected as expected. Hence, we could not use a parsimonious empirical model to evaluate the effect of the policy introduced in 2000. Rather we used a simple statistical method to extract enough empirical evidence fro m the data available. In the near future, we would expect to see more research that analyze the exact effect of policy separating dispensary and medical practice with concrete empirical model using more sophisticated dataset.
Kim, Kwang-Myo;Kim, Bo-Ri;Lee, Jeong-Seon;Han, Ok-Yeon;Park, Mi-Sun;Yim, Hyeon-Woo;La, Hyen-O;Park, Young-Min
Korean Journal of Clinical Pharmacy
/
v.21
no.2
/
pp.161-169
/
2011
The purpose of this study is to survey on the pharmacists' medication teaching service for topical steroids in regions without separation of dispensary from medical practice. The questionnaire was sent to 199 pharmacists who work inregions without separation of dispensary from medical practice via mail, e-mail or fax. 112 out of 199 pharmacists requested have answered the survey (response rate 56.28%). The questionnaire was composed of 4 categories with demographic characteristics, generally explained contents, adverse effects and precaution in pregnancy, breastfeeding and children. We analyzed the questionnaire by the 6 items with reference to the practical guidelines for medication teaching service. The medication teaching service for topical steroids in terms of generic name, physical characteristics, efficacy, usage and dosage, warning and precaution has been well provided by pharmacists in regions without separation of dispensary except for means and duration of optimal storage. The majority of pharmacists provided their patients with 4 and more kinds of items (69.64%), but the generally recommended 4 kinds of items such as generic name, efficacy, usage and dosage, warning and precaution were provided in as low as 48.22% of the respondents. These results show that the medication teaching service for topical steroids in terms of means and duration of optimal storage (45.54%) and the generally recommended 4 kinds of items have not been enough provided by pharmacists in regions without separation of dispensary. Taken together pharmacists in these regions should make a proper guideline for medication teaching service that can prevent the adverse effects of topical steroids.
Proceedings of the Korean Institute of Interior Design Conference
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2004.05a
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pp.95-99
/
2004
The purpose of this study was to provide basic data for better design of Pharmacy after introducing the new system of separation of dispensing from prescribing medicine. To analyze characteristics of interior design in pharmacy and measure workers' satisfaction, a questionnaire survey was conducted with 255 workers who serve at any Pharmacies located in Busan, Korea. For data analysis, descriptive statistics, t-test, One-way ANOVA were performed with the SPSS Win program(Ver. 10.0). The satisfaction level of working environment was a little higher then an average. In terms of an area, an entrance was the highest, and dispensary was the lowest. Compared to the result of working time in the dispensary, it is necessary to study more about dispensary design for workers.
This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.
The purpose of this study was to provide basic data for better design of Pharmacy after introducing the new system of separation of dispensing from prescribing medicine. To analyze characteristics of interior design in pharmacy and to measure worker satisfaction, a survey was conducted with 255 workers who serve at any Pharmacies located in Busan, Korea. For data analysis, descriptive statistics, t-test, One-way ANOV A were performed with the SPSS Win program(Ver. 10.0). The major findings were as follows: 1) As a result of analyzing the role and functions of the pharmacist is to be classified into many items such as entrance, a waiting room, a dispensary, a medication & consultation area, a drug storage and a worker's room. 2) Natural substances should be used more widely instead of using chemical substances for the pharmacy interior design as finishing materials 3) Pharmacy worker's satisfaction with dispensary is specially low among the total satisfaction which is :slightly higher than the average. 4) The degree of satisfaction between pharmacy workers from different groups varied depending on work hours, and especially long time(over 10hrs) workers showed dissatisfaction. Pharmacy managers need to consider the option of expanding convenience facilities. 5) According to the satisfaction analysis for each pharmacy conditions, the group who worked in 30-pyeong spaces were most satisfied. Since the 30-pyeong space is most standardized space research should be conducted.
Objectives: Korea has been practicing the separation of dispensary from medical practice since 2000 as a national policy to prevent misuse or overuse of medicines. This study aimed to investigate prescription patterns from except pharmacies in order to determine the appropriateness of drug usage among those patients. Methods: Thirty-two pharmacies in the Yeongdong area of Gangwon Province were examined in this study. The same simulated patient complaining of cold symptoms for 3 days visited each pharmacy to obtain a prescription for medication. Results: At pharmacies prescribing medicine, steroids (53.1%) and antibiotics (50.0%) were used to treat the common cold. Duplicate prescriptions of drugs, such as antihistamines (47.0%) and decongestants (31.3%) were common. The average number of drug prescriptions was 6.59, and 53.2% of pharmacies had prescribed more than seven drugs. The average total cost of the prescriptions was 6,093 won, and the daily cost was 2,544 won. Conclusions: Steroids and antibiotics were frequently abused among patients whose medications had been prescribed by pharmacies. Also, there were a considerable number of drugs and duplicate prescriptions. The prices of the drugs were somewhat high.
Based on a previous literature about hospital capital structure(Shyam- Sunder & Myers, 1999), this study attempted comparison and analysis on whether the forecast of trade-off and pecking order theory could be validated in hospital's capital structure. First, this study analyzed whether hospitals follow the priority for each capital source as suggested by pecking order theory under lack of capital running in hospital. Next, it analyzed whether debt level is regressed on the average to target debt level so as to verify the validity of trade-off theory. Finally, it also analyzed possible associations between debt level and determinants of capital structure as adopted in static trade-off theory, so as to verify relative advantages of these two theories about hospital capital structure. The analysis over whole period showed that both trade-off theory and pecking order theory isn't supported particularly. This mean that each hospital's financing behaviors is different and that has not dominant financing behaviors. In the midst of separation of dispensary from medical practice, medical institutions in Korea first finances funds required using retained earnings and then use liabilities. however pecking order theory is supported, the preference of long-term liabilities and short-term liabilities is not clear. In addition, considering that debt level is in no average regression to target debt ratio, it is found that hospital capital structure following trade-off theory turns into that subject to pecking order theory via the separation of dispensary from medical practice.
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.
Background : In western medicine, there has been much interest in medication teaching since the separation of dispensary from medical practice in 2000. On the other hand, few investigations have been carried out about medication teaching for herbal medicine. Objectives : The purpose of this study wasto investigate the current status of medication teaching of herbal medicine and develop a better guide. Methods : Pharmaceutical affairs law in Korea was searched and some medication teaching guides were compared and analyzed to develop a better guide suitable for herbal medicine. Results and Conclusions : The future guide should be based on scientific evidence and include the following: (1)the origin of each herbal formula (2)the constitution of each herbal formula and proportion of each herb included (3)the chief virtue of each herbal formula (4)the efficacy of each herbal formula (5)the safety of each herbal formula (6)combined treatment with herbal formulas and western drugs (7)the way of decocting each herbal formula (8)the way of safekeeping and period of circulation of each herbal formula (9)a summary and evaluation for each herbal formula (10)references of each herbal formula.
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