• Journal of Korean Medical classics
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• v.23 no.1
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• pp.133-142
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• 2010

Preconditions for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine are classification of medicinal herbs for general public and special medical uses, establishment of national medicinal herb distribution company of governmental base, restriction in purchase of medicinal herbs for special medical use, partnership between doctors and pharmacists of Traditional Korean Medicine, and coverage of herbal medicine-based medication in national health insurance, etc. The number of Traditional Korean Medicine Pharmacists which was born during 'the herbal medicine conflict' initiated in 1993, goes over 1,000 and will increase by 120 annually. The number of Traditional Korean Medical Doctors is over 17,000 and increases by 850 annually. So in order to engage partnership between two groups, the government have to arrange the number of outputs of each group. Standardization and classification of diagnosis and diseases in Traditional Korean Medicine is a matter of course in the separation of prescribing and dispensing medicinal herbs. Related societies and academies need to do researches with governmental fund first. After these works, we can launch a task force team for implementation of process for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine properly. Entering the national health insurance system for full coverage of Korean Medicine care service will be essential for the patients. Implementation the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine would be the core of health insurance coverage for medication.

• YAKHAK HOEJI
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• v.52 no.6
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• pp.471-479
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• 2008

The purpose of this study is to investigate the best way that Oriental medicine contributes for activation of pharmacy management after the separation of prescribing and dispensing practice since July 2000. In order to investigate current pharmacy conditions for handling of Oriental medicine and many problems for administering the Oriental medicine to patients, a questionnaire was written with a list of questions related to pharmacy management with Oriental medicine, and given to 58 subjects via fax or personal visit during the period of April 21 to 30, 2003. The research results was as follows; In th 58 subjects, 45 subjects (77.6%) were pharmacists with a licence for dispensing Oriental medicine. 70.7% of subjects most likely preferred to extract granule as administering type of oriental medicine. About the motivation using Oriental medicine, the reason for activation of pharmacy management was 39.7%, second, the reason for resolving the limitation of treatment over western medicine was 25.9%. Oriental medicine for patients was mainly administered by recommendation with pharmacist (65.5%). In comparison with after and before the separation of prescribing and dispensing, 51.7% of subjects answered that sale volume was decreased after the separation. Concerning the ratio of total sales volume to Oriental medicine within 5 years, 50% of subjects expected that sales volume will increase positively. About treating Oriental medcine, 34.5% of subjects thought the problem is the regulation by limiting 100 kinds of formulary. The most important factor for increasing Oriental medicine selling amount was continueous education for various information of oriental medicine in case of 44.8% of sujects. The best pharmacy to handle oriental medicine was community pharmacy (36.2%). It was expressed the reason why many pharmacists have not been treated oriental medicine because lots of time needs for dispensing prescription from clinics in these 4 years after the separation of prescribing and dispensing. These results lead to the conclusion that the Oriental medicine at pharmacy will greatly increase within 5 years and will be very important portion for pharmacy management.

• YAKHAK HOEJI
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• v.53 no.2
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• pp.45-50
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• 2009

The purpose of this study is to investigate the best way that health functional food contributes the diversification of pharmacy management at the new point after the separation of prescribing and dispensing practice. In the question of the number of prescription paper, it was more than 200 papers (18.9%), next 100 papers (11.3%). In case of daily total sales volume except prescription fee, it was more than 1,000,000won (28.3%). About the motivation using health functional food, the reason for activation of pharmacy management was 66%. The selling method was mainly by pharmacist recommendation and consumer's need. In comparison with after and before the separation of prescribing and dispensing, more than 60% of subjects answered that sales volume was decreased and no changed. Concerning the ratio of total sales volume to health functional food within 5 years, 66% of subjects expected that it will be increased positively. The type of best pharmacy to handle health functional food was community pharmacy. These results suggest that the handling of health functional food by pharmacist will greatly increase in near futures and will be very important portion for pharmacy management.

• Health Policy and Management
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• v.11 no.1
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• pp.87-106
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• 2001

There has been a series of struggles around the governmental enforcing separation of prescribing and dispensing since the consensus for the policy at May 10, 1995, and the strike among the physicians nationwide at June 19, 2000. This thesis is to review the process of the affair as a whole and find out some achievements and lessons from it. Most visible achievement is that physicians have obtained governmental apology for the enforcing the unprepared policy, and promise to revise the Law on the Pharmaceutical Affairs, to enlarge governmental support for the medical insurance program, to construct a presidential committee for the reformation of medical affairs, and so on. Besides these achievements, physicians have learned much on the relations among them and with society in general. However this is only the first scene on the road to an extensive transformation in the medical area following more critical Issues on the medical reformation.

• Korean Journal of Clinical Pharmacy
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• v.12 no.2
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• pp.85-90
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• 2002

The aim of this study was to examine the current turnover status of hospital pharmacists and to analyze the factors which affected the turnover of them after the separation of prescribing and dispensing practice. We surveyed 19 managers of hospital pharmacies and 154 hospital pharmacists. Results are as follows. Pharmacist manpower of hospital pharmacies was only $63.99\%$ in tertiary hospitals and $76.78\%$ in general hospitals respectively of the number of pharmacists before the separation of prescription and dispensing practice. The ratio of those who left hospital pharmacies during the period of January 2000 and October 2001 was $80.23\%$ for tertiary hospitals, and $100.84\%$ for general hospitals. Decrease in the number of pharmacists brought the increase of work load and night duty. Major factors which affected the turnover of hospital pharmacists were found as following: income gap between hospital pharmacists and community pharmacists, increasing workload especially at night and on holidays, infrequent chance for the promotion, and low chance to provide clinical pharmacy services after the separation of prescribing and dispensing practice. Adequate manpower is the basic factor for providing hospital pharmacy services and improving clinical pharmacy services. The study suggested that proper number of hospital pharmacists is to be ensured through strengthening the legal requirement for the hospital pharmacists and improving health insurance reimbursement rate for the pharmaceutical services at hospital.

• Health Policy and Management
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• v.11 no.4
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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.

• Health Policy and Management
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• v.14 no.1
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• pp.44-64
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• 2004

As of 1 July 2000 a big reform was introduced into the Korean health care system: the separation between prescribing and dispensing of drugs (SPD reform). There was, however, a big financial stake associated with pharmaceuticals, particularly before the reform, because physicians as well as pharmacists were allowed to purchase drugs at much lower costs than the insurance reimbursement. In this respect, this study focuses on the change in income and profit of both doctor's clinics and pharmacies after the reform. Data from National Health and Nutritional Survey by the ministry of health and welfare were used to estimate the income or expenditure that are financed by out-of-pocket payment of the patients, while national health insurance data etc. were used for the estimation of the income or expenditure that is financed by insurers. Average annual income per doctor's clinic increased from 299 million won to 338 million won for the three years between 1998 and 2001, whereas average annual income per pharmacy increased enormously from 60 million won to 305 million won for the same period. Average annual 'profit' increase per each doctor's clinic caused by the reform itself was estimated to range from 50 to 83 million won, while that per each pharmacy, from 23 to 87 million won. In sum, while both doctor's clinics and pharmacies are beneficiaries of the SPD reform, its positive impact is particularly prominent on the latter.

• Health Policy and Management
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• v.16 no.2
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• pp.117-134
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• 2006

Korean health care system introduced the reform for separation between prescribing and dispensing of drugs (SPD reform) in the latter part of the year 2000. The objective of this paper is to look at what change this reform has brought about in the financial situation of Korean public health insurance scheme, particularly in terms of insurance benefit outlay. Since the inception of the reform is a development of more than five years ago, its impact on the finance situation would now start to become apparent. Hypothesis is set in this study for each of three components of drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. In terms of the classification of health care services by mode of production, the impact of the SPD reform is confined mainly to the last two among three drug reimbursement fields including inpatient department, out-patient department and pharmacy. Pure impact of the SPD reform was estimated to be more or less than 1.7 trillion won, 13.1% of the total outlay of the Nation Health Insurance in 2001, and more than 2.0 trillion won, 14.9% of the total outlay of the Nation Health Insurance in 2003. Both dispensing fees for the pharmacists, which had been newly introduced on occasion of the SPD reform, and larger share of expensive drugs in the medicines prescribed by doctors were confirmed to be main drivers of the augmentation of drug reimbursement.

• 대한예방의학회:학술대회논문집
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• 2001.10a
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• pp.173-174
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• 2001

• Health Policy and Management
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• v.17 no.4
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• pp.1-30
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• 2007

This study aims to analyze the policy change which is caused by conflicts between interest groups when the Separation of the Prescribing from the Dispensing of Drugs (SPDD) was enforced. With the theory of New Institutionalism, the reason why the policy was to be changed can be explained by the concept of property right and transaction cost. As the government did not consider the change of property right and transaction cost between actors before introducing new institution, it was hard to adapt the SPDD. Though, under the established institution, the institutional change can cause the alteration in property right and transaction cost, government just focused on the new institution's execution. Therefore, the group which suffers the loss could not accommodate to the change of institution. For this reason, the adaptation of SPDD also caused huge conflicts between doctors and pharmacists. Then, this research shows that the reason why they conflict to the some issues in the content of PSPDD and why the issues was changed with the property right and transaction cost.