• Korea Journal of Hospital Management
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• v.8 no.4
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• pp.121-148
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• 2003

This study is designed to evaluate the contents of the separation of prescribing and dispensing roles(SPD) policy based on the theoretical backgrounds. The results are as follows; Considering the purpose of SPD policy, 'increasing the efficiency in manpower management by separating the role of medical doctor and pharmacist and improving the quality of SPD service through specialization of function' as a policy objective is valid and very important agenda in health care. But the objectives are not working well by no keeping the detail means to actualize it. Also, some policy objectives are unclear or inappropriate and it makes the focus of that policy obscure or misleads inadequate policy alternatives. In terms of means of policy, it is evaluated to have some limits in effectiveness, efficiency, equity, rationality, technical feasibility, economic feasibility, administrative feasibility, social and time feasibility. In conclusion, it's necessary to investigate the some problem mentioned in this paper with empirical evidence. Also, it should be needed to improve the validity of policy by correcting policy objectives and means in execution of policy.

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.84-101
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• 2002

This study estimated the influence of 'the separation of prescribing and dispensing roles' (SPD) policy, which implemented in July 2000, on the community pharmacies in Korea, by using data on the revenues and expenditures in the previous researches. We first assumed the rate of drug price differential was 20% with four different models which was based on various data of studies carried out in the similar period. Later, we applied different rates for the sensitivity analysis. According to the results, all community pharmacies made the net profit of 118.9 billion won (0.552 million won monthly per one pharmacy) after the SPD policy. The ratio of net profit to net sales dropped by 7.41%p from 22.19% to 14.78%. Additional sensitivity analysis indicated there were wide range of differences about whether net profit or net gain, and that extent which either existed.

• Health Policy and Management
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• v.11 no.3
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• pp.151-164
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• 2001

This study is to investigate the level of understanding of the separation of dispensing and prescribing health policy in Korea and its associated factors. A questionnaire survey was conducted upon a sample of college students responded from 540, response rate 77.1%, 4 months after the introduction of the policy. The understanding level was measured using 4 question items describing the goal and motivation of the policy, and 8 items describing its operational rules. For each item, respondents were asked to mark whether the description was true or false. While the goal and motivation of the policy was relatively well informed (mean understanding score: 69.6 out of 100), the students did not have good understanding of the operational details of the policy (mean score: 32.5). The results of regression analyses showed that personal interest and agreement with the need of the policy were the most significant factors affecting the understanding level. It is suggested that, for other health policies in the future, policy makers in Korea need to develop more effective media communication strategies to inform general public of the practical details of the policy.

• Health Policy and Management
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• v.12 no.3
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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.

• Health Policy and Management
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• v.10 no.2
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• pp.41-77
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• 2000

This study aimed at the analysis, from the perspective of rationality, of policy making process in the separation of prescribing and dispensing. This study is to identify the characteristics and problems of the policy process to introduce the new durg-prescription system, and make policy recommendations. In terms of separation of prescribing and dispensing, the development of policy making process can be divided into two periods; periods before and after the inauguration of the govemment of people. In the period before the govermment of poeple, one of the major characteristics of policy decision on the new system was the poweful influence of interset groups. At that time, the ministry lacked the problem-solving ability and commitment on the policy. Consequently, during the former period, the policy making process had been driven by interest groups. Therefore, the original purpose of the policy to secure the pulic health was lost. During the latter period, there was also the strong influence of interst groups, complexity of interest, the ministry's inability of problem solving. However, in this period, it is notable that this has drawn nation-wide attention, severl civic grouos have participated in the policy making process, and that the number and voice of these groups have remarkably increased. With regards to rationality, incrementalish model is highly sutable to explain the policy making process in the former period. But in the latter period when the new drugperscripition system became a national issue and civic groups began to participte in this matter more actively, rational model is more explanatory that incrementalism to understand the process. During the latter period, the original goal of this policy was not distored by a few interest groups thanks to the rapid development of civil movement and therebly a big influence of civic groups on the policy making. For that reson, a jigh level of rationality is found in the policy-making process of the latter period. Some suggestions to achieve the rationality in the policy making process based on the results of this study are as follows; Frist, the public's participation should be enered in the policy making process. Second, the govermment should make contiuns efforts to enhance its ability of long-term planning and policy implementation, and increase rationality of policy making process. Third, balance among interset groups should take place in the process of policy making. Forth, sound, constructive, and logical activity of interest groups is necessary to express and promote their interests.

• 대한예방의학회:학술대회논문집
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• 2004.10a
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• pp.77.2-78
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• 2004

• 대한예방의학회:학술대회논문집
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• 2004.10a
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• pp.47.1-47.1
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• 2004

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.75-86
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• 2002

This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

• YAKHAK HOEJI
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• v.49 no.6
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• pp.449-458
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• 2005

There have been rapid changes in the pharmaceutical environment after the separation of Dispensing and Prescribing practice. In the early stage of this system, outpatients had few options to choose their pharmacies due to various obstacles. Under these circumstances, this study on the defection tendency of long-term care patients was performed through the analysis of outpatients who quit visiting a pharmacy nearby general hospital. PowerBuilder ver 9.0 program was used to extract significant data, and SPSS package was employed for statistic analysis. 3,308 outpatients who visited a pharmacy nearby hospital for a month (in January, 2004) were studied. Patients' sex, age and location of residence, the class of medical insurance, the characteristic type of medication (powder, split form, medication for external use/injection), waiting time, disease (department) were considered as variable factors. It turned out that the patient revisit ratio was 80.8$\%$ and the patient defection ratio was 32.4$\%$. As was expected, those factors mentioned above influenced on the revisit and defection ratio considerably. In terms of patient factors, it proved that there was no relationship among sex, location of residence, the class of medical insurance and revisit (defection) ratio. Only age factor influenced the ratio; the older, the higher revisit ratio and the less defection ratio. In respect of dispensing factors, there were obvious relationships among the factors and the ratio: bill (money they had to pay individually), waiting time, number of medications, splitting of tablets, unit price of drug and revisit (defection) ratio showed significant relationship. The result of this study revealed an aspect of outpatients' behavior and it could be used as a reference for better patient service and customer relationship management.