우리나라 양.한방 보건의료 부문간의 현황과 과제 : 새로운 의료체계로의 전환을 위한 공공정책의 선택

한동운,윤태형,Han, Dong-Woon,Yoon, Tae-Hyung 대한예방한의학회 2005 대한예방한의학회지 Vol.9 No.2

Internationally, many countries are facing the demand for reshaping health care systems to cope with rapid changing circumstances in health care sector. The recent growth of oriental medicine and complementary and alternative medicine (CAM) in the many countries is, to a large extent, due to the growth of the number of oriental medical doctors and physicians who have taken up alternative therapies alongside conventional medicine. To cope with the changing environments, many countries consider to develop integrative health care which is now used widely in health care sector. In both biomedical and CAM sectors(including oriental medicine), attention appears to have shifted away from separating therapeutic modalities into categories such as biomedical or CAM, towards a focus on merging diverse modalities into a 'new' integrative health system. In Korea, one of peculiar characteristics of health care system is that as health care provider, Hanbang medicine (traditional Korean medicine) and (western) medicine coexist since 19 century. Recently, the government of Korea has given many efforts to enhance the role and function of traditional Korean medicine in health care sector. However, the strategies and measures for integrative health care settings combining traditional Korean medicine and western medicine on health sector have not been developed yet. The research question of this study is In Korea, what are the trends and problems in interface of traditional Korean medical sector and Western medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the causes?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? In order to do this, this study explores the current situations and issues on the interface between traditional Korean medicine and (western) medicine in various ways using contents analysis of existing data and documents related to traditional Korean medicine and health policy. Finally, we discussed stakeholders' views on the interface in the health care sector. Then, health policy options to have shifted away from separating therapeutic modalities into categories such as 'traditional Korean medicine' or 'western medicine', towards a focus on merging diverse modalities into a 'new' integrative health system.

우리나라 한방의료의 현황과 과제 : 미래사회를 위한 정책적 선택

한동운,김향자,윤태형,우혜경,Han, Dong-Woon,Kim, Hyang-Ja,Yoon, Tae-Hyung,Woo, Hye-Kyung 대한예방한의학회 2005 대한예방한의학회지 Vol.9 No.1

Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.

유방암환자의 한의약의료서비스이용 결정요인

한동운,김운용,최수정,황정혜,Han, Dong-Woon,Kim, Yoon-Yong,Choi, Soo-Jeong,Hwang, Jung-Hye 대한예방한의학회 2012 대한예방한의학회지 Vol.16 No.3

Objectives : The objective of this study is to determine the present state of patients with breast cancer use of Korean medicine(KM) and predictive factors for the use. Through this, the present study is intended to present reasonable treatment approaches for patients with breast cancer as well as communicating correct information on KM to healthcare providers and presenting objective alternatives for patients with breast cancer management based on the subjects' experience in health benefits obtained from their use of KM. Methods : To collect data for the present study, questionnaire surveys were conducted on outpatients who visited four hospitals located in Seoul, Korea during around three weeks from May 31, 2012. Although the total number of the questionnaire sheet distributed in the form of directly asking questionnaire questions was 300, 12 incomplete questionnaire sheets were excluded. Therefore, the number of questionnaire sheets actually used in analyses was 288 and thus the collect rate was 96%. Results : Major results of this study are as follows. First, the number of subjects who responded to the questionnaire was 288 in total. Forty-six percent of the patients reported KM usage and the most commonly used ginseng and qigong/exercise. KM use was found to be associated with age, experiencing side effects of cancer treamnent. Factors that affect the use of KM were analyzed by Linear Logistic Regression and the results showed that age, experiencing side effects of cancer treatment, effectiveness of cancer treatment, and satisfaction of the treatment were factors that were related with relatively more frequent use of KM. Conclusions : Comparing the previous studies, it could be seen that patients with breast cancer were highly interested in and used KM in which conventional medicine and KM are used simultaneously. Knowledge on the integrative use of KM and conventional therapies is necessary for cancer physicians and traditional Korean medical doctors to help patients make informed choices. KM use may play a role in the positive benefits associated with process of breast center treatment. Healthcare providers should communicate correct information on the KM use that has been scientifically verified and talk with each other openly. The fact that the significant correlation between predictive factors for the use of KM was identified trough the present study is quite meaningful.

선진국의 일차의료부문의 통합의료 - 일차보건의료체계에서의 한의학에 주는 함의 -

한동운,Han, Dong-Woon 대한예방한의학회 2012 대한예방한의학회지 Vol.16 No.1

The objective of this study is to discuss the role of integrative medicine (IM) in contemporary health care settings, and how and which factors affect and facilitate the success of IM in terms of the integration of complementary and alternative medicine (CAM) and conventional medicine in primary health care (PHC). IM is meant to provide the best possible health care, for both patient and physician. The way of IM use in the developed countries presents various ways that IM can be provided, and it appears that strategies have been successfully developed to facilitate integration. Although few of the barriers to the integration of CAM and conventional medicine have been resolved, concerns over the legitimacy of CAM in health care (e.g., safety, biomedical evidence, and efficacy) are being overcome by the use of evidence-based practice in IM delivery. There are dominant models of IM that have been developed. The model types signify different levels of equity between CAM and conventional medicine in regard to the power, autonomy, and control held by each. However, the factors common to all IM models, whether describing CAM as supplementary or complementary to conventional medicine, is the concept of a health care model that aspires to be client-centred and holistic, with focus on health rather than disease as well as mutual respect among peer practitioners. Finally, this study concluded that the growth and viability of traditional Korean medicine(TKM) depend on evidence-based practices and identifying the successful influences on the integration of TKM and conventional medicine for recognition of its inherent value in PHC. Some recommendations for the integration of TKM and conventional medicine were suggested.

종합병원인력의 직무만족요인과 충성지수

한동운,엄승섭,문옥륜,Han, Dong-Woon,Eom, Seung-Sub,Moon, Ok-Ryun 대한예방의학회 1995 예방의학회지 Vol.28 No.3

This study was intended to enhance the level of hospital personnel management through analysing job satisfaction of hospital employees in terms of structural, personal and environmental variables. The sample of this study consist of a total of 790 persons including doctors, residents, interns, pharmacists, nurses, medical engineers, office workers and manual workers who have worked for general hospitals with 200 beds, 300 beds and 800 beds respectively. The Likert's 5 scales were used for the measurement of satisfaction. The results can be summarized as follows: 1. Structural Variables The level of satisfaction on the job itself was generally low, 2.8 in Likert's 5 scales, with the order of role ambiguity(3.87), routinization(2.6), work overload (2.45) and autonomy(2.37). Hospital employees are aware of their responsibility and they regarded their work as heavy one. The compensatory satisfaction degree was 2.5 which was also low: There were in the order stability(3.1), distributive justice(2.57), pay(2.3) and promotion(1.9). Usually hospital employees showed high degree of stability, while, their satisfaction on promotion possibility is quite low due to specially differentiated structures of hospitals. The degree of satisfaction on the internal conditions of organizational culture was relatively higher as 2.92: They were co-worker's support(3.69), supervisory support(3.15), role conflict(2.64) and welfare(2.17) in order. The satisfaction on welfare as an economic condition was the lowest. 2. Personal Variables The level of satisfaction on personal variables was 3.27 which seemed to be quite high: Contribution to the hospital(3.38), attitude on job performance(3.28) and pride as a member of the hospital(3.07). They seem to believe that their work has been helpful to the performance of hospitals. 3. Environmental Variables The degree of satisfaction on these variables was 3.07 on the average which was derived from environmental factors such as family-role conflict and community support related to hospital employees' environment. The order of satisfaction for each variable is community support(3.2) and family-role conflict(2.94). They turned out to be fairly satisfied with their job in community and yet, they wanted more spare time to spend with their family.

재활치료 중인 뇌졸중환자의 한의약의료에 대한 태도

한동운,안택수,최수정,김지우,Han, Dong-Woon,An, Taek-Soo,Choi, Soo-Jeong,Kim, Ji-Woo 대한예방한의학회 2011 대한예방한의학회지 Vol.15 No.3

Background : Complementary and alternative medicine has bee used to cardiovascular diseases. In recent years, many hospitals have tried to integrate complementary and alternative medicine(CAM) with conventional medical approaches for patients with chronic diseases. Recently, the prevalence of the use of traditional Korean medicine(TKM) among patients with chronic diseases, expecially, hemiplegia patients after cerebrovascular accident is increasing in Korea. To date, however, there were only few studies addressing the patients' attitudes, and utilization of TKM, compared to the well-documented escalating use of TKM among consumers in Korea. Objectives : The objective of this study was to analyze the prevalence of TKM use among hemiplegia patients after cerebrovascular accident and to determine what factors affect to use CAM among the patients. The study also aims to provide information on TKM and assist therapy selection among various CAM therapies for hemiplegia patients after cerebrovascular accident within health care system in which both practitioners of TKM and practitioners of modern Western medicine coexisted. Methods : The design of the study was descriptive cross-sectional, and data were collected using a 32-items questionnaire. The subjects were one hundred fifty nine patients with chronic diseases who visited or admitted to health care facilities in a hospital in Seoul Metropolitan city, Korea. Data were analyzed using 'SPSS Statistics 18.0 Network Version(on release 18.0.1 of PASW Statistics)' program. Various statistical methods were used to obtain a profile for participants and the therapies most frequently used by hemiplegia patients of TKM. Logistic regression analysis was employed in order to determine the predicting variables of TKM use. Results : The prevalence of the use of TKM was 51.6%. The most common TKM therapies used by the patients included acupuncture(93.2%), herbal medicine(64.8%), and cupping(37.5%). Results of logistic regression analysis revealed that the variables significantly related with TKM use were gender, marital status, job, No. of visiting health care facilities/week. Conclusions : This study shows that the use of TKM among the hemiplegia patients is relatively high in Korea, this topic should be taken into account in the development of a holistic approach for patients with chronic diseases and an efficient chronic disease management system in Korea.

선진국의 보완대체의료 정책의 함의

한동운,Han, Dong-Woon 대한예방한의학회 2008 대한예방한의학회지 Vol.12 No.3

Traditional, complementary, and alternative medicine(CAM) constitutes a major source of health care in developing countries. Its therapies, products and practices are increasing used in industrialized countries, typically by around 50% of the population. However, controls on the provider of CAM services and supply and promotion of complementary medicines are weak in these countries. These trends evoke important public health questions relating to benefits and detriments, safety and quality from medical, financial, and social perspectives. In the western counties, investment in research is increasing, and some guideline is now available for ensuring their quality, efficacy, and safety according to the criteria of evidence-based medicine as legally demanded. National policies and legislation are being developed in many countries and often include partnerships between biomedical and traditional health practitioners. The purposes of the study were to review the policies on CAM, to examine the responses of the government to cope with use of CAM in industrialized countries. Lastly, some implications and recommendation are suggested.

영국 Health Action Zones의 함의: 건강불평등

한동운 ( Dong Woon Han ) 한국보건경제정책학회(구 한국보건경제학회) 2004 보건경제와 정책연구 Vol.10 No.2

초소형 전기차량 조향용 랙 피니언 파손경향 분석

한동운(Dong-woon Han),김성탁(Seongtak Kim),모찬빈(Chan-Bin Mo) 한국트라이볼로지학회 2022 한국트라이볼로지학회 학술대회 Vol.2022 No.4

영국 일차보건의료부문 개혁의 경험과 과제 - Primary Care Groups/Trusts를 중심으로 -

한동운 ( Dong Woon Han ) 한국보건경제정책학회(구 한국보건경제학회) 2006 보건경제와 정책연구 Vol.12 No.1