의료기관조제실제제의 전문$\cdot$일반의약품 분류

이의경,고리경,장원기,Lee, Eui Kyoung,Ko, Reek Kyoung,Jhang, Won Ki 한국임상약학회 2000 한국임상약학회지 Vol.10 No.3

This study is intended to set the criteria for the classification of prescription and non-prescription drugs, and classify hospital pharmacy formulations according to the criteria. 717 hospital pharmacy formulations were collected ken the Center for review and evaluation of health insurance, and national provincial offices. Hospital pharmacy formulations were evaluated based on the 'Guidelines on the Hospital Pharmacy Formulations (Notification No. 2000-46)'by the Ministry of Health and Welfare. Drug classification advisory committee was composed of twelve medical and pharmaceutical specialists, and suggested opinions on the drug classification. Among 717 formulations, 651 drugs $(90.8\%)$ satisfied the basic conditions for the hospital pharmacy formulations. 312 formulations $(43.5\%)$ were classified as drugs for the disinfection and tests. For the rest of them, 231 formulations were classified as prescription drugs whereas 108 drugs were as non-prescription drugs. 56 non-prescription drugs were included as hospital formulations, because there were no therapeutic alternatives. Iu sum 599 drugs $(83.5\%)$ were suggested as hospital pharmacy formulations. The study also recommends pharmaceutical companies to produce drugs of limited commercial value, and doctors to change their unique prescribing behavior in order to prevent the abuse of hospital pharmacy formulations.

약국의료보험 참여도에 영향을 미치는 약국특성에 관한 연구

이의경 ( Eui-kyoung Lee ) 한국보건사회연구원 1991 保健社會硏究 Vol.11 No.2

약국의료보험제도는 도입당시의 기대와는 달리 제도의 실시 성과가 미미하며, 약국에 따라 보험참여도는 매우 다양한 실정이다. 그러므로 본 연구에서는 1991년 「표준약국 모형개발을 위한 기초연구」의 일환으로 실시된 서울시내 약국의 경영실태 조사자료를 이용하여 보험참여도에 영향을 미치는 약국의 특성을 살펴보고자 하였다. 조사결과에 따르면 보험조제건수가 전혀 없는 약국은 조사대상 약국의 19.8%, 조제건수는 있으나 약제비를 청 구하지 않는 약국은 16.8%였으며, 조제건수도 있고 청구도 하여 제대로 보험에 참여하고 있는 약국은 63.4%로 나타났다. 또한 약국방문한 조제환자중 보험조제환자의 비율은 11.6%에 불과하였다. 보험참여 여부에 영향을 미치는 요인을 파악하기 위해 판별분석을 실시했으며, 참여약국중 참여정도, 즉 월평균 조제건수와 관련된 요인을 찾기 위하여 중회귀 분석을 실시하였다. 분석결과 컴퓨터 소지여부, 경영다각화 정도, 제도에 대한 약사의 의견 둥은 두가지 분석에서 모두 유의하게 나타났다. 반면 참여여부에는 환자카드와 가운 착용상태가, 참여정도에는 약사연령과 약사수가 각각 주요 요인으로 나타났다. 이상에서 살펴본 보험참여도와 관련된 약국 특성은 약국의료보험제도의 활성화 방안 마련에 중요한 자료로 이용될 것이다. The pharmacy insurance system was implemented in 1989 to cover pharmacists, dispensing services. The use pattern for medical help and effective financial management for the insurance system were the major considerations in introducing the system. Contrary to expectations in the beginning, however, the performance of the system was very weak. The number of cases for reimbursement has decreased since January 1990, so this study was conducted to learn about the present situation of the system, and to learn the characteristics of pharmacies influencing the degree of participation in the pharmacy insurance system. The pharmacy management survey data were used for the analysis of the study, which was conducted from July 22 to August 16, 1991 with a 97.7% response rate. Respondents were the pharmacists in seven hundred and thirty nine pharmacies in Seoul, which were selected at random from 22 districts by a stratified sampling method. The results showed that 19.8% of the pharmacies do not participate in the insurance system at all ; 16.8 % have cases for pharmacy insurance but do not claim reimbursement, and the rest, 63.4%, participate in the program correctly. The ratio of customers who benefit from the pharmacy insurance system was just 11.6%, and this needs to increase for the success of the system. A discriminant function analysis was performed using 13 pharmacy management variables as predictors of membership in two groups : participating and non-participating pharmacies in the pharmacy insurance system. One discriminant function was statistically significant, and 6 predictor variables were selected. The results revealed that participating pharmacies were more likely to have computers, patient profiles, more customers for dispensing, and diversified items. The pharmacists in the participating pharmacies tend to have more positive opinions on the system, and wear gowns on a regular basis. Major determinants affecting the degree of participation in the system were also found using multiple regression analysis. The degree of participation was measured by the number of dispensing cases for pharmacy insurance among the participating pharmacies. The following four variables were significant in both the discriminant analysis, and regression : computerization, diversification, pharmacist opinion, and number of dispensary customers. The direction of the relationship was the same in both analyses. Besides these, the pharmacist`s age, and the number of pharmacists were significant and negatively related to participation. The study results are expected to contribute in activating the pharmacy insurance system, and ultimately maximizing the contribution of pharmacies to society and the welfare of the public.

의약품(醫藥品) 안전관리(安全管理) 현황(現況)과 정책과제(政策課題)

이의경 ( Eui-kyoung Lee ) 한국보건사회연구원 1995 保健社會硏究 Vol.15 No.1

오늘날 生活水準의 向上과 人口의 高齡化로 의약품에 대한 需要가 增加하고 있으며 개방화 · 국제화로 國家間 醫藥品 交易이 활발해짐에 따라 醫藥品 安全管理에 대한 중요성이 한층 더 부각되고 있다. 따라서 본 논문에서는 우리나라 의약품 안전관리의 現況과 問題點을 분석하고 외국의 예와 비교함으로써 醫藥品 安全管理體系를 再整備하기 위한 발전방향을 모색하였다. 현재의 分節化된 안전관리 체계를 개선하기 위해서는 전국적인 統一性과 함께 專門性을 갖춘 統合的인 管理體系로 전환해야 한다. 醫藥品 管理 全據機構를 설립하고 의약품의 특성에 따라 審査組織을 구성하며, 심사조직 내에 약리, 화학, 임상 등 許可官妓 審査協議體를 구성하여 責任所在가 명확하며, 동시에 綜合的 · 體系的인 平價가 이루어지도록 해야 한다. 향후 증가하는 行政 需要에 능동적으로 대응하기 위해서는 관리의 效率性 側面도 고려해야 하는데, 전문성이 낮은 업무는 선별하여 直屬機關으로 委任하는 것이 바람직하다. 행정수요가 많은 일부 지역에 직속기관을 설치하는 것은 地方組職의 專門性을 제고하는 최선안이 된 것이다. 이밖에 有效性 · 安全性 확보를 위한 制度的 裝置를 강화하고 消費者의 監視機能을 활성화하는 것은 안전관리의 실효성을 제고하기 위한 중요한 방안이다. 의약품 안전관리는 일반 행정과 구별화된 技術行政, 또는 科學行政으로 발전해 나가야 한다. 尖端 技術에 신속히 連繫될 수 있도록 안전관리 조직을 再整備하고 專門性을 제고하여 科學的 根據主義에 입각한 행정이 되도록 노력해야 한다. 즉, 醫藥品의 安全管理 정책은 行政管理의 效率化 및 업무의 綜合化를 통하여 안전관리의 質的 水準을 高揚시키는 방향으로 발전되어야 한다. The pharmaceutical administration at present faces changing situations as it is involved with a number of problems such as intensifying international relations, an increasing aged population, expansion of medical insurance program, and technical innovation. With these changes, people have expected and demanded the higher quality, efficacy, and safety of drugs. In this regards the purpose of this paper is to develop policy measures to improve the safety assurance system of drugs, by evaluating the present status and problems of our system and by comparing the system with those of the U.S. and Japan. The study has found that drug safety assurance system in Korea is far behind the international level. In order to meet people`s demand, the policy priority is to be placed in strengthening the expertise and specialty in safety assurance of drugs. Experts must be recruited for drug quality control and approval, and a drug information management system is to be established. Regulations to prove the safety and effectiveness of drugs are to be strengthened, and government inspection needs to be tightened. In addition, the evaluations of new drug applications should be conducted systematically by three distinct review teams: the medical/clinical group, the pharmacology/toxicology group and the chemistry group. As for managerial efficiency, routine work and regulatory matters related to on-site manufacturing activities need to be delegated to local branches. The Ministry of Health and Welfare will be able to focus more on review and approval of new drugs and measures to ensure efficacy/safety and a stable supply of drugs The drug safety assurance system is to be remodeled from the perspectives of specialization, and managerial efficiency for drug administration. It will be necessary not only to project. the people`s security, but to strengthen the international competitiveness of the pharmaceutical industry.

모바일매핑시스템과 딥러닝을 활용한 불법도로점용 시설물 인식

백주호,성하경,도명식 한국ITS학회 2020 한국ITS학회 학술대회 Vol.2020 No.11

병원 약제행위의 원가구조 및 수가체계 개선방향

황인경(In Kyoung Hwang),이의경(Eui Kyoung Lee),이진이(Jin Nie Rhe),장선미(Sun Mee Jang) 한국병원경영학회 2000 병원경영학회지 Vol.5 No.1

The price systems of the hospital drug services play key roles in the provision of quality services and the development of pharmacy service technologies. Under the premises, this study attempted to determine the costs of hospital drug service, to compare the costs calculated with the fees publicly fixed by the Government, and based on the results of the analysis, to propose directions for the improvement of the price systems. A Costing model for the study was developed based on the cost-fee relationship analysed of the Korean fee-for-service systems. Data on costs and workloads of the 25 hospitals were collected through survey forms designed for the costing and analysis for the duration of 12 months of 1998. The results of the analysis show that a tremendous unbalance between cost and price levels of the drug services, and that overally the price level of the services is extremely low when compared to the costs of services. Based on these findings, this study suggests that unfairly high or low price level be corrected, and that service items newly developed and being practiced at tertiary hospitals, such as TDM and TPN consultation services, be compensated by fixing a proper level of price.

의료보장(醫療保障) 가입자(加入者)와 미가입자(未加入者)의 인구(人口) · 사회적(社會的) 특성(特性) 및 의료이용실태(醫療利用實態)에 대한 비교(比較) 분석(分析)

송건용 ( Kun-yong Song ),이의경 ( Eui-kyoung Lee ) 한국보건사회연구원 1990 保健社會硏究 Vol.10 No.2

의료이용의 접근성 고양을 통한 국민의 건강수준 향상이라는 목표하에 1989년 7월 전국민 의료보장제도를 실시함으로써 보험 적용대상이 전국민으로 확대되었다. 그러나 1989년 10월에서 동년 12월에 걸쳐 조사된 『국민건강조사』 자료를 분석한 결과 어떤 형태의 의료보장 혜택도 받지 못하고 있는 미가입자가 조사대상자의 4.8%로 나타났다. 그러므로 본 연구에서는 보험 미가입자의 인구 · 사회적 특성, 건강수준 및 의료이용 형태를 비교 분석함으로써 현재 소외되고 있는 계층을 모두 제도권 안으로 수용하여 균등하고 완전한 전국민 의료보장제도를 실현하는데 기여하고자 한다. The national health insurance system was developed in 1989 to expand insurance coverage to the entire population. The purpose of the program was to ensure equitable access to health care for all. The National Health Interview Survey, conducted during the period from October 30 to December 9, revealed, however, that 4.8% of the respondents were covered by no health insurance plan. This study was intended to compare socio-demographic characteristics, perceived health status, and utilization of health services of the insured and uninsured. The result showed that the uninsured tended to by young adults aged 20~29, unmarried, with one or two in the household. The uninsured were less sick than the insured according to serveral indicators on health status: morbidity rate for the previous fifteen days, prevalence of chronic disease, average days of restricted activity, percentage with perception of poor health, and percentage of those who needed medical care. Based on the study`s results, it appears that whether an individual buys coverage is influenced by his or her perceived risk of economic loss and perceived health status. In terms of health service utilization, the uninsured had fewer physician visits and were less likely than the insured to be hospitalized. The average number of physician visits per person per year was 2.4 among the uninsured, compared with 6.4 visits for the insured. The difference continued to exist even when adjusted for the differences in the perceived health status. The rate of met need for those who needed medical care was not, howoever, significantly different between the uninsured and insured. It seems that the pharmacy has helped to fill the gap for many of the uninsured. Since the physician visits of the uninsured were many fewer than those of the insured, some of the uninsured may not obtain proper care, often postponing care until conditions have become life-threatening. Thus several actions are required to correct these disparities between the uninsured and insured if equal access to health care in an important social goal.

의약분업이후 약국 경영수지 및 관련 요인 분석

박혜경,권창익,엄태훈,김예순,노연숙,정규혁,이의경,Park, Hye-Kyung,Kwon, Chang-Ik,Eom, Tae-Hoon,Kim, Ye-Soon,Rho, Yeun-Sook,Jeong, Gyu-Hyeok,Lee, Eui-Kyoung 대한약학회 2008 약학회지 Vol.52 No.6

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.

선별등재 제도에 대한 전문가와 제약회사의 인식도 비교분석

하동문(Dong Mun Ha),이수경(Su Kyoung Lee),김대업(Dae Up Kim),정규혁(Kyu Hyuck Chung),이의경(Eui Kyung Lee) 대한약학회 2010 약학회지 Vol.54 No.4

The Positive List System was newly introduced in South Korea as of January 2007. This study aims to survey and compare perception of and attitudes toward the Positive List System in the process of new drug listing that health professionals and pharmaceutical companies have. 50 professionals and 52 companies answered the questionnaire regarding health policy environments, policy decision/enforcement process, policy effects and satisfaction related to introducing the Positive List System. SAS 9.1 was used for statistical analyses. The results showed that participants had the general sympathy with health policy environments for the introduction of the Positive List System into South Korea. However, the response rates of policy decision/enforcement process and effects were negative and these tendencies were more striking in pharmaceutical companies. As for policy satisfaction, participants marked positive responses more than negative ones. It is necessary to remedy and supplement problems with policy decision/enforcement policy and effects revealed in this study and to improve the Positive List System through gathering opinions among groups and organization concerned.

골다공증성 골절 예방에 대한 지불의사금액 추정

박주연 ( Joo Yeon Park ),안정훈 ( Jeong Hoon Ahn ),서혜선 ( Hae Sun Suh ),박선영 ( Sun Young Park ),현민경 ( Min Kyung Hyun ),성윤경 ( Yoon Kyoung Sung ),이의경 ( Eui Kyung Lee ),김윤희 ( Youn Hee Kim ) 한국보건경제정책학회(구 한국보건경제학회) 2011 보건경제와 정책연구 Vol.17 No.3

본 연구는 적절한 급여기준 설정과 관련한 의사 결정에 근거를 제공하기 위해 일반인을 대상으로 골다공증 골절 위험 감소에 대한 편익의 가치를 추정하고자 수행되었다. 서울특별시와 충청도의 중소도시에 거주하고 있는 일반인 101명을 대상으로 조건부 가치측정법을 사용하여 골절예방에 대한 지불의사금액(Willingness To Pay, WTP)을 조사하였다. Generalized Linear Model(GLM)을 사용하여 WTP에 영향을 미치는 요인을 확인하였으며 남성과 여성에 대하여 별도로 분석하였다. 분석 결과 척추골절 위험률을 10%, 50% 낮춰주는 치료법에 대한 WTP로 본인의 경우 연평균 66만원, 135만원을, 가족의 경우 82만원, 160만원을 각각 제시하였다. 대퇴부골절의 경우 각각 연평균 116만원, 235만원을 본인에 대한 WTP로 응답하였으며 가족에 대해서는 10% 더 높은 수준의 금액을 제시하였다. WTP에 대한 회귀분석 결과 성별에 따라 유의미한 인자가 달랐으나 두 집단 모두 골절 감소 효과가 높을수록 WTP 수준이 더 높은 것으로 나타났다. 골다공증성 골절 위험 감소에 대한 WTP는 골다공증 약물 치료 선택에 기초자료로 활용될 수 있으며, 약물치료를 골감소증 환자에게 확대하고자 할 때도 기준으로 활용할 수 있어 궁극적으로 합리적인 의료비 지출을 위한 정책 결정과정에 기여할 수 있을 것으로 기대한다. This study was performed to estimate willingness to pay(WTP) for treatment that would reduce osteoporotic fractures to provide evidence-based decision making related to the reimbursement of osteoporosis use. 101 people in Seoul and Chung Cheong-Do were interviewed face to face and asked about their WTP for treatment that would reduce their or their family``s risks of vertebral or hip fracture by 10% or 50%. Each question was repeated for the fracture risk of a family member. A generalized Linear Model(GLM) was used to identify factors affecting the level of WTP in male and female group separately. The WTP for treatment that would reduce the risk of vertebral fracture by 10% and 50% were 660,000 and 1,350,000 Korean won, respectively, per year; and the WTP for treatment that would reduce the risk of hip fracture by 10% and 50% was 1,160,000 and 2,350,000 Korean won, respectively, per year. The average WTP for a family member was around 10% higher than the WTP for oneself. The factors affecting the WTP have differences in male and female group but the WTPs of both groups were associated with higher effect of reducing fracture. These consumers``WTPs would provide information regarding the treatment of osteoporosis and contribute to appropriate drug use and rational pharmaceutical spending.

DDD(the Defined Daily Dose) 방식에 의한 국내 항생제 사용량 산출 및 항생제 약제비 분석

이의경,장선미 大韓臨床藥理學會 2000 臨床藥理學會誌 Vol.8 No.1