미국의 보완대체의학 제도와 정책 - 면허제도와 의료보험급여를 중심으로 -

임병묵,Lim, Byung-Mook 대한예방한의학회 2010 대한예방한의학회지 Vol.14 No.1

In recent decades, as the utilization of complementary and alternative medicine in the United State have been growing rapidly, regulatory controls surrounding complementary and alternative medicine(CAM) aims to ensure patient protection against unproven practices and to provide safe and effective treatments. Regulation and policy method on licensing CAM practitioners varies across the states. Over 85% of the states have the licensing system for acupuncturists, chiropractors, and naturopaths. For acupuncture, although the requirements for formal education are various across the states, a unified written examination has been adopted by almost entire states which have acupuncturist licensing law. Medicare, the public medical insurance, does not cover CAM practices except chiropractic and biofeedback. In some states, however, Medicaid programs cover some CAM therapies including acupuncture, naturopathy, and massage therapy. 67% of Health Maintenance Organizations, the private health plans, provide at least one modality of CAM services. In conclusion, government policies have been strengthened to ensure patient protection, and will continue to integrate CAM practices that are proven to be safe and effective into mainstream health care system.

계층화 분석법(Analytic Hierarchy Process)을 활용한 한의사 업무량 산출

임병묵,권혁상,한창호,신병철,Lim, Byung-Mook,Kwon, Hyuk-Sang,Han, Chang-Ho,Shin, Byung-Cheul 대한예방한의학회 2009 대한예방한의학회지 Vol.13 No.1

Background: The resource-based relative value scale has been applied to Korean medicine services as part of the National Health Insurance, yet the proper scoring method for physician's work needs to be developed. Objectives: To measure physician's work for Korean medicine services using Analytical Hierarchy Process(AHP) and to compare results abstracted by AHP with those by Magnitude Estimation method. Methods: We developed the AHP questionnaires for Korean Medicine services and administered it to 12 Korean medicine insurance experts. Weighted scores were calculated and were converted into physician's work scores. Results: In AHP measurement, the physician's work scores for acupuncture activities, especially special acupunctures, far increased, while those for diagnosis and basic consultations decreased. Variations in the scores enlarged. Conclusions: As an alternative, AHP method can be considered for measuring the physician's work for Korean medicine services with careful management of scoring variation.

조탁(曺倬)의 이양편(二養編)에 나타난 양생사상(養生思想) 연구

임병묵,소경순,김광호,Lim Byung-Mook,Soh Kyung-Sun,Kim Kwang-Ho 대한예방한의학회 1997 대한예방한의학회지 Vol.1 No.1

Cho, Tak(曺倬)'s Yi-Yang-Pyun(二養編), first published in the 12 year of Kwang-Hae-Kun(光海君) era(1620), is composed of two parts. The first part is an edition of various Confucian scriptures that is used to control and restrain the mind. The second pan, considering mostly of contents borrowed from medical works, anthologies and books on yang-saeng(養生), is used to maintain the well-being of the body. Yi-Yang-Pyun shows several distinct characteristics of Yang-saeng ideas. first, it follows the teachings of Yi, Hwang(李滉) which denotes the state of body and mind according to the Kyung(敬) philosophy. 'Kyung' is a state of being that does not require bondage as it automatically reveres the mind. Therefore, actively fostering the body and mind is to maintain this respective state of being. Second, it has summarized and arranged certain medical contents from the Dong-Eui-Bo-Kam(東醫寶鑑) for the purpose of discovering the truth underlying one's body in an effort to pursue the logics of universal nature. Third, although it was based on the contents of Confucianism related books, it widely encompassed the regimen of Taoism. Fundamentally, the Confucian had regarded the Taoism as a heretic, but accepted it in e influence of Zhu xi(朱熹) who interpretated Can-Tong-Qi(參同契) with Confucian perspectives and put in practice the regimen of Taoism. In this context, Yi-Yang-Pyun also used jointly Taoism-related books with Confucian scriptures. Although Taoist regimen was accepted, elixir(外丹), conjury of Taoist hermit(神仙方術) and issues which run counter to morality like sexual practices(房中術) were not. Most of regimens used were related to disease-prevention and health-enhancement like breathing(服氣法), gym-nastics(導引), Diet(服餌) etc. Ideas of Yi-Yang-Pyun, written from Confucian perspectives, latter heavily influenced on scholars of inner elixir(內丹).

사상체질처방 복합제제의 보험급여화 추진 과제

임병묵,Lim, Byung-Mook 사상체질의학회 2011 사상체질의학회지 Vol.23 No.1

Reforming the insurance scheme for herbal drugs in the National Health Insurance is a long-cherished desire for Korean Medicine doctors. Because most Korean Medicine doctors distrust the quality of existing insured herbal drugs, which are powdered mixes of each herbal extract, the use and the expenditure of insured herbal drugs have been decreased in the last ten years. To address this, it has been demanded to insure the composite type of herbal preparation, which is the extracted powder of the whole prescription, to the benefit coverage for herbal drugs. Many stake holders, however, have so far been unable to reach an agreement on this. In this situation, Sasang Constitutional prescriptions are expected to make a breach of insuring the composite herbal preparations, because some of them were approved as prescription drugs in 1999. In this review, I discussed the problems of insured herbal drugs, the necessity of insuring the composite herbal preparations and Sasang Constitutional prescriptions, and the tasks of Sasang Constitutional Society to insure them.

한방물리요법 상대가치 산출과 급여 확대 시 재정부담 추계

임병묵,신미숙,신병철,송윤경,송미연,신승우,김호준,이명종,Lim, Byung-Mook,Shin, Mi-Sook,Shin, Byung-Cheul,Song, Yoon-Kyung,Song, Mi-Yeon,Shin, Seung-Woo,Kim, Ho-Jun,Lee, Myeong-Jong 대한예방한의학회 2010 대한예방한의학회지 Vol.14 No.2

Backgrounds : Since December 1, 2009, National Health Insurance began to reimburse for three physical therapies of Korean medicine. The extension of insurance coverage is demanded by Korean medicine societies. Objectives : This study aimed to measure the resource-based relative value scale (RBRVS) scores for thirty four physical therapies of Korean medicine and to estimate the insurer's expenditure for them in National Health Insurance. Methods : To measure the physician's work and the practice expense, the 'magnitude estimation method (MEM)' and the 'fully distributed cost - attributable cost method (FDC-ACM)' were applied respectively. We collected the frequency data of physical therapies from Korean medicine hospitals and clinics to estimate the total expenditure. Results : The resource-based relative value scale scores of physical therapies were measured from 23.44 to 160.66. Total insurer's expenditure was calculated to be 95.5 billion won as of 2009. Conclusions : Based on the result that showed minor increase of total expenditure, most physical therapies of Korean medicine need to be reimbursed in the National Health Insurance.

우리 나라 국민의 대체요법 이용 및 비용지출 현황

임병묵(Byung-Mook Lim),민지현(Ji-Hyeon Min),장욱승(Uk-Seung Jang),민무홍(Moo-Hong Min) 대한한의학회 2004 대한한의학회지 Vol.25 No.1

협진병원 근무 의사들과 종합병원 근무 의사들의 양.한방 협진에 대한 인식도

류지선,임병묵,조병만,이원철,윤태호,Ryu, Ji-Seon,Lim, Byung-Mook,Cho, Byung-Mann,Lee, Won-Chul,Yoon, Tae-Ho 대한예방한의학회 2009 대한예방한의학회지 Vol.13 No.3

Objectives : This study was performed to compare consciousness of doctors on cooperative practices of western medicine and traditional Korean medicine, and to provide policy implication for development of cooperative practices. Methods : The structured questionnaires were mailed to 132 doctors working in non-cooperative practicing university hospital and 77 doctors working in cooperative practicing hospitals in Busan metropolitan city. The response rate was 40.2% and 40.3% respectively. This survey was performed from 10 Oct. 2008 to 31 Oct. 2008. Results : The doctors working in general hospital had comparatively negative consciousness on basic concept, value and necessity for cooperative practices and traditional Korean medicine. In regards with disease treatment's effectiveness of cooperative practices, both groups evaluated musculoskeletal and immune disease were more effective than others. There were positive relationships between perception for cost-effectiveness and consciousness on intention to participate cooperative practices(p<0.05). Also doctors who experienced traditional medicine treatment had positive consciousness on cooperative practices(p=0.05). Conclusions : To activate cooperative practices of western medicine and traditional Korean medicine, some efforts should be carried out. These include promoting cooperative education programs in medical schools and traditional Korean medical schools, doing research on cost-effectiveness of cooperative practices, and trying to minimize legal and systemic restrictions for cooperative practices.

한.양방협진에 대한 의.한의.간호대학생의 태도비교

정인숙,임병묵,이원철,Jeong, Ihn-Sook,Lim, Byung-Mook,Lee, Won-Chul 대한예방한의학회 2010 대한예방한의학회지 Vol.14 No.1

Objectives : This study was aimed to investigate attitude of western medicine(WM), Korean medicine (KM), and nursing school students toward the east-west collaborative medical practices(EWCMP). Methods : The participants were 185 WM students, 123 KM students, and 230 nursing students belonging to two universities (P and D) in Busan metropolitan city, Korea. Data were collected with self-administered questionnaires and analyzed with descriptive statistics, $X^2$ test, t-test and ANOVA with SPSS win 14.0. Results : Of 538 participants, overall 87.1% has heard EWCMP. Preferred type of EWCMP was significantly different by participants' backgrounds. WM students preferred (western) medical treatment with minor supportive Korean medical care(85.5%). However, KM students emphasized EWCMP with the same weight in both medical and Korean medical treatment(59.0%), and nursing students were in between two schools. Intention to recommend EWCMP for the consumer was 67.4%, and also showed very different between WM students and others, 37.3% of WM students, 89.4% of KM students, and 83.9% of nursing students. WM students showed more negative opinion on the EWCMP than KM and nursing students, Conclusions : The attitude of WM, KM, and nursing school students toward EWCMP was very similar to that of WM doctors, KM doctors, and nurses, respectively. WM students showed big difference in the overall attitude toward EWCMP from that of KM and nursing students. It is recommended to introduce the joint curriculum or exchange programs between WM and KM schools.

시나리오 플래닝기법을 활용한 한.중 FTA 체결이후의 한의서비스 시장 분석 및 대응전략

김정민,임병묵,신미숙,Kim, Jung-Min,Lim, Byung-Mook,Shin, Mi-Sook 대한예방한의학회 2012 대한예방한의학회지 Vol.16 No.2

Objectives : This study aimed to analyze the fundamentals of a Korea-China FTA and suggest strategies for Korean medicine market that correspond with each scenario selected from foreseen circumstances after the conclusion of the FTA through the scenario planning, which is one of management techniques. Methods : Four scenarios have been established by means of key questions : the scope of FTA, health care policies, and the combination of western medicine(WM) and Korean medicine(KM). Each scenario is defined as the Maximized Competitive Market, Neutral Market, General Completive Market, and Conservative Market. This study suggests brand marketing, extending of health insurance coverage, launching local network, and strategy for Korean medicine based health promotion programs. Results and Conclusions : Although Korean medicine could be prompted by the trade policies between countries, related studies are very limited. Therefore, more research is needed to suggest the detailed strategies for change of Korean medicine market through various strategic analysis tools.

한방의료 관련 산업의 국민경제적 기여도 및 파급효과

김진현,임병묵,Kim Jin-Hyun,Lim Byung-Mook 대한예방한의학회 2004 대한예방한의학회지 Vol.8 No.1

The purpose of this parer is to identify the input-output structure of oriental medicine and its alternative medicine industries in an inter-industry context and to estimate its forward and backward effects on macroeconomic variables such as production, employment and price level. Input-output tables released by The Bank of Korea were used as data in this research and inter-industry analysis was adopted as research methodology. The industry takes less share of production, price and trade in a Korean economy, compared with other industry. However, the industry's capability of creating value added is estimated to be well above that of other industry and that of making new employments is as more than 4 times as other industries. This result gives us policy implications that the government should enhance its subsidy policy and economic (tax) incentives for oriental medicine and its related alternative medicine industries.