치매환자관리와 치매수가에 대한 한·일 비교 연구

남은우,박경화,허종,서종범,임부경,西野憲史,芭修一 고신대학교보건과학연구소 2001 보건과학연구소보 Vol.11 No.-

Since increasing number of the elderly, Korean society has discussed needs of long-term care insurance for them. Those Japanese experiences should give lots of implications to manage institutions for caring dementia patients in Korea. In the case of Japan, if hospitals hospitalized dementia elderly patients with strange behaviors (like wandering) over one third of all patients, the hospitals can take higher nursing care fee due to needs of special protective cares. Japanese long-term insurances allow dementia patients to the reconstructive fee of elder dementia wards in short-term intensive cares. This policy encompassed day care fee, hospitalization fee of a serious dementia patient and hospitalization fee for the elderly dementia patients. Long term care coverage of Japan (Kanbyoungin-ryo) reimburses long-term care assistance (a Japanese care manager, or Kaigo hoken staffs) but health insurance coverage of Korea do not have that coverage. As a result, all patients have paid that cost since Korean medical care law did not permit long term care hospitals and did not allow special reimbursement of staffs who work for long-term care. Thus, Korean medical care law should be revised and allow nursing fee (kanbyoungin-ryo) to health care organizations.

의약분업 실시 전ㆍ후 영도지역 주민의 약국 및 의료기관 의료이용 양상 변화 분석

南銀祐,朴宰成,M. Nishigaki,T. Hamai 고신대학교 영도발전연구소 2000 영도연구 Vol.2 No.-

The purpose of this study is to assess the effects of the separation of prescribing and dispensing in Korea and to find how civilians' usage behaviors on medical institutes such as hospital, clinics, drugstore, and community health center are changed due to the policy. To examine the differences of usage behaviors, this study used a before-after design. Using self-administered questionnaires, this study performed survey from June 26 to August 1, 2000. Chi-square test and generalized logit model was utilized in each observation period. Based on the results of each observation period, this study evaluated the effects of the policy. On the basic finings, most civilians did not agree to the separation policy regardless of both observation periods. However, after the separation, civilians' behaviors seemed to be modified as the policy maker had intended. Most of civilians purchased their drugs from pharmacists after receiving physicians' prescriptions. Specifically, males and elder persons had the exactly same behaviors as the intended utilization behaviors. All study subjects agreed to the basic purpose of the policy for the purpose of the reduction of drug abuse and misuses. The implications of this study are two fold: First, how civilians' short-term inconvenience caused by the policy should be alleviated without interrupting well-established usage patterns. Second, a special attention to the elderly is needed.

日本의 醫藥分業推進政策의 考察

南銀祐,朴永澤,西垣克 고신대학교 보건과학연구소 2000 보건과학연구소보 Vol.10 No.-

Korean government decided to implement the separation policy of prescribing from July in 2000. The separation policy of Prescribing and dispensing belongs to public policy, and it is agreed important policy that is necessary system for improvement of public health. However, in case of Korea, there is not made a sense of its necessary and implementing period to both of providers and consumers yet. In spite of that, Korean government has a plan to enforce the separation of prescribing and dispensing without the result of proper pilot project in July 2000. Therefore, this study looked over the process separation politic implementation of prescribing and dispensing in Japan which is similar with medical care system of Korea. Especially this study was emphasized about the pilot project and support policy of government to the separation of prescribing and dispensing, and evaluation to the operation of separative system of prescribing and dispensing. The consequence of this study will be referred for the separation politic implementation of prescribing and dispensing in Korea. As a result, the core of the separation policy of prescribing and dispensing of Japan was the achievement of the separation of prescribing and dispensing through gradually expansive project. The pilot project was practiced at the demonstration area. Through this consequence, there used the supplement method from the problem of separation prescribing and dispensing. The present practiced rate of separation of prescribing and dispensing is 30%, and there was evaluation system of separation of prescribing and dispensing in order to promote efficiency of separation of prescribing and dispensing. Department of Drug Administration in Ministry of Health and Welfare was in charge of the evaluation of separation of prescribing and dispensing and dispensing based unit on the Promotive Conference of Separation of Prescribing and Dispensing in each area. The expense for the evaluation of separation of prescribing and dispensing was from national budget.

한국과 일본의 건강증진정책 비교

남은우,조은주,남정자,Toshihiko HASEGAWA,Yoshi FUJISAWA 고신대학교보건과학연구소 2003 보건과학연구소보 Vol.13 No.-

한국의 당뇨병 관리를 위한 건강증진정책 연구

남은우,사카마키 히로유키,조은주,조혜전 고신대학교 보건과학연구소 2002 보건과학연구소보 Vol.12 No.-

This research is based on the drastically increased occurrence and death rate of diabetes recorded within the past ten years and the analysis of the Korean government's Diabetes Mellitus Management system in Korea in handling this alarming problem. The information used for this analysis is based on documents and statistics from the Ministry of Health and Welfare Statistics(2001, 2002) and also, health insurance statistics and documents from the National Health Insurance Corporation, 2001. The analysis of Health Plan 2010 will also be a key issue discussed in this paper. The Korean government's Diabetes Mellitus Management Plan's aim of increasing the life and healthy life expectancy while decreasing the medical costs at the same time is considered as a vital link in the government's Chronic Disease Management Plan. The main aim is to decrease the death rate, due to diabetes, from 22.6 people in 2000 to 19.0 by the year 2010. Health Plan 2010 plans to increase the role of public health centers. It also plans to form a system that will be used as a device in decreasing chronic diseases such as high blood pressure, diabetes and increasing general health by using the strategies of Health Plan 2010 against diabetes -to increase the government's role in public health. Korea's death rate, due to diabetes, is 2.2 times higher than that of Japan. Korea's being 22.6% compared to that of Japan which is only 10.1%. From now on our concerns should be directed in education and manpower. We need to have more specialized personnel who can be responsible for the nutrition, exercise, prevention and care of the public. Education is the fundamental basis for the control of Diabetes and is known throughout the world as the most cost-effective treatment. From this point on, the Government should concentrate on educating the people on the importance of healthy life styles. To do this it needs to provide the necessary funds needed in Health promotion and health education, and also to provide for professional personnel(eg. health educator).

거제도지역 아동의 보건위생 및 체력측정 연구 : BMI지수에 의한 중국 연변지역 조선족 아동과의 비교 Comparative Study with Ethnic Koreans in the People's Republic of China by BMI Index

남은우 高神大學校 保健科學硏究所 1995 보건과학연구소보 Vol.5 No.-

The purpose of this study is to compare the health status of Korean and Chosun-jok elementary children. To accurately achieve the purpose, a survey was conducted in Yanbian Area in China and Kojae in Korean during the period of June 15 to 16 in 1995. This survey was performed by using two survey methods. The first was the parents' survey metod. It asked structured questions about their children. The second method focused on the actual health of the children. It used the collection of children's physical records in school. Guided by the school teachres, each child distributed the questionnaires to their parents. We used to analyze the data (666 questionnaires were incomplete and were not used in the analysis). Each questionnaire matched the data of their physical record: Body Weight, Body Height, Chest-Circumstance, Eyesight, Dental Health. Using the data, we compared the BMI(Body Mass Index) the Koreans and Chosun-Jok, the general physique of Chosun-Jok is inferior to that of Korean regardless of age and sex. Meanwhile, the average physical constitution of Korean compared the Chosun-Jok (i.e. eyesight and dental hygiene), revealed that the physical constitution of Chonsun-Jok is superior to that of Korean without concern of age and sex. Average BMI of Chonsun-Jok is lower than that of Koreans. But, it seemed that most of the students in both groups maintain an adequate health level. In the case of children from 10 to 12 years old, females are superior to males through all data contained of the body weight, the chest circumstance, and the body height. It seems that females and males have a different maximum growth age. Most of the parents preferred a good physique as a good health condition for their children. The physique of each child was affected with some variables, including the number of family members, and the educational level of the parents. According to the above results, the student's physique in Korea is superior to that of Chonsun-Jok in China. But, Koreans are inferior to Ethnic Koreans in China in the students' physical constitution. In conclusion, we consider Chosun-Jok in China to maintain an adequate health level in their physique and physique costitution.

보건의료분야의 국제협력

남은우 高神大學校 保健科學硏究所 1995 보건과학연구소보 Vol.5 No.-

지방공사 부산의료원의 경영효율화 방안 연구

남은우,강성권 고신대학교보건과학연구소 1999 보건과학연구소보 Vol.9 No.-

The purposes of this study are to identify and analyze the current state of management and operation of Puasan Medical Center, a local public medical institution, and related- controversial problems, and then to suggest some policies for the improvement of its managerial and operational erriciency. Considering its special role and function as a prblic medical institution, in particular, focusing on medical services in which its private counterpart does not actively engage, the improvement of its managerial and operational efficiency are considered to be a continuously-pursued issue. Recently, as an effort to improve its efficiency, some policies such as the introduction of reservation system for medical service, active compaign for patient attraction, and through monitoring on personal expenses, the costs of material and management expenses are being implementer. However, despite this effort, the current management and operation are still found to be problematic. Thus, this study by conducting the analysis on its current controversial problems, suggests some alternative policies as follows: first, thecurrent operating system is seemingly required to bo maintained for its special role and function as a public medical center. However, the managerial system is suggested to be subject to an innovative change. Furthermord, in case of a continued-unsatisfaction in relation with the improvement of its managerial efficiency, the adoption of managerial system entrusted to private managerial specialists can be an alternative. second, for the improvement ofmedical service quality, increase in the emplyment of distinguished medical specialists, and the expansion and modernization of medical facilities and instruments are required. third, for the increase in its efficiency harmonized with its public nature, the mutual connecting system between the medical center and university hospitals should be reregulated. Fourth, the adoption of a responsible management system is recommended, together with a post management control system in which the actual performance of manager is evaluated expost facto.

음악치료 실시가 뇌졸중 환자의 혈압과 맥박에 미치는 영향

남은우,김혜경 고신대학교보건과학연구소 2001 보건과학연구소보 Vol.11 No.-

The purpose of this study was to identify the impact of music therapy on apoplexy patients' blood pressures and pulse. During seven months in 2001, one music therapist gave patients music therapies and one nurse measured blood pressure (BP) and pulse. There were no statistical differences of BP and pulse after music therapy given compared to before music therapy. However, there of BP. Thus, this study concludes that music therapy focuses on patients' emotional aspect instead of physical response of human body such as BP and Pulse.

개호보험의 실시가 병원경영에 미치는 영향 : 일본 후라데 니시노병원의 경영사례를 중심으로

南銀祐,徐種範,西野憲一,芭修一 고신대학교 보건과학연구소 2002 보건과학연구소보 Vol.12 No.-

Since the introduction of Long Term Care Insurance (Kaigohoken), the hospital management style in Japan has changed. The experiences of the Japanese can be used by the Koreans to improve their hospital management style. The Case study hospital, The Nishino General hospital, had established an intermediate facility (Rojinhokenshisetsu) which consisted of a home care service center, a visiting nursing center etc. to form a health, medical and welfare mix style management system. For the analysis of the system, how it was established and management, we studied the financial statements of the 2001 Furate (Corporation of Nishino hospital etc.). From the analysis of the financial statements one could see that the Rojinhokenshisetsu had a higher profit margin than the hospital itself. This has to do with the Japanese government's administrative plan in decreasing the number of acute hospitals while trying to increase the number and upbringing of long term care facilities and mixed style welfare service facilities. And the reason for the difference in profit is because of the quick response of the hospitals in following the plan. This conversion of administrative plans and medical management structure has not only decreased the national medical expense but has also given the regional population a comprehensive health care system and can be seen as a desirable model. Owing to the desirable changes from the conversion in administrative plans and medical management structure brought on by the Long Term Care Insurance in Japan, one can see Korea also applying such methods and forming a Long Term Care Insurance in the near future.