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J Acupunct Res > Volume 31(1); 2014 > Article
Choi, Lee, and Kim: Analysis Study of the Korean Medical Treatments in Care Hospital※
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Abstract

Objectives :

The purpose of this study is to analyze the Korean medical treatments in care hospitals and to provide the fundamental information for Korean medical policy.

Methods :

Data were collected from the patients who had been taken Korean Medicine in 00 Care Hospital from Jan. 1. 2011 to Dec. 31 2012, and their medical records werere viewed retrospectively. In addition, 42 inpatients were recruited and responded to the survey.

Results :

Major results of the analyses are as follows; 91.0 % of Western medical inpatients were treated with Korean medicine. And medium medical care group is 38.8 % among the inpatients that are treated with Korean medicine. Especially, musculoskeletal disease and stroke disease are treated more frequently at the rate of 43.9 %, 41.2 %. 92.8 % of patients responded to the survey were content to the Korean medical treatments.

Conclusions :

The result of this study shows that patients prefer Korean medicine, and it is necessary to supplement the Korean medical policy.

Notes

This research was supported by a grant from Daegu Haany University Kylin Foundation in 2012

Table 1.
The Number of Inpatients in Korean Medicine And Western Medicine
Male Female Sum
Actual number Western medical inpatients 195 354 549
Korean medical inpatients 8 8 16(6.4 %)
Annual number Western medical inpatients 33,356 88,079 121,435
Korean medical inpatients 83 50 133(0.1 %)

The actual number describes how many people are staying in the rooms, and the annual number refers to how many days each patient stays in the room.

Table 2.
The Count of Claims in Korean Medicine And Western Medicine
Male Female Sum
National health insurance The claim of western medicine 884 2,343 3,227
The claim of Korean medicine 419 1,104 1,523
Medical aid program The claim of western medicine 311 824 1,135
The claim of Korean medicine 156 410 566

This survey is divided into two; National health insurance, medical aid program. The claim of western medicine is the number of claims using the fixed sum medical fee per day. And the claim of Korean medicine is that how many times which is treated with Korean medicine among the western medical inpatients by collaborative practice. Each count of claim is calculated every month. The total count of claim of western medicine is 4,362, and total count of claim of Korean medicine-by collaborative practice- is 2,089.

Table 3.
The Number of Inpatients According to the Admission Period and the Count of Claims which is Treated with Korean Medicine
Classification Admission period Count of claims
Under 1 month 1 month∼3 months 4 month ∼ 6 months 7 month∼ 1 year Over 1 year Sum
Ultra high medical care Count 3∼6 1 1 2 3
Count 1∼2
Sum 1 1 2(0.4 %) 3 (0.1 %)
High medical care Active daily living 17∼20 8 7 1 4 20 40 230
Active daily living 9∼16 1 3 3 30 37 105
Active daily living 4∼8 1 1 11 13 42
Sum 9 8 5 7 61 90 (18.0 %) 377 (18.0 %)
Medium medical care Active daily living 16∼20 3 2 22 27 210
Active daily living 9∼15 10 8 3 3 76 100 629
Active daily living 4∼8 8 3 2 54 67 168
Sum 21 13 3 5 152 194 (38.8 %) 1007 (48.0 %)
Behavioral problem Active daily living 4∼20 6 1 1 32 40 (8.0 %) 83 (3.0 %)
Impaired cognition Active daily living 4∼20 7 1 2 70 80 (16.0 %) 398 (19.0 %)
Low medical care Active daily living 13∼20
Active daily living 6∼12 1 58 59 147
Sum 1 58 59 (11.8 %) 147 (7.0 %)
Impaired cognition Active daily living 13∼20
Active daily living 6∼12 1 16 17 42
Active daily living 4∼5 4 2 1 11 18 32
Sum 5 0 2 1 27 35 (7.0 %) 74 (3.5 %)
  Total sum 48 25 13 13 401 500 2,089

This survey is divided into 7 groups by patient’s disease, physical condition, major treatment, cognition. And it is subdivided more complicatedly with active daily living, rehabilitation service which is needed. 500 of total sum means the inpatients treated with Korean medicine among the western medical inpatients by collaborative practice. 2,089 of total sum means the total count of claims that how many times which is treated with Korean medicine among the western medical inpatients by collaborative practice. And the count of claims is calculated every month.

Table 4.
The Diagnosis According to the Count of Claims of the Inpatients
Western medical inpatients Inpatients treated with Korean medicine
Diagnosis Count of claims(Ratio) Diagnosis Count of claims(Ratio)
1 Dementia 2,243(49.2 %) Musculoskeletal disease 936(43.9 %)
2 Stroke 1,126(24.7 %) Stroke 877(41.2 %)
3 Diabetes mellitus 307(6.7 %) Dementia 147(6.9 %)
4 Cancer 248(5.4 %) Cancer 78(3.7 %)
5 Musculoskeletal disease 237(5.2 %) Parkinson’s disease 70(3.3 %)
6 Parkinson’s disease 140(3.1 %) Digestive trouble, heart & kidney disease 16(0.8 %)
7 Lung disease & cold 101(2.2 %) Lung disease & cold 4(0.2 %)
8 Any other disease 157(3.4 %) Diabetes mellitus 2(0.1 %)
Sum 4,559 Sum 2,130

This survey is investigated according to the count of claims. The count of claims is calculated every month. 4,559 of sum means the total sum of claims that how many times which is treated with western medicine. The total number of western inpatients is 549. Otherwise, 2,130 of sum means the total sum of claims that how many times which is treated with Korean medicine including Korean medical inpatients and western medical inpatients. The total number of Korean medical inpatients is 16, and the total number of western medical inpatients that treated with Korean medicine by collaborative practice is 500.

Table 5.
The Treatment Duration and the Classification of diseases of the Inpatients Which Is Treated with Korean Medicine
Treatment duration Patient Ratio Classification of diseases
Under 1 month 48 10 % Musculoskeletal disease Fracture
1∼3 months 25 5 % Musculoskeletal disease Fracture
4∼6 months 13 2.5 % Musculoskeletal disease Cancer
7∼12 months 13 2.5 % Musculoskeletal disease Stroke
Over 1 year 401 80 % Stroke Dementia
Sum 500 100 %

This survey is investigated according to discharged patients. The diagnosis is major disease when treated with Korean medicine. 500 of total sum means the inpatients treated with Korean medicine among the western medical inpatients by collaborative practice.

Table 6.
The Item in Korean Medical Treatment which is Claimed
Item Count of claims Ratio
1 Acupuncture at 2 points 18,021 29.9 %
2 Indirect moxibustion 11,911 19.8 %
3 Intraarticular cavity acupuncture 10,523 17.5 %
4 Electric stimulus acupuncture 8,467 14.0 %
5 Penetration acupuncture 6,298 10.4 %
6 Dry cupping therapy 2,464 4.1 %
7 Intervertebral acupuncture 941 1.6 %
8 Division acupuncture 765 1.3 %
9 Intraperitoneal acupuncture 352 0.6 %
10 Hoechun-moxibustion 237 0.4 %
11 Wet cupping therapy 181 0.3 %
12 Pharmacopuncture 71 0.1 %
13 Bulky moxibustion 53 0.1 %
14 Intra-nasal sinus acupuncture 12 0.0 %
15 Laser acupuncture 2 0.0 %
Sum 60,298

This survey conducts of the inpatients that are treated with Korean medicine including Korean medical inpatients and western medical inpatients. The total number of Korean medical inpatients is 16, and the total number of western medical inpatients that treated with Korean medicine by collaborative practice is 500. The count of claims is calculated every month.

Table 7.
The Count of Prescribed Herbal Medicine Extracts
Herbal medicine extract Out-patients In-patients
Gamisoyo powder 1,128 82
Galgeun decoction 1,701 0
Saengmaek powder 210 282
Sosiho decoction 113 1,041
Socheongnyong decoction 1,053 0
Ojeok powder 4,156 45
Jowiseunggi decoction 903 849
Hyangsapyeongwi powder 1,065 135
Hyeonggaeyeongyo decoction 134 252
Hoechunyanggyeok powder 279 381

This survey conducts of the outpatients and the inpatients including Korean medical inpatients and western medical inpatients. There’s a huge list of herbal medicine extracts, so following list is summarized in frequently used herbal medicine extracts.

Table 8.
The Count of Prescribed Herbal Medicine
Herb medicine Out-patients In-patients
Gamidaebo decoction 40 250
Damcheong pill 855 0
Danggwisu powder(extractives) 1,531 145
Banhabaekchulcheonma decoction 590 88
Boikyangwi decoction 80 120
Bojungikgi decoction 1,264 126
Samchulgeonbi decoction 1,064 1,065

This survey conducts of the outpatients and the inpatients including Korean medical inpatients and western medical inpatients. There’s a huge list of herbal medicine, so following list is summarized in frequently used herbal medicine.

Table 9.
The Hospitalization Period of Inpatients Responded to the Survey
Hospitalization period 6 months 7∼12 months 13∼24 months 25∼36 months 37∼48 months 49∼60 months Over 60 months
Inpatient 14 5 9 2 5 5 2

42 inpatients were recruited and responded to the survey.

Table 10.
The Age Of Inpatients
Age Under sixty Sixties Seventies Over eighty
Inpatient 3 2 24 13

42 inpatients were recruited and responded to the survey.

Table 11.
The Disease of Inpatients
Disease Stroke Hypertension Diabetes mellitus Dementia Musculoskeletal disease Any other disease
Patients 10 3 5 4 17 3
Table 12.
The Kind of Korean Medical Treatments Used To Inpatients
Treatment Only acupuncture Only herb medicine Both treatment
Patient 40 0 2

42 inpatients were recruited and responded to the survey.

Table 13.
The Satisfaction of Inpatients
Satisfaction Very good Good Not bad Bad Very bad
The number 33 6 3 0 0

42 inpatients were recruited and responded to the survey.

VI. References

1. Oh HS, Kim HK, Park JE, Kim KS, Kim ME. Clinical epidemiology for elderly patients of Oral medicine Clinic. Kor J Oral Med. 2013;38(1):19–28.
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2. Choi YH. Time series comparison of health utilization and medical cost of 19 geriatric disease in Korea[dissertation]. Seoul: Kunkuk University. 2010:Korean.

3. Kim DH. The effect of introducing per diem payment system on inpatient expenditure of long-term care hospitals in Korea[dissertation]. Chuncheon: Hallym University. 2012:Korean.

4. Yang YS, Kim DH. Nurses’ professionalism and job satisfaction on the level of delegation of nursing activities in long-term care hospitals. J Kor Gerontol Nurs. 2013;15(2):175–84.

5. The Korean Health Insurance Review & Assessment Service Criteria. The information of medical resources. Available from:URL:http://www.hira.or.kr/rec_infogis.resource.do?method=openGISResources&pgmid=HIRAA030501000000.

6. Kim YB. A study on evaluation and improvement of long-term care hospitals for changing long-term care hospital fee system. Kor J Health Service management. 2011;5(2):105–17.
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7. Kim BY, Jeong MA. The effects of medical service qualities on satisfaction, relationship quality, and revisit intent in long term care hospital an elderly out-patients. Kor J of Health Policy & Administration. 2012;22(2):183–206.
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8. Kim JS, Kim SJ, Lee HJ. Comparative analysis study of oriental and western medical insurance fee in long-term care hospital. J Korean Oriental Med. 2013;34(1):35–44.
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9. Lee JY, Yoon JY, Kim JH, Song SH, Joo JS, Kim EK. Development of patient classification system in long-term care hospitals. Kor J Acad Nurs Admin. 2008;14(3):229–40.

10. Won HJ. Trend of changes in medical expenses of the elderly in long-term care hospitals[dissertation]. Seoul: Inje University. 2010:Korean.

11. Yang JH, Chang DM. The effects of medical service quality on the customer satisfaction and intention of revisit in long-term care hospitals. Kor Soc of Hospital Admin. 2012;17(3):37–56.

12. Ko MS. Assessment of medical service quality perceived by in-patients of geriatric hospitals-using revised IPA applying the Kano’s model-. Kor J of Health Service Management. 2013;7(1):133–44.
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13. Ga H. Critical pathway of long-term care hospital for doctor, nurse. Seoul: Gunja. 2012:2–9.



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