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KMID : 0376219860230010047
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Chonnam Medical Journal
1986 Volume.23 No. 1 p.47 ~ p.74
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A Study on Pilot Programs of Mogpo Regional Medical Insurance and Separation of Medical and Pharmaceutical Practice
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Abstract
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An analytic study on Pilot Programs of Mogpo Regional Medical Insurance and Separation of Medical-Pharmaceutical Practice was performed to know the effects of the enforced separation program on the case rates and society finance, and opinions of residents on the both programs. The materials for case rates and society finance from Jan. 1, ´82 to May 31, ´85 were furnished from Mogpo medical insurance society and physician´s society, and the materials for the opinions were collected through survey with questionnaires about the programs to 3,702 residents of Mogpo City and to 2,625 residents of Yeosu City as a control group.
1. The average monthly case rate during the enforced separation of medical-pharmaceutical practice was 38.45% which is significantly higher than that of 22.84% during the voluntary separation.
2. Although the individual medical charge per case paid by insurance society (4,492 won) during the enforced separation was lower than that during the voluntary separation (before: 7,811, after: 6,045 won), it was supposed that the total sum of medical charge paid by insurance society during the former period was higher than that during the latter period due to the increased frequency of patients clinic visiting. The total sum of medical charge during the period of the enforced separation was calculated to be 122,272,000 won higher than the total amount of medical charge assumed to be spent during the same period if the separation had not been enforced.
3. To the question whether the insurance premium is expensive, 52.6% of the respondents regarded it as "expensive" or "unreasonable", and especially most of the regional insurance-beneficiaries and higher income group responded so.
4. One-third(36.1%) of the beneficiaries had the occasion of the insurance premium unsettlement, mostly(56.3%) on account of poor economic status.
5. The frequency of medical clinics utilization paralleled with the utilization of pharmacies. In comparison with the control Yeosu region, the morbidity’s of both regions seemed to be same level statistically, and Mogpo region showed the higher utilization of medical facilities with little difference in the pharmacy utilization.
6. The pros for the voluntary separation of medical and pharmaceutical practice were 57.7% while the pros for the enforced separation were only 15.9%. The main reason (18.4%) for the pros of the voluntary separation could be ascribed to its convenience and being free of administrative complexities and time-and money saving, whereas the reason (36.7%) for the pros of tja enforced separation was its encouragement of the cooperation of physicians and pharmacists.
7. The physicians´ prescriptions were occasionally (16.4%) disobeyed and changed by pharmacists and discarded by patients(17.6%) on account of "troublesomeness in visiting pharmacy".
8. The time spent for utilizing medical facilities was longer during the enforced separation than the voluntary separation. Over one-third(37.4%) of the beneficiaries had the occasion of utilizing transportation vehicles to go from clinics to pharmacies, and 35.4% had the occasion of visiting pharmacies on account of the lack of the prescribed drug at the first pharmacies.
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