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KMID : 0379320020270020075
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Korean Journal of Rural Medicine
2002 Volume.27 No. 2 p.75 ~ p.86
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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center
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Chun Jae-Kyung
Kam Sin
Han Chang-Hyun
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Abstract
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This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpese of this study, prescription data of 5,89() prescribed patients in March 2(X()(bef ore the Separation of Prescription and Dispensing) and 3,4 prescnbed patients in March 2(~)1(after the Separation) in 4 Health Centers located in Gyeongsangbtilcdo and Gyeongsangnanrdo were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.l%), patients with musculoskeletal disease(70.5%). patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by ~?O~, The mean Health Center visited days of prescribed patients decreased significantly after the Separation oC Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and [)ispensing(4.7drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70o, and the prescription rate of antibiotics decreased significantly from 337% to l9.l%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to and the prescnption rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.0l). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.
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KEYWORD
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Changes in patients and medical service, health center, Separation of prescribing and dispensing practice
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