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KMID : 0379320010260010019
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Korean Journal of Rural Medicine
2001 Volume.26 No. 1 p.19 ~ p.35
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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center
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Jeong Myeong-Sun
Kam Sin
Kim Tae-Woong
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Abstract
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This study was conducted to investigate the internal changes and the countermeasure for performance iii prove ent by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were ´development of heath works contents´(62.4%), ´rearrangement of health center personnel´(51.6%), ´priority setting for health works´(48.4%), ´restructuring the organization´(36.2%), ´quality improvement for medical services´ (32.1%), ´replaning the budgets´ (23.1%) in order. And to better the image of health centers, health center officers replied that ´health information management´ (60.7%), ´public relations for health center´(15.8%), ´kindness of health center officers´(15.3%) were necessary in order. Health center officers suggested that ´vaccination program´, ´health promotion´, ´maternal and children health´, ´communicable disease management´, ´community health planning´ were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through ´vaccination program´, ´health promotion´, ´mother-children health´, ´acute and chronic communicable disease management´, ´community health planning´, ´oral health´, ´chronic degenerative disease management´, etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas (metropolitan. city, county).
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KEYWORD
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Internal changes, Countermeasure for performance improvement, Separation of prescribing and dispensing practice, Health center
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