Factors affecting utilisation of traditional Korean medical services by privately insured persons: a retrospective study using Korean Health Panel Survey (KHPS).

OBJECTIVE: This study aimed to use the Korean Health Panel Survey (KHPS) data to identify the key factors that influence decisions regarding the use of traditional Korean medicine (TKM) by privately insured persons. DESIGN: A retrospective study on episodic KHPS data from 2009 to 2013. SETTING: Nationwide-based survey using the KHPS data. PARTICIPANTS: The study included outpatients aged ≥20 years who had used private medical insurance at least once during the 5 years of the survey. After excluding cases where TKM was not used and those with missing values, this study ultimately included 1874 patients. PRIMARY AND SECONDARY OUTCOME MEASURES: The main dependent variable was TKM utilisation (number of outpatient visits and outpatient costs of TKM). We used multiple linear regression analysis to identify determinants of TKM while controlling for clustered errors. RESULTS: Approximately 6.1% (1874) of all doctor visits (30 982) were characterised as TKM services. For therapeutic purposes, TKM visits increased despite not being guaranteed in private health insurance (coefficient=3.0, p=0.045) and TKM outpatient costs decreased (coefficient=-0.3, p=0.001). Women used more therapeutic TKM services than men (coefficient=2.8, p<0.001). Older patient groups used more therapeutic TKM services than younger patient groups (coefficient=11.5, p=0.012), but paid less on outpatient costs than younger groups (coefficient=-1.0, p=0.001). For preventive services, sex and age were not statistically significant factors. Regardless of the purpose of the visit, the more chronic diseases, the more people who have previously experienced TKM service use more TKM services (p<0.001). CONCLUSIONS: Despite a policy to reduce services that are not guaranteed by private health insurance, the increase in the number of outpatient visits for uncovered therapeutic TKM services implies a high public need for TKM in Korea.

Clinical and cost-effectiveness of collaborative traditional Korean and Western medicine treatment for low back pain: A protocol for a prospective observational exploratory study.

BACKGROUND: In South Korea, a few patients with low back pain (LBP) are currently being treated with a combination of traditional Korean medicine (KM) and Western medicine (WM). Although a recent research has reported results regarding patient satisfaction and exploratory effectiveness, evidence of comparative effectiveness still needs to be reviewed. The aim of this study is to evaluate the clinical and cost-effectiveness of KM and WM collaborative treatment (CT) compared with that of sole treatment (ST) for patients with LBP in Korea. METHOD/DESIGN: This multisite, prospective observational comparative effectiveness research study is part of a nationwide pilot project for KM and WM collaboration launched by the Korean Ministry of Health and Welfare. The duration of the study is 8 weeks, and the target number of inclusion is 360 patients. Participants receive treatment according to their treatment plan, and a researcher conducts investigations thrice, every 4 weeks. In the final analysis, the merged data from the participants' questionnaire responses, hospital medical records, and administrative data, and Health Insurance Review and Assessment service data will be compared between the CT and ST groups. DISCUSSION: This study will provide clinical and economic information about CT for LBP, which might be a milestone for establishing future polices about this collaboration in Korea. TRIAL REGISTRATION: The study protocol has been registered with the Clinical Research Information Service (KCT0002827).

Effectiveness of collaborative treatment using Korean and Western medicine for mild cognitive impairment or dementia: A protocol for a prospective observational exploratory study.

BACKGROUND: South Korea has a dual medical system comprising conventional Western medicine (WM) and traditional Korean medicine (KM), which has yielded both positive results (increased opportunity to choose medical care) and negative results (increased medical costs). Thus, the Ministry of Health and Welfare has been performing a pilot project to evaluate this collaborative system in the real clinical situation. As treatment of dementia requires a social approach, the Korean government aims to strengthen the role of the national health care system to reduce the burden of dementia. The aim of this study was to evaluate the clinical - and cost-effectiveness of collaborative KM and WM treatment in patients with dementia or mild cognitive impairment (MCI) in Korea. METHOD/DESIGN: In total, 180 patients with dementia or MCI will be recruited and will undergo monthly check-up for 12 weeks. Information regarding demographic characteristics, baseline disease-related data, and outcomes related to cognitive function and quality of life will be obtained. For data analysis, the patients will be classified into 2 groups using a comparative observational study design: the sole treatment group, which will receive either WM or KM alone, and the collaborative treatment group, which will receive both WM and KM. DISCUSSION: The treatment of dementia/MCI in South Korea will be studied in the real world during the pilot project. There will be no limitations on the type of treatment or the specific treatment method. Examining the clinical- and cost- effectiveness of the different methods will supply information for building an optimal medical system for the treatment of dementia/MCI. TRIAL REGISTRATION: The protocol for this study has been registered at the clinical research information service (CRIS: KCT0002868).

The effectiveness, safety, and economic evaluation of Korean medicine for unexplained infertile women: A multi-center, prospective, observational study protocol.

Infertility is a condition in which a woman has not been pregnant despite having had normal intercourse for 1 year. The number of unexplained infertile females is increasing because of late marriage customs, as well as environmental and lifestyle habits. In Korea, infertile females have been treated with Korean medicine (KM). However, these effects have not been objectively confirmed through clinical trials. Therefore, this study was conducted to demonstrate the effectiveness of herbal medicine treatment in infertile patients and to demonstrate the economic feasibility through economical evaluation with assisted reproductive technology.This study is designed as a multicenter, single-arm clinical trial. All participants included will be from 3 Korean Medicine hospitals in Korea and will voluntarily sign an informed consent agreement. All recruited patients will conduct related surveys and tests, and be provided with treatment according to their menstrual cycle. Patients will take herbal medicines for 4 menstruation cycles and receive acupuncture and moxibustion treatment at 3 times (menstrual cycle day 3, 8, 14) during 4 menstruation cycles. They will also undergo an approximately 4 menstrual cycle treatment period, and 3 menstrual cycle observation period. If pregnant during the study, participants will take the herbal medicine for implantation for about 15 days. In this study, the primary outcome will be the clinical pregnancy rate, whereas the secondary outcome will include the implantation rate, ongoing pregnancy rate, and live birth rate.Ultimately, this study will provide clinical data regarding the effectiveness and safety of KM treatment for females with unexplained infertility and important evidence for establishing standard KM treatments for unexplained infertility. Moreover, we will identify the most cost-effective way to treat unexplained infertility. TRIAL REGISTRATION IDENTIFIER: Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002235. Date: February 21, 2017 (retrospectively registered).