Dept. of Health Administration, College of Health Science, Yonsei University, Maeji-ri. #234, Hungob-Myon, Wonju-city, Kangwon-do, Republic of Korea.
Health Policy. 2009 Dec;93(2-3):165-71. doi: 10.1016/j.healthpol.2009.07.009. Epub 2009 Aug 13.
This paper compares the process and results of the reform which confined doctors to prescribing and pharmacists to dispensing in both Korea and Japan from comparative and politico-economic perspectives. At the present time, several years since the reforms were implemented, a 'compulsory separation' is being established in Korea. The claims containing antibiotics against the total claims from the doctor's clinic dropped from 55.7% in 2000 to 29.6%, and the number of drugs per claim from 5.9 in 2000 to 4.2 in 2008. Japan selected an 'arbitrary separation'. Efforts to raise the rate of the 'separation' have increased the rate from 1% in 1974 to 57.2% in 2007, but nearly half of medical prescriptions are still being dispensed by doctors. Disparity in the two countries has been brought about by what follows: first, the president's political leadership caused a radical shift in the attitude of the bureaucratic group in Korea; second, in their confrontation with doctors the pharmacists' camp in Korea proved to hold political power stronger than that in Japan; third, intervention in policy of progressive civic groups in particular played a pivotal role in accomplishing the reform in Korea.
本文从比较和政治经济学的角度比较了韩国和日本将医生的处方权和药剂师的配药权分开的改革过程和结果。目前,在改革实施几年后,韩国正在建立“强制性分离”。从医生诊所开出的含抗生素的总处方比例从 2000 年的 55.7%下降到 2008 年的 29.6%,每张处方的药物数量从 2000 年的 5.9 下降到 4.2。日本选择了“任意分离”。提高“分离”率的努力使该比率从 1974 年的 1%上升到 2007 年的 57.2%,但仍有近一半的处方由医生开出。两国之间的差异如下:首先,总统的政治领导导致韩国官僚团体的态度发生了根本性转变;其次,在与医生的对抗中,韩国药剂师阵营表现出的政治权力强于日本;第三,进步的公民社会团体对政策的干预尤其在韩国的改革中发挥了关键作用。