Background
: Continuity is very important in primary care, and in most studies continuous care has been reported to have a good effect on the result of care. So we studied the factors influencing the continuity of patient care by physician in charge, especially in case of out-patient department in a university hospital.

Methods : We posed questionnaires to 55 persons who had visited continually to Paik Hospital in Pusan for at least 6 months. We classified them into three groups according to the degree of continuity using 'Modified Continuity Index', and compared the lower group(18 patients) with the higher group(18 patients).

Results : The income of the higher continuity group was significantly less than that of the lower continuity group(P=0.042). But there were no significant differences between the two groups according to sex, age, the type of family, marital status, job and the level of education. The higher continuity group agreed more significantly than the lower continuity group with the question whether it is important to be treated continually from physician in charge(P=0.005). About the reasons for visiting to other doctors instead of the physician in charge, most of them in both group replied that they could not keep appointment. And there were no significant differences in the care pattern of disease between the groups.

Conclusion : To improve the continuity of patient care by physician in charge, it is necessary to instruct the importance of continuous care to the patients and to motivate them through various methods.

Background
: Smoking is a high risk factor for various chronic diseases. Therefore, physicians are expected to play a critical role in patients' smoking cessation. There have been a number of studies which show that cessation recommendation by physicians is effective for patients to stop smoking. The purpose of this study is to assess physician's smoking status and its effect on physician's attitude for their advice to patients to quit smoking.

Methods : During August and September in 1995, self-report questionnaire was distributed to doctors in Jin-Gu, Pusan. It consisted of inquiries on their demographic features, their smoking status, whether physicians ask patients their smoking status or not, whether physicians advise patients to quit smoking or not, and whether physicians confirm patients' smoking cessation. Among 203 responses returned, 193 cases was analyzed.

Results : Among the total 193 persons, 60 persons are smoking now(31.4%, Men 34.5%, women 0%), and 88 persons(67.2%) are ex-smoker. 84.1% of smokers have tried to quit smoking, and stress was the most common reason for failure. Smoking rate and experience rate were higher in men than in women(P<0.001), but there were no significant differences in smoking rate and experience rate according to ages, religions, specialties, hospital types, and positions. Among responders 144 cases(75.0%) asked smoking status of patients. 21.4% of them asked smoking status of all patients who may smoke, and 25.0% of them hardly ask smoking status of patients. For question about patients' smoking status, the younger physicians were more active in asking smoking status of patients(p=0.038), and the physicians in hospital did much more than physicians in university hospital and private clinics(p=0.015). Among responders, 161 persons(84.7%) advised patients to quit smoking, and 19.5% of them advised to quit smoking for all patients who smoked. However, 15.3% of them hardly gave patients such suggestion. It was found that there was no significant relationship between physicians' smoking status and attitudes toward giving patients suggestion to quit smoking.

Conclusion : This study revealed that there was no significant relationship between physician's smoking status and their attitudes toward giving patients suggestion to quit smoking, and physician's smoking status did not have any effect on smoking cessation advice. However, this study does not exclude the possibility that the results might be reversed, if the census would be extended to broader area. Physicians should take an active role against smoking.