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Journal of the Korean Academy of Family Medicine 1989;10(8):1-15.
Published online August 1, 1989.
한국 개원의 ( 일차의료 ) 의 진료내용에 관한 연구 (Analysis of the Clincial Contents of primary Care in Korea)
윤방부(Youn Bang Bu),이혜리(Lee Hye Ree),곽기우(Kwak Ki Woo),이영진(Young Jin Lee),이홍수(Lee Hong Soo),오미경(Oh Mi Kyung)
연세대학교의과대학 가정의학교실
Abstract
Primary care is a form of delivery of medical care which encompasses the frist contact care, the continuity and the comprehensiveness of care, and the coordinative function. It is a highly personalized type of care. In order to assess the contents of primary care in Korea, 1,642 practitioners who were board certified in Family Medicine were requested to record the clinical contents of daily practice for three random days in the second week of March, May, July, September and November in 1988. The response rate was 17.5% and we analyzed the data obtained from 288 doctors regarding 116,936 patients for 2,643 days.
The results are as follows:
1. The age distribution of doctors in this study was 46.2% in the fifties, 30.9% in the sixties, 13.2% in the forties, 7.3% in the thirties and 2.4% in the seventies, and was revealed to be older than the age distribution of the total primary care physicians in our country. Twenty-four percent of respondents had another specialty board certified with Family Medicine.
2. The total number of patients was 116,936, of which 54,751 were male and 62,185 were female. The largest group of patients was in the first decade of life(30.9%) and the over seventy-one years group was 3.8%. Male patients were more dominant under the age of 20 years, however at ages over 20, female patients outnumbered male patients.
3. The chief complaints or problems of the patients were classified according to the 333 items of the first component in ICPC method. The doctors observed 168 items(50.5%) and 175,392 problems were validated, of which 83,191 originated from males and 92,201 were from females.
4. Cough was the most common problem(26.05%) among the classified problems. The percentage of problems from the most frequent to the 10th most frequent was 62.54%, and to the 20th most frequent, it was 77.01%. In every age group and sex group, 77.8% of problems coincided with the 20 most frequent problems.
5. The diagnoses by the doctors were classified according to the 378 items in the ICHPPC Ⅱ-Defined method. The doctors observed 292 items(77.8%) and 119,021 total diagnoses(55,478 in males, 63,5443 in females) were validated.
6. Among the 292 kinds of diagnoses, acute upper respiratory tract infection was the most common diagnosis. The cumulative percentage from the most common diagnosis to the 10th most common accounted for 59.17%, and to the 20th most frequent, it was 70.00%. In every age group and sex group, 66.6% of diagnoses coincided with the 20 most frequent diagnoses.
7. When the data was analyzed on a monthly basis, 94% of problems were coincided with as the 20 most common problems, and 84% of diagnoses coincided with the top 20 diagnoses in each monthly group.
8. There were 56 kinds of tools used in diagnosis, the number of cases was 23,305, and the average number of laboratory tests done per patient was 0.20. Urinalysis and microscopic examination(24.32%) was the most commonly used diagnostic tool, followed by chest x-ray at 14.29%, and CBC with differential count at 13.93%. The cumulative percentage of the 20 most commonly performed tests was 90.67%.
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