• The Korean Nurse
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• v.24 no.4 s.132
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• pp.103-111
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• 1985

• Journal of Digital Convergence
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• v.10 no.10
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• pp.347-352
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• 2012

As medical treatment is developing with technology, the men's average life expectancy is extended. Therefore, primary medical care becomes emphasized in order to reduce the medical expenses in the long term by satisfying individual's life being healthy. The date for this thesis was collected from January 2011 to June 2011. 889 patients who visited the university hospital emergency room and hospitalized in internal medicine, were picked as the research subjects and they were targeted to be recorded the distribution of chief complaint and principal diagnosis of the patients. Also, this record was used to apply to the standard Classification of Diseases(as known as ICD) and the method of detailed classification of the primary medical care(as known as ICPC) to compare each other. In order to analysis, frequency analysis was used to see vital statistics and the cross tabulations were used to see the distribution of chief complaint according to ICD and ICPC. Results of the research were Abdominal pain(17.7%), Dyspnea(13.5%), Fever (12.5%), and Haematemesis (9.8%), and those symptoms represented the 54.5% of overall chief complaints that is treated in primary care. Therefore, it is acceptable to use the classification of the primary medical care at doc-in-a-box. Also, in case of diagnosis of abdominal pain, it is classified to R10 in ICD and 116 patients(18.7%) belonged to it, but according to ICPC, it is subdivided to Epigastric(11.5%) and General(5.8%). ICPC classification, which is focused to primary medical care is more detailed than ICD classification. Because the data that is collected for this thesis is from only one hospital, it is hard to represent to all the cases, but ICPC in emergency medical care, it has more classification available and it can subdivide the patients effectively, so it is meaningful.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.530-548
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• 2020

Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Journal of agricultural medicine and community health
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• v.42 no.1
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• pp.24-35
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• 2017

Objectives: This study aimed to evaluate the primary care quality of a public health center in a rural area using the Korean Primary Care Assessment Tool (KPCAT). It also examined some methodological issues in applying the KPCAT and interpreting its results. Methods: Seventy-nine patients who had visited their doctor more than four times responded to the KPCAT questionnaire. Descriptive statistics and a radar chart were used in analyzing data. Sign test was used to test the KPCAT score difference by don't know option scoring methods. Results: Median and interquartile range of the public health center's KPCAT scores were forty-five and sixteen points, respectively. Only the median of the first contact domain reached the expected value of seventy-five points. The proportions of those who scored under the expected value were under fifty percent in two of four comprehensiveness items, all of three coordinating function items, two of five personalized items and all of four family/community orientation items. There were some methodological issues including, how to score don't know option and make sure response scale consistency. Conclusions: There was much room to improve the primary care quality of the rural public health center. Especially, improvement is needed in the domain of coordinating function and family/community orientation. We also hope that methodological improvement of the KPCAT contributes to more valid and reliable primary care assessment.

• Journal of Yeungnam Medical Science
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• v.4 no.2
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• pp.139-148
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• 1987

The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post(PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows : The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours was longer for older, married and more experienced CHPs than others. About 80% of the CHP's activities took place within the PHP and only about 20% occured outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical work and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent for direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province-level.

• Research in Community and Public Health Nursing
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• v.1 no.1
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• pp.174-175
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• 1989

본 연구는 보건진료원의 업무를 분석하기 위하여 충북에서 활동하고 있는 보건진료원 136 명을 대상으로, 설문지를 흥해 자료수집을 하였으며 백분률, 평균값, 표준편차로 자료처리를 하였다. 조사기간은 1968 년 8월 1일부터 11월 20일까지 했으며 그 결과를 요약하면 다음과 같다. 1. 보건진료원의 일반적 특성과 업무에 관련 된 배경을 살펴보면 다음과 같다. 보건진료원의 일반적 특성으로 연령 분포는 30 - 34세가 30.1 %로 가장 많았고 결혼 상태는 기혼자가 61.8 % 였다. 종교는 기독교가 42.6% 로 많았고 학력은 3 년제 간호전문대학 과정졸업 자가 78.9 %로 많았다. 현 가족과 동거상태에서 배우자와 자녀가 함께 사는 경우가 76.5% 였고, 보건진료원의 경력은 1 년 마만이 41.2 %로 가장 많았다. 보건진료원의 업무에 관련된 배경을 살펴보면, 근무지역조건은 갑지가 65.3 % 였고, 현 거주지는 보건진료소내 숙소가 대다수 였다. 보건진료소는 신축된 건물이 대다수였고, 보건진료소 시설은 '그저 그렇다'고 대답한 수가 가장 많았다. 보건진료소 운영협의회 수당은 월 $5\sim7$만원인 경우가 85.6 % 였다. 2. 보건진료원의 보건의료제공 실태는 다음과 같다. 보건진료원이 현재 담당하는 주민수는 $501\sim1,000$ 명이 35.3 % 이고, 1,500 명 이상의 주민을 담당하는 경우도 32% 였다. 보건진료소를 이용한 주만은 연평균 1,956 명이고, 보건진료소 평균 이용건수는 1,812건이다. 보건진료원의 직업만족도는 만족한다가 40.6%로 대체로 긍정적으로 나타났다. 3. 보건진료원과 보건의료 관련기관과의 관계는 다음과 같다. 지역주민의 보건의료자원 이용 정도는 보건소 진료소가 1 위로 가장 많았고, 약국, 약방, 의원, 보건지소의 순위로 나타났다. 보건의료 관련기관과의 협조가 잘 되고 있지 않다고 응답한 경우도 있는데, 보건소(19.7 %), 보건지소( 20.2%) 민간보건 의료기관(22.4 %)이며, 그 이유를 알아서 협조가 잘 이루어지도록 노력해야겠다. 원하는 감독체계는 보건소장(47.3 %), 보건간호 전문가(37.2 %)로 나타났으나 이는 현재있는 감독체제내에서 생각한 것이며 간호전문가에 의한 새로운 감독체제를 원하고 있었다. 많이 이용하는 의뢰 기관은 병원(52 %), 의원(24.4 %), 보건소(10.2 %) 순이었다. 4. 보건진료원의 업무 영역별 수행정도를 살펴보면 다음과 같다. 보건진료원의 업무 영역을 7개 영역으로 구분하여 수행평균 평점을 보면통상질환 관리가 3.70점, 사업운영 관리 및 지도가 3.44 점, 사업계획 수립이 3.19 점, 지역사회 조직 및 개발이 3.17 점, 모자보건 및 가족계획이 3.14 점, 지역사회 보건관리가 3.09 점, 보건 정보체계 개발이 3.02 점으로 나타났다. 위의 결과에서 지역사회 보건관리가 3.09점으로 통상질환 관리 3.70 점 보다 낮게 나타났는데 이는 일차보건의료 사업 정착의 과도기적인 현상으로 생각하며, 이 부분을 더 많이 수행해야 할 것으로 사려된다. 5. 보건진료원의 업무 영역별 수행 소요시간의 평균은 다음과 같다. 지역사회 조직 및 개발 3.48 시간, 사업계획 수립 3.55 시간, 지역사회보건 관리 6.74 시간, 모자보건 및 가족계획 5.55 시간, 통상잘환 관리 15.94시간, 사업운영 관리 및 지도 4.39시간, 보건정보체계 3.62 시간으로 나타났다. 보건진료원이 통상질환 관리와 더불어 예방활동을 효율적으로 할 수 있도록 적절한 행정적, 교육적 지원이 있어야 한다고 생각한다.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.78-87
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• 2008

Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.53-61
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• 2001

The authors, in this paper, addressed a variety of problems and difficulties which Korean psychiatrists should cope with. The surprising development of neurosciences, splitting of neuropsychiatry into neurology and psychiatry, easygoing attitude of psychiatrists, changes in the delivery system of health care and ill-balanced education of psychiatry were listed as causes of or contributors to them. Social bias to psychiatry and regulations from outside are also considered as contributors. Psychiatric education, including medical school, residency training, continuing medical education and psychiatric textbooks, need to be changed in order to enlarge the boundary of psychiatry. Reestablishment of identity of psychiatry and psychiatrist is unavoidable, considering far-reaching new knowledge of neuroscience and gradually invisible borderzone between neurology and psychiatry. The other ways worth while to consider are : the expansion of psychiatrists' activities, development of medical behavioral science to a clinical specialty, creation of new psychiatric subspecialties, and additional training of psychiatric residencies in the primary medical care.

• Journal of Korean Academy of Rural Health Nursing
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• v.14 no.1
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• pp.17-22
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• 2019

Purpose: This study was done to describe a community health practitioner's nursing case study for a hypertension patient. Methods: For this purpose, data were collected through interviews and nursing records. The nursing process was carried out from January to March in 2019. Results: For this patient, blood pressure was checked 5 times and total cholesterol test was performed 5 times over 41 consultations. Even though the patient was 84 years old, he was very interested in health. When the blood pressure and cholesterol level measured by community health practitioner were high, he was embarrassed by the recommendation to get a hospital checkup. After referral to a medical clinic and hospital, he was satisfied with the results of the tests and medical treatment, and constantly practiced daily walking exercise. Conclusion: It is very important for community health practitioners to assess patient symptoms correctly and refer the patient timely to manage complications.