• Health Policy and Management
• /
• v.3 no.2
• /
• pp.81-99
• /
• 1993

The purpose of this research is to assess the geographical distribution of physicians and dentists and the degree of maldistribution of the physician. Data were obtained form the Korean Medical Association's report on physicians registry and census for 1990. To assess the degree of disparity in the rural-urban distribution of physician manpower and to identify changes in the distribution pattern, the Gini index of concentration was used. Major findings are as follows; 1. Urban-rural disparity in the distribution of physician manpower exists in all categories of manpower, i.e. physician, dentist, oriental medical doctor, general practitioner, medical specialist, practitioner, public health physician and public health dentist. Urban area which had 74.4% of nation's population, accounted for over 90% of all physician manpower. 2. In terms of the ration of physician manpower per 10, 000 population, in urban area, they were 8.2 physicians, 2.7 general practitioners, 5.5 specialists, 3.0 practitioners, 1.8 dentists and 1.3 oriental medical doctors. In rural area, the ratios were 1.4 physicians, 0.6 general practitioners, 0.9 specialists, 1.0 practitioners, 0.4 dentists and 0.4 oriental medical doctors. 3. Gini indicies computed to measure inequality of physician manpower distribution were 0. 3675 for physicians, 0.3372 for general practitioners, 0.3338 for specialists, 0.2263 for practitioners, 0.3132 for dentists and 0.3293 for oriental medical doctors. 4. Inspite of increase in the number of physician manpower, urban concentration of physician manpower intensified from 1980 to 1990. However, the Gini index for all physician manpower fell by 18.3~36.7% from 1980 to 1990, indicating more even distribution. 5. In rural area, the public health physicians and dentists had increased the ratios of physicians, general practitioners, practitioners and dentists per 10, 000 population remarkebly, and had decreased the Gini indicies of physicians, general practitioners, practitioners and dentists. Thus, public health physicians and dentists contributed to improve the distribution of physician manpower in rural area. Based on the results of this study, long-term and rational manpower policies should be developed to solve the problem of geographical maldistribution of physician manpower as well as short-term policy for inducing physicians to the rural areas.

• Journal of Preventive Medicine and Public Health
• /
• v.23 no.4 s.32
• /
• pp.428-435
• /
• 1990

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows : 1) Total number of respondents was 405 ; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized n surge, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's ma discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.

• Health Policy and Management
• /
• v.3 no.1
• /
• pp.124-145
• /
• 1993

General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.

• Health Policy and Management
• /
• v.12 no.4
• /
• pp.68-90
• /
• 2002

The purpose of this study is to investigate the determinants of intent to leave among hospital physicians. A causal model of intent to leave among hospital physicians was constructed based on the exchange theory. The sample of this study consisted of 185 physicians from 8 general hospitals located in Seoul, Taegu, Kyunggi-province, and Kyungsangnam-province in Korea. Data were collected with self-administered questionnaires and analyzed using LISREL. The results of this study indicate that the following variables, listed in order of size, have significant negative effects on intent to leave among hospital physicians; job satisfaction, organizational commitment, task variety, promotional chances, task significance, and pay. Sex (female=0, male=1) was found to have significant positive effects on the intent to leave among hospital physicians. The results imply that hospital administrators should make an effort to improve job satisfaction and organizational commitment which are the key determinants of intent to leave among hospital physicians.

• Quality Improvement in Health Care
• /
• v.5 no.1
• /
• pp.140-150
• /
• 1998

A mailed survey with structured questionnaire was conducted to study the demand of private physicians who were operating their own clinics in the community to be a attending physician at the general hospital. The responding proportion was 21.6 percent of the 960 private physicians. A total of 207 responders; 65.2 percent wanted to be a attending physician. In particular, the physicians who were male, young, surgeon and teaching hospital careered after specialist were more highly motivated. The major activities what they wanted as a attending physician were medical care for the admission patients. They responded that the hospital charges for the medical services and the responsibility of malpractice issues should be fairly shared by attending physician and hospital according to their contributions. There is growing consensus that the need of attending physician at the general hospital will become wide spread, but little organizational preparation to assure the quality of medical care of attending physicians including training of resident physicians and students. In addition, the effective reimbursement system should be develop to compensate appropriately according to the medical achievement of the attending physicians.

• Journal of Korean Medical Science
• /
• v.33 no.49
• /
• pp.327.1-327.10
• /
• 2018

Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

• Health Policy and Management
• /
• v.9 no.4
• /
• pp.41-64
• /
• 1999

The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.27 no.3
• /
• pp.186-195
• /
• 2024

Purpose: Infantile colic diagnostic criteria were established by Rome IV. A universally accepted management remains to be established. We aimed to evaluate diagnostic criteria, management strategies, and perceived regional prevalence of infantile colic in Pakistan, as well as its effect on physicians and parents. Methods: A questionnaire was distributed amongst 1,256 physicians. Results: We received 800 replies. Wessel and Rome IV criteria were used by most physicians for diagnosis; however, the response "any infant who cries a lot" was selected by older physicians (48% of those over 60 years), physicians in rural areas (32%), physicians practicing in private clinics (27%), and general physicians (30%). Estimated prevalence of infantile colic ranges from 21-40%. Reassurance was the most widely recommended management strategy followed by herbal teas (51%), switching to a different formula (49%), probiotics (28%) and antibiotics (26%), discontinuation of breastfeeding (14%), elimination of dairy products from the breastfeeding mothers' diet (6%), and the administration of colic drops (1%). Most physicians considered the negative impact of colic on their personal lives and the parents as mild-to-moderate. Notably, 38% of percent of physicians routinely screened for maternal depression, and 45% of physicians were aware of the association between infantile colic and shaken baby syndrome. Conclusion: Most physicians in Pakistan diagnose and manage infantile colic according to the established guidelines. However, the guidelines pertaining to treatment planning are not followed. Educational efforts directed toward general physicians and doctors practicing in rural areas and clinics must be implemented to avoid unnecessary testing and treatment burden.

• Health Policy and Management
• /
• v.9 no.2
• /
• pp.139-156
• /
• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• Quality Improvement in Health Care
• /
• v.4 no.1
• /
• pp.36-49
• /
• 1997

Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.