• 정신신체의학
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• 제6권1호
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• pp.46-58
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• 1998

Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.

• 대한예방한의학회지
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• 제8권2호
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• pp.129-139
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• 2004

This paper analysed the RBRVS for a doctor's consultation by measuring the time consumed in outpatient consultation, and compared the time among medical doctors, dentist, and oriental medical doctors. The time used in consultation could be a proxy for measuring RBRVS for medical services because it is the only common factor we observe in three different clinical settings. The results show that the optimal RBRVS for consultation is 183.22 for medical doctor, 99.12 for dentist, and 236.17 for oriental medical doctor. This implies the current fee schedule for consultation should be revised as 10,740 Won for a visit to medical doctor, 5,808 Won for dentist, and 13,832 Won for oriental medical doctor.

• 보건행정학회지
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• 제24권3호
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• pp.254-260
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• 2014

Background: The purpose of this study is to assume appropriate outpatient consultation time for each clinical department on the basis of measured outpatient consultation time and satisfaction of outpatient. Methods: We surveyed the feeling and satisfactory outpatient consultation time, satisfaction, revisiting intention and recommendation to others to 1,105 patients of single general hospital in Gyeonggi-do and measured their real outpatient consultation time from October 28 to November 27 in 2013. On the basis of satisfaction, we estimated appropriate outpatient consultation time through area under the receiver operating characteristic curve in logistic regression model. Results: Feeling outpatient consultation time was 5.1 minutess, satisfactory outpatient consultation time which was suggested by patient was 6.3 minutes, and real outpatient consultation time was 4.2 minutes. Department which had longest real outpatient consultation time was infection (7 minutes) and department which had longest satisfactory outpatient consultation time was neurology (9.4 minutes). From the univariate and the multiple linear regression analysis, real outpatient consultation time was longer in pulmonology patient, new patient and afternoon patient, satisfactory outpatient consultation time was longer in infection, neurology, neuropsychiatry, neurosurgery, and rehabilitation patient. Appropriate real outpatient consultation time was suggested as 5.6 minutes which differentiated high and low satisfied patient group. However, we could not assume appropriate outpatient consultation time for each clinical department because the number of patient who had bad satisfaction was too low. Conclusion: To improve patient's satisfaction, we hope outpatient reservation system is operated as each patient's outpatient consultation time is at least 5.6 minutes.

• 정신신체의학
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• 제2권1호
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• pp.98-106
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• 1994

The authors investigated 131 nonpsychiatric physicians' attitudes toward psychiatric consultation, using questionnaires. A comparison was made as regards psychiatric consultation from nonpsychiatric physicians over position(staffs vs. residents) and department(medical vs. surgical). These findings are as follows ; 1) 51.9 percent of nonpsychiatric physicians estimated that less than 30 percent of their patientshadpgychiatricproblems. 2) The percentage of the patients referred for psychiatric consultation were 30 or less than 30 percent 3) Staffs tried to refer their patients to psychiatric department for psychiatric consultation more frequently than residents. 4) Medical physicians tried to refer their patients to psychiatric department for psychiatric consultation more frequently than surgeons. 5) Psychiatric consultation was estimated to be most frequently requested for overt psychiatric symptoms(23.0%) and past history of psychiatric treatment(20.8%). 6) The most frequent causes of not referring to department of psychiatry were found to be the patients' rejection(46.8%) and non-psychiatric physicians' dissatisfaction with the results of consultation (22.2%). 7) Medical physicians tended to explain the reasons for psychiatric consultation more adequately than surgeons. 8) Residents more specifically wrote the reasons for psychiatric consultation on the chart than staffs. The results suggest that staffs are more active in psychiatric consultation than residents, whereas medical physicians are more active than surgeons. Thus, education should be more emphasized for surgeons and residents, especially for the latter for effective consultation-liaison activity. On the other hand, psychiatrists should try to improve nonpsychiatric physicians' dissatisfactions with the results of psychiatric consultations, which will positively change their attitudes toward psychiatric consultation.

• 정신신체의학
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• 제6권2호
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• pp.176-187
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• 1998

This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

• 정신신체의학
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• 제16권1호
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• pp.25-30
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• 2008

최근 노인인구의 급속한 증가로 인하여 정신과에서 노인에 대한 자문의 중요성이 확대되고 있다. 따라서 임상에서의 노인에 대한 정신과 자문의 특징과 지침에 대한 이해가 필요하다. 타과적 질환을 갖는 노인에 대한 정신과적 자문은 다른 연령층과는 다른 특성을 갖는다. 노화에 따른 장기 기능의 변화와 약동학 및 약력학의 변화에 대한 숙지가 노인에 대한 정신약물학적 접근에 매우 필수적이다. 타 연령층에 비해 노인에 대한 정신과적 자문은 상대적으로 적은 것으로 조사되었으나 실제 정신과적 자문이 노인질환의 재원기간이나 기타 사망률 등을 낮출 수 있음을 고려할 때, 노인에 대한 자문을 저해하는 요인들을 분석하고 교정하는 것이 매우 필요하다.

• 대한의용생체공학회:의공학회지
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• 제26권5호
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• pp.301-307
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• 2005

We introduce a new multimedia telemedicine system which is called Telemedicine for Real-time Emergency Multi-consultation(TREM), based on multiple connection between medical specialists. Due to the subdivision of medical specialties, the existing one-to-one telemedicine system needs be modified to a simultaneous multi-consulting system. To facilitate the consultation the designed system includes following modules: high-quality video, video conferenceing, bio-signal transmission, and file transmission. In order to enhance the operability of the system in different network environment, we made it possible for the user to choose appropriate data acquisition sources of multimedia data and video resolutions. We have tested this system set up in three different places: emergency room, radiologist's office, and surgeon's office. All three communicating systems were successful in making connections with the multi-consultation center to exchange data simultaneously in real-time.

• 정신신체의학
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• 제10권1호
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• pp.3-7
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• 2002

자문조정 정신의학은 정신 신체의학의 발전과 궤를 같이 하면서 발달되어 왔는데 특히 종합병원 정신과 성장과 더불어 한 영역을 구축해 왔다. 자문조정 정신의학의 발전은 정신의학이 의학의 주류에 끼게 된 계기가 되었다고 할 수 있는데, 저자는 이러한 발전의 단계를 역사적 흐름으로 살펴보고 정선 신체의학과 정신 역동의 밀접한 관계에 대해서도 자료를 정리 해 보았다. 또 이러한 이론적 배경이 어떻게 의학적 정신 치료에서 적용되는지도 살펴보고자 하였다.

• 정신신체의학
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• 제1권1호
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• pp.98-100
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• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• 한방안이비인후피부과학회지
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• 제35권4호
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• pp.95-105
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• 2022

Objectives : The purpose of this study is to retrospectively analyze 3 years of inpatient dermatologic and surgical consultation to Korean medicine ophthalmology, otolaryngology & dermatology department in Korean medicine hospital. Methods : We classified dermatological and surgical inpatient consultations between September 1st, 2019 and August 31st, 2022, based on electronic medical record by gender, age, hospitalized department, categories of diseases. Results : Total number of consultations were 336. The proportion of female and male were 2.5:1, and the average of age was 65.6 and 60, respectively. The most frequently referred skin disease category was infectious skin disease(39.9%), followed by eczema(20.2%), dermatoses due to physical forces(10.1%), pigment anomalies(7.1%), nevi and tumors(4.8%), diseases of the skin appendages(4.2%), urticaria(3.9%), and others(4.9%). Consultations from department of Korean rehabilitation medicine, and Korean internal medicine were most common, because they have a comparatively large number of inpatients and long hospitalization period. In case of infectious disease and skin ulcer, patients from Korean internal medicine were frequently consulted due to characteristics of stroke and internal diseases. Conclusions : This study identified the frequency of consultation and the disease group with many requests for each department. Identifying the characteristics of diseases with a high frequency of consultation will prevent various dermatological problems that may occur by department. In addition, it was found that a prompt consultation was needed for accurate diagnosis and treatment in dermatological problem.