• 제목/요약/키워드: treatment patterns

검색결과 1,856건 처리시간 0.03초

소아 단순 비만의 변증 유형, 변증별 증상, 치법 및 한의치료 분석 - 중의학 논문을 중심으로 - (Analysis of Pattern Identification and Related Symptoms, Treatment Principles and Korean Medicine Treatments on Childhood Simple Obesity -Focused on Traditional Chinese Medicine Literature-)

  • 정윤경;김재현;방미란;이보람;장규태
    • 대한한방소아과학회지
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    • 제37권1호
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    • pp.15-44
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    • 2023
  • Objectives The purpose of this study is to analyze the types of childhood simple obesity and suggest clinical symptoms, treatment principles, and traditional Chinese medicine (TCM) treatments for each type. Methods All kinds of literature published by the China National Knowledge Infrastructure (CNKI) up to August 20, 2022 were analyzed. We extracted information about types of childhood simple obesity, relevant clinical symptoms, treatment principles and TCM treatments. Results 25 studies were included. Spleen deficiency with dampness obstruction, gastrointestinal dampness-heat, internal excess of phlegm-dampness were the most reported. Spleen deficiency with dampness obstruction has symptoms of powerless, heavy limbs, pale tongue, teeth-marked tongue, sunken and slippery pulse. As a treatment, herbal medicine (HM) like modified Banggihwanggitang and acupoint like Joksamri were mainly reported. Gastrointestinal dampness-heat has symptoms of thirst, constipation, edacity, rapid hungering, heavy limbs, red tongue, slippery and rapid pulse. HM like Modified Xiehuangsan to clear heat was mainly reported. Internal excess of phlegm-dampness has symptoms of heavy limbs, lack of strength, tongue with white slimy fur, slippery pulse. Modified Ijintang to dry dampness to resolve phlegm was mainly reported. Conclusions This study analyzed types of pattern, clinical symptoms, treatment principles, and TCM treatments of childhood simple obesity. Based on this study, it is necessary to derive a standardized dialectical information that reflects the domestic situation.

Patterns of Care 연구 개발을 위한 직장암의 수술 후 방사선치료 시 적정 방사선치료 조사영역 제안 (Suggestion of Optimal Radiation Fields in Rectal Cancer Patients after Surgical Resection for the Development of the Patterns of Care Study)

  • 김종훈;박진홍;김대용;김우철;성진실;안용찬;유미령;전미선;홍성언;오도훈;김일환
    • Radiation Oncology Journal
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    • 제21권3호
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    • pp.183-191
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    • 2003
  • 목적: 전국의 각 병원 방사선종양학과 전문의들이 시행하고 있는 직장암의 수술 후 방사선치료 조사영역 결정 원칙들을 취합하여 이를 바탕으로 표준적인 조사영역을 제시하고 향후 Patterns of Care 연구를 위한 기본 자료로 삼고자 한다. 대상 및 방법: 경인지역 소재 18개 병원의 방사선종양학과 전문의들이 모인 합의도출 위원회에서 직장암의 수술 후 방사선치료 조사영역 결정 원칙을 파악하기 위해 개발한 항목들을 이용하여 직장암의 방사선치료를 담당하고 있는 전국의 48개 병원 방사선종양학과 전문의들을 대상으로 설문조사를 시행하였다. 전문의 별 치료원칙의 파악에 사용된 설문 항목들은 모의치료 시 조사영역 결정 19개 항목으로서 전후방 치료 시의 상연, 하연 및 측연과 측면 치료 시 전연, 후연 및 차폐물의 적용 범위 등을 묻는 내용이었고, 45개 병원 중 33개 병원의 전문의들로부터 회신된 내용과 해부학적, 임상적 결과들을 바탕으로 일반적으로 권장할 만한 적절한 방사선조사영역을 도출하였다. 결과: 직장암의 수술 후 방사선치료 조사영역 결정에 있어 권고할 만한 일반적인 원칙으로 다음의 사항들을 개발하였다. 상연은 제5요추 하단이나 중간부위, 또는 천장골관절 상단, 하연은 전하방 절제수술 시에는 문합부로부터 일정거리 하방, 복회음부 절제수술 시는 회음부 봉합부로부터 일정거리 하방, 전후방 치료 시의 측연은 골반강 내벽면으로부터 일정거리 외측, 측면 치료 시의 전연은 치골결합부 후단, 그리고 후연은 천골 전면 또는 후면으로부터 일정거리 후방으로 정하여 천골 전면부의 공간을 충분히 포함시키는 것이 합리적인 것으로 나타났다. 권고안과 비교할 때, 상연의 경우 23건($70\%$), 하연의 경우 전하방절제수술 시 13건($39\%$), 복회음부 절제수술시 32건($97\%$), 측연의 경우 32건($97\%$), 후연의 경우 32건($97\%$), 그리고 전연의 경우 16건($45\%$)에서 부합되는 것으로 나타났다. 결론: 직장암의 수술 후 방사선치료 시 적절한 방사선치료 조사영역의 결정을 위하여 표준적인 조사영역을 제시 하였으나 개별 환자의 병변 위치와 진행상태, 수술 소견 등에 따라 적절한 변형은 필수적이라 하겠다. 이 권고안의 임상적 타당성은 향후 시행될 Patterns of Care 연구를 통하여 증명하는 것이 필요하겠다.

최근 5년간 연세대학교 치과대학병원 소아치과의 환자 분포 및 치료 경향 (The Distribution of Patients and Treatment Trends in the Department of Pediatric Dentistry, Yonsei University Dental Hospital for Last 5 Years)

  • 강정민;이효설;최형준;최병재;손흥규;이제호
    • 대한소아치과학회지
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    • 제41권2호
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    • pp.134-144
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    • 2014
  • 본 연구는 환자분포 및 치료경향을 조사하여 소아치과의 변화하는 진료 양상을 알기 위해 시행하였다. 2008년 1월부터 2012년 12월까지 연세대학교 치과대학병원 소아치과에 내원한 환자를 대상으로 전자의무기록을 수집하고 분석하였다. 조사 결과 초진환자와 비선택 진료의사 1인당 환자 수는 감소하였고 외국인 환자수가 급증하였다. 신환은 만 0~2세의 연령층이 가장 많았고, 내원 주소는 치아우식증, 외상, 부정교합 순으로 높게 나타났다. 수복치료의 분포 결과 복합레진 수복, 아말감 수복, 치면열구전색술은 감소하였고, 자가중합형 글라스아이오노머, 예방적 레진수복이 증가하는 추세였다. 다내원근관치료가 감소하고 당일발수 근관 충전이 증가했으며, 치수복조술과 치수절단술과 같은 보존적 치수치료의 비율이 증가하였다. 환자의 불안을 감소시키기 위해 진정법을 선택하는 경우가 증가하였으며 아산화질소의 이용이 주를 이루었다. 내원 환자의 분포 및 특성을 파악하고, 최신 치료 경향을 제공함으로써 환자의 요구에 부합하는 적절한 치료계획을 수립하는데 도움이 될 것으로 생각된다.

뇌성마비 아동의 신체 기능수준과 재활 목적 치료 강도가 신체 기능향상에 미치는 영향: 6개월간 추적연구 (The Effects of Physical Function Level and Intensity of Treatment for Rehabilitation on Improvement of Physical Function in Children with Cerebral Palsy: Follow-up Study for 6 Months)

  • 김부영;윤영주;신용범;김수연;오태영
    • 대한물리의학회지
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    • 제13권1호
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    • pp.27-38
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    • 2018
  • PURPOSE: The purpose of this study was to find out the treatment patterns of Children with cerebral palsy, and to analyze the effect of physical function level and treatment intensity on improvement of physical function in children with cerebral palsy for six months. METHODS: Participants were 126 children (boys 83, girls 43) diagnosed cerebral palsy that the mean age was at 33months, ranged from 8 months to 77 months. We collected data related on demography and disable characteristic, treatment pattern using by questionnaire constructed ourselves for six months on caregivers. The treatment pattern includes, type, frequency, and institute of treatment. We performed the evaluation of Gross Motor Function Measurement (GMFM) and Pediatric Evaluation of Disability Inventory (PEDI) between pre and post for six months in order to find out improvement of physical function. We analyzed the effect of physical functional level measured by Gross Motor Functional Classification system, age, treatment intensity on physical function using by repeated measures ANOVA for SPSS PC ver. 22.0. RESULTS: The average of treatment frequency for physical therapy was 5.74 times per week, occupational therapy was 3.96 times, speech therapy was 2.96 times, treatment for accompanying disability was 3.12 times. Physical function level and age was significantly factors affecting improvement of physical function, there was no significant difference according to treatment intensity. CONCLUSION: We suggest that physical function and age might be important factors on improvement of physical function and professional rehabilitation team must consider the appropriate treatment type customized to each children.

편측안면경련에서 미세혈관감압술의 성적 (Results of Microvascular Decompression in Hemifacial Spasm)

  • 곽형준;김재휴;이정길;김태선;정신;김수한;강삼석;이제혁
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.501-508
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    • 2001
  • Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.

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은화연교탕(銀花連翹湯)을 투여한 기침 환자에 대한 후향적 연구 (Retrospective Study of Patients with Cough Treated with Eunhwayeongyo-tang)

  • 백현정;이범준;정승기;정희재
    • 대한한방내과학회지
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    • 제37권6호
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    • pp.961-977
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    • 2016
  • Objectives: This study was designed to analyze the treatment effects of Eunhwayeongyo-tang through retrospective chart reviews. We also checked the correlation between each pair of variables of the symptoms and curative rates of patients with cough. Methods: Thirty-three patients with cough who had satisfied the selection criteria were retrospectively reviewed through their basic medical records, nasal endoscopy, and questionnaires about cough on their first and second visits. The questionnaires used were "The questionnaire on clinical symptoms of cough & sputum", Leicester Cough Questionnaire Korean Version (LCQ-K), Total Nasal Symptom Scores (TNSS), Visual Analog Scale (VAS), and "Cold-heat patterns". The improvement rate, calculated by "The questionnaire on clinical symptoms of cough & sputum" was considered to be clinically effective if reduction of symptoms scored more than 30%. The state of nasopharyngeal mucosa was assessed to categorize the cold-heat patterns of the upper respiratory tract and for diagnosis. Results: According to this study, cough and sputum improved by $57.22{\pm}37.76%$. Most patients (76%) improved significantly after $12.18{\pm}6.59days$ of taking Eunhwayeongyo-tang. The cure rates of 26 patients among the 33 patients were judged as effective. All the mean scores of the questionnaires and the anterior nasal cavity states were significantly improved on the patients' second visits. After $18.39{\pm}15.68days$, 30 patients were completely cured and ended treatment. The nasopharyngeal mucosa states of all patients were categorized as heat patterns. Conclusions: The conditions of the patients with nasopharyngitis significantly improved after taking Eunhwayeongyo-tang. All of the patients had pharyngitis or rhinitis. The cold-heat pattern of nasopharyngeal mucosa was a significant indicator of upper respiratory inflammation diagnosis.

Ultrastructures of Oocyte Development and Electrophoretic Patterns of the Yolk Protein Following HCG Treatment in Korean Native Catfish (Silurus asotus)

  • Yoon, J.M.;Chung, E.Y.;Kim, G.W.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권2호
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    • pp.174-183
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    • 2001
  • During the rapid phase of gonadal development of the freshwater teleost, the catfish (Silurus asotus), the influence of hCG upon the inducement of final oocyte maturation and spawning was investigated electrophoretically and ultrastructurally. The electrophoretic patterns obtained were different in the presence and absence of some of the major or minor zones, because of the hormone level in catfish. The vitellogenin of hormone-treated fish was stained more intensively than that of sham-treated fish. These proteins showed some minor or main bands of egg extracts which migrated at positions corresponding to molecular weights of approximately 90,000. However, the thickness of electrophoretic band in molecular weight for hCG-treated fish was slightly lower than that for saline control. It seemed the plasma protein with molecular weight of approximately 45,000 in hCG-treated fish disappeared. In contrast to the control fish, the ovaries in the catfish treated with hCG shows a marked ultrastructural change under the electron microscope. No dilated profiles were seen in the granulosa cells of the mature oocyte before ovulation. After germinal vesicle breakdown (GVBD), the zona radiata interna (ZRI) becomes more compact, and there is a loss of all the processes from the pore canals. There is a wide space between the vitelline membrane and zona radiata. Also, during final maturation, the microvillar processes from the oocyte are seen no longer to penetrate deeply into the extracellular spaces of the overlying granulosa cells, and the reticulate patterns of the zona radiata interna becomes occluded, giving the zona radiata a more solid appearance. It has been possible to initiate 100% oocyte maturation in yolk granules and follicles in vivo by treatment with hCG and a high water temperature ($27^{\circ}C$). In hCG-treated fish, the percentages of successful artificial fertilization and hatching were maximal at 15 h after a single injection. It seems clear that a long acting preparation containing hCG can be successfully used in prespawning fish to advance the final events of gonadal maturation and initiate spawning. Further studies are necessary to evaluate the potential of hCG to either stimulate or inhibit the reproductive development of fish at other stages of the seasonal reproductive cycle.

간호사의 통증관리에 대한 주관성 연구 (A Study on the Subjectivity of Pain Management of Nurse)

  • 박경숙;송미승;김경희
    • 성인간호학회지
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    • 제13권1호
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    • pp.123-135
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    • 2001
  • The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.

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제초제 Thiobencarb 처리에 의한 수도품종간 단백질 유형의 변화 (Protein Patterns of Rice(Oryza sativa L.) Cultivars as Affected by Herbicide Thiobencarb)

  • 김학윤;김길웅;신동현;김건우
    • 한국잡초학회지
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    • 제16권4호
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    • pp.354-361
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    • 1996
  • Thiobencarb 처리에 의한 수도품종의 내성 정도를 조사하고 내성 메카니즘을 연구하기 위하여 내성 및 감수성 품종간의 단백질 함량, SDS-PAGE에 의한 단백질 유형의 변화를 조사하였다. 본 시험에 공시한 5개 품종 중 IR 10198-66-2와 IR 9660-50-3-1은 온실 및 실내실험에서 공히 thiobencarb에 대하여 내성을 보였으며 IR 22, IR 31802-48-2-2, IR 20656-R-R-R-6-1은 제초제 농도가 증가함에 따라 생장이 크게 억제되어 감수성을 나타내었다. Thiobencarb 처리에 의한 단백질의 함량은 내성 및 감수성 품종간에 뚜렷한 차이를 보였는데 감수성 품종의 단백질 함량은 제초제 농도가 증가함에 따라 크게 감소하는 경향을 나타내었으나 내성품종의 경우 감소가 거의 없었다. SDS-PAGE에 의한 단백질 밴드는 내성 품종의 경우 5ppm 처리에서도 변화가 없었으나 감수성 품종은 5ppm 처리에서 94-30 kD 사이와 14.4kD 부근의 단백질 밴드가 사라지는 경향을 보였다. Thiobencarb 3ppm을 처리한 감수성 품종인 IR 22의 2차원 전기영동에 의한 단백질 패턴에서는 14.4kD와 55kD 부근의 spot가 사라지거나 density가 감소하는 경향을 보였다. 이상의 단백질 함량과 유형의 변화로 미루어 보아 thiobencarb 처리는 감수성 품종의 특정 단백질 합성을 억제하는 것으로 나타났으며, 벼의 thiobencarb에 대한 내성은 이 부위의 단백질과 밀접한 관계가 있는 것으로 사료된다.

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의료보험 실시후 2년간의 진료양상의 변화 -서울시내 의료기관 입원환자를 중심으로- (Changes in Hospital and Clinic Care Patterns Under the Medical Insurance System)

  • 서일
    • Journal of Preventive Medicine and Public Health
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    • 제14권1호
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    • pp.3-12
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    • 1981
  • To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.

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