傷病別로 본 一部 無醫地域 住民들의 醫僚利用에 關한 調査

安僑燦 충남대학교 대학원 1977 論文集 Vol.9 No.-

Because of a desire to know the illness and choice medical care of Doctorless Rural Residents, in Chungnam province, we conducted a survey among doctorless Sae Ma Eul villages near main street, for the 1 month period from 1976 June 15th to July 15th. Information was gathered from 2,271 persons, from this group, 197 persons, had experience of recieving medical treatment; and these are the conclutions drawn therefrom. 1. Record of Disease For. 1 month, from 1976 June 15th to July 15th, followings are the incidence of disease Disease of the digestive system : 29.4% Disease of the respiratory system : 17.8% Disease of the bones and organs of movement : 12.2% Allergic, endocrine system, metabolic and nutritional disease : 10.2% Others : below 5% 1) Result of Age Difference The highest incidence was 40-49 age group, followed by 0-9 age group. In 0-29 age group, "Disease of the respiratory system" was highest rate, but in other age groups, the highest rate was "Disease of the digestive system", Especially, in 0-9 age group, that of digestive system was very high. 2) Result of Sex Difference The incidence rate of male was higher than that of female. "Disease of the digestive system" was highest rate in both sex. "Accidents, poisoning and violence" was higher in male. 3) Result of Householder's Educational Influences Among diseased persons, about 90% were educated below primary school. "Mental psychoneurotic and personality disorders" was higher among educated above high school level. But "Disease of the digestive system" and "Disease of the respiratory system" were very high in groups of educated below middle school level. 4) Result of Householder's Occupational Influences "Disease of digestive system" was higher in agriculture and forestry, but among sales and service workers, "Disease of respiratory system" was high. 5) Result of Monthly Income of each Household There was no difference in the high income brachet and low income brachet. 2. Record Concerning Usage of Medical Facility l) Result of Treatment Total recovery : 41.6% Discontinued treatment : 27.9% Continuing treatment : 27.9% Among "Infections and parasitic disease" and "Accident, poisoning and violence", the rate of total recovery was high, but "Disease of respiratory system" and "Deliveries and complication of pregnancy, childbirth and puerperium", the rate of discontinued treatment was high. 2) Type of Medical Facilities 1st choice medical facility for seeking treatment, the residents utilized drug stores, private clinics, oriental medical facility, in that order. Among "Disease of the circulatory system" and "Deliveries and complication of pregnancy, childbirth and puerperium", the utility rate of private clinics was high, but "Mental psychoneurotic and personality disorders" that of oriental medical facility was high. 42.1% of persons who visited 1st choice medical facility, change to the 2nd choice medical facility. 2nd choice medical facility for seeking treatment, the residents utilized private clinics, drug stores, oriental medical facility, in that order. "Allergic, endocrine system, metabolic and nutritional disorders" and "Disease of the bones and organs of movement" : higher utility rate at private clinic "Disease of the genito-urinary system" and "Disease of the circulatory system" : higher utility rate at drug stores After visiting 3rd and 4th choice medical facility, the numbers of resident was so few that any special fact was difficult to find. 3) Location of Medical Facility The location of 1st choice medical facility was followed, Within residing Kun : 51.8% Within residing Myon : 17.8% Neighboring Kun : 13.2% The location of 2nd choice medical facility revealed similar to that of 1st choice medical facility, but the utility rate of large city, such as Daejon, Seoul, was increased. 4) Reasons for Selection of Medical Facility A) Selection of 1st choice Medical Facility The reasons for selection of 1st choice medical facility were "Distance", "Trust for medical skill", "Economic problem", in that order. Among "Accidents, poisoning and violences", trust factor was the reasons given largest number of persons, but among other diseases, "distance" was the main reasons. B) Reasons for Changing to the 2nd Choice Medical Facility Main reason was "No effective", "trust" factor, economic factor, in that order. Trust factor was main reason among "Allergic, endocrine system, metabolic and nutritional diseases", but among "Mental psychoneurotic and personality disorder", "Disease of the circulatory system", "Disease of the digestive system" "Disease of the bones and organs of movement", "Effective" factor was main reason. 5) Reasons for Discontinuation of Treatment "Economic" factor revealed 50.9%, discontinuation at their own discretion was 43.6%. Rate of discontinuation was higher in "Disease of the digestive stsyem", "Disease of the respirarory system", in that order. Among "Neoplasms", "Disease of the genitourinary system", there was no person to discontinuation of treatment. "Economic" factor was main reason for all disease classified.

傷病別로 본 一部 無醫地域 住民들의 醫療利用에 關한 調査

安僑粲,沈雲澤 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.1

Because of a desire to know the illness and choice medical care of Doctorless Rural Residents, in Chungnam province, we conducted a survey among doctorless Sae Ma Eul villages near main street, for the 1 month period from 1976 June 15th to July 15th. Information was gathered from 2,271 persons, from this group, 197 persons, had experience of recieving medical treatment, and these are the conclutions drawn there from. 1. Record of Disease For 1 month, from 1976 June 15th to July 15th, followings are the incidence of disease Disease of the digestive system : 29.4% Disease of the respiratory system : 17.8% Disease of the bones and organs of movement : 12.2% Allergic, endocrine system, metabolic and nutritional disease : 10.2% Others : below 5% 1) Result of Age Difference The highest incidence was 40-49 age group, followed by 0-9 age group. In 0-29 age group, "Disease of the respiratory system" was highest rate, but in other age groups, the highest rate was "Disease of the digestive system," Especially, in 0-9 age group, that of digstieve system was very high. 2) Result of Sex Difference The incidence rate of male was higher than that of female. "Disease of the digestive system" was highest rate in both sex. "Accidents, poisoning and violence" was higher in male. 3) Result of Householder's Educational Influences Among diseased persons, about 90% were educated below primary school. "Mental psychoneurotic and personality disorders" was higher among educated above high school level. But "Disease of the digestive system" and "Disease of the respiratory system" were very high in groups of educated below middle school level. 4) Result of Householder's Occupational Influences "Disease of digestive system" was higher in agriculture and forestry, but among sales and service workers, "Diseases of respiratory ystem" was high. 5) Result of Monthly Income of each Household There was no difference in the high income brachet and low income brachet. 2. Record Concerning Usage of Medical Facility 1) Result of Treatment Total recovery : 41.6% Discontinued treatment : 27.9% Continuing treatment : 27.9% Among "Infectious and parasitic disease" and "Accident, poisoning and violence," the rate of total recovery was high, but "Disease of respiratory system" and "Deliveries and complication of pregnancy, childbirth and puerperium", the rate of discontinued treatment was high. 2) Type of Medical Facilities 1st choice medical facility for seeking treatment, the residents utilized drug stores, private clinics, oriental medical facility, in that order. Among "Disease of the circulatory system" and "Deliveries and complication of pregnancy, childbirth and puerperium", the utility rate of private clinics was high, but "Mental psychoneurotic and personality disorders" that of oriental medical facility was high. 42.1% of persons who visited 1st choice medical facility, change to the 2nd choice medical facility. 2nd choice medical facility for seeking treatment, the residents utilized private clinics, drug stores, oriental medical facility, in that order. "Allergic, endocrine system, metabolic and nutritional disorders" and "Disease of the bones and organs of movement" :higher utility rate at private clinic "Disease of the genito-urinary system" and "Disease of the circulatory system" : higher utility rate at drug stores After visited 3rd and 4th choice medical facility, the numbers of resident was so few that: any special fact was difficult to find. 3) Location of Medical Facility The location of 1st choice medical facility was followed, Within residing Kun : 51.8% Within residing Myon : 17.8% Neighboring Kun : 13.2% The location of 2nd choice medical facility revealed similar to that of 1st choice medical facility, but the utility rate of large city, such as Daejon, Seoul, was increased. 4) Reasons for Selection of Medical Facility A) Selection of 1st choice Megical Facility The reasons for selection of 1st choice medical facility were "Distance", "Trust for medical skill", "Economic problem", in that order. Among "Accidents, poisoning and violences", trust factor was the reasons given largest number of persons, but among other diseases, "distance" was the main reasons. B) Reasons for Changing to the 2nd choice Medical Facility Main reason was "No effective", "trust" factor, economic factor, in that order. Trust factor was main reason among "Allergic, endocrine system, metabolic and nutritional diseases", but among "Mental psychoneurotic and personality disorder", "Disease of the circulatory system", "Disease of the digestive system" "Disease of the bones and organs of movement", "Effective" factor was main reason. 5) Reasons for Discontinuation of Treatment "Economic" factor revealed 50.9%, discontinuation at their own discretion was 43.6%. Rate of discontinuation was higher in "Disease of the digestive stsyem", "Disease of the respirarory system", in that order. Among "Neoplasms", "Disease of the genitourinary system", there was no person to discontinuation of treatment. "Economic" factor was main reason for all disease classified.

錦江流域 住民의 肝吸蟲 感染에 對한 疫學的 調査硏究

安僑燦,沈雲澤 충남대학교 의과대학 지역사회의학연구소 1982 충남의대잡지 Vol.9 No.1

A study was carried out from the epidemiological aspects on the Clonorchis infection in a certain area along the main stream of the Geum River, which exercised for three times between June 10, 1980 and May 27, 1981. The subjects were chosen 6,950 people who inhabit in 49 Ri along the Geum River. For the beginning of the examination, we had intradermal test for 6,950 people. The next was the stool examinaton for 2,213 people who showed the positive reactive reaction at the first test. Finally we got the response of fheir understanding about Clonorchiasis from 1,929 by the means of questionaire among the 2,213 people who received the stool examination. The follwing results are obtained : 1. From the examination, the 31.8% of the examinee appeared to be positive in the intradermal test. The rate of male(44.7%) showed three times higer than that of female(13.3%). By the age distribution, the postive rate increased sharply in 3rd decade, reached its peak at 4th decade and decreased thereafter. By the areal distribution, the inhabitant in the upper area of the river showed positive rate more highly than the middle or lower area. 2. As a result of stool examination, the egg finding rate of Clonorchis sinensis was 45.2% among the positive reactors by intradermal test. 3. Among the subjects, the 27.3% of them did not know the infection route of Clonorchis sinensis and the 59.9% of them uneducated the health guidance of Clonorchis sinensis.

流行性 히스테리의 臨床的 觀察

安僑燦 大韓神經精神醫學會發行 1977 신경정신의학 Vol.16 No.3

The present author had an opportunity of direct clinical participation in the epidemic outbreak of hysteria at Yaechun county, Kyungpook province, June, 1976. The total cases involved in the epidemic numbered 25 girl students(including six recurrent cases) at the age of thirteen to sixteen years. The duration of illness lasted only a few days with no lasting effects, and cardinal symptoms were regularly observed; headache, altered state of consciousness, hyperventilation, paralysis of extremities, convulsive attacks and abdominal pain and numbness. As to the sociocultural background of the community, that of Yaechun area has been notified by one of the most conservation in its traditional cultural value system, which is recently superimposed by industrialization process and therefore is rather conflictful in its value system. Another important precipitating factors seemed to be related with a long lasting drought which had been a potent stress to the most residents before the epidemic. In addition there was a climate of unrest in the school due to a construction of new buildings and imminence of term examination at that time. The most marked characteristics of the courses of the epidemic were extreme suggestibility among girl students and strong need for attention-getting. And psychodynamics among patients group could be easily analyzed as positive and negative identification including competitiveness. Lastly, the author was much impressed by the attitudes of the school teachers in managing the patients of the epidemic before and after the outbreak which were considerably misleading due to their own anxiety and misunderstanding of psychiatric illness.

一部綜合病院入院患者의 特性에 關한 調査硏究

羅瑨薰,權章遠,安僑燦,沈雲澤 충남대학교 의과대학 지역사회의학연구소 1980 충남의대잡지 Vol.7 No.1

A study was conducted to provide comprehensive information on general characteristics and medical care utilization of in-patients of a hospital. Out of 5,627 in-patients admitted to Chungnam University Hospital from January 1 to December 31, 1978, 2,525 were randomly sampled for the study. Medical records the those selected were carefully reviewed and analyzed. The results obtained are as follows; 1. Among the total admitted, the most predominant age group were those of 20 and over years of age. Male was more dominant under 20 and over 60, however female aged 20-59 outnumbered male. 2. Deparment of internal medicine were followed by general surgery and pediatrics with about one thirds of the total admitted being taken care under it. 3. About fifty-eight percent of patients stayed in the hospital shorter than 1 week, while 33. 4 percent stayed 2-4 weeks, and those stayed longer than 4 weeks were mostly come from the department of orthopedics, neuropsychiatrics, and neurosurgery. 4. The most prevalent cause of admission was accident and poisoning (XVII) with highest frequency at age 20-29 both in male and female. and for female only the most prevalent cause was deliveries and complication of pregnancy, childbirth and puerperium(XI). 5. Among the admitted, nearly half of then were from Dae Jeon City where the hospital was located. 6. About forty-four percent of the admitted had no previous treatment before admission, while 33.2 percent visited private clinic, 8.5 percent had their previous treatment at general, and only 4.9 percent sought for treatment from auxilliary personnel at, such as, pharmacy. 7. In-patients from C and D area utilized private clinic and hospital for the treatment of their condition before admission to the hospital, and those from A area less utilized herb drug store and health center compared to the other. Patients of the department of pediatrics visited private clinic most, those of neuropsychiatrics department visited general hospital and those of dermatology department mainly depended on pharmacy. 8. About thirty-three percent of the patients had their condition improved, 27.8 percent recovered at his or her own will, 5.2 percent worsened, and 4.8 percent deceased as an outcome of treatment since their admission.