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2차 진료기관 비뇨기과의 현황 및 비뇨기과 의사의 역할
김종현(Jong Hyun Kim),박창수(Chang Soo Park),이웅희(Woong Hee Lee),신관희(Kwan Hee Shin),김용수(Yong Soo Kim),허준(Jun Heo),최동원(Dong Won Choi),안주형(Joo Hyeong Ahn),김강원(Kang Won Kim),강주호(Joo Ho Kang),원용연(Yong Yeun Won) 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.1
Purpose: We investigated the characteristics of patients transferred from other department or other healthcare institution and tried to find a way to develop the role of urologist and department of Urology in secondary healthcare institution. Materials and Methods: Thirty-eight secondary healthcare institutions were involved in the survey of questionnaire study which includes overall status of urology department and private information of 357 patients transferred from other departments of same institution or other healthcare institutions. Results: The number of hospital bed was 267 and the urologists were at work for 4.7 years on average. In 35/38 (92%) institutions, only one urologist was at work for clinical practice. Average patients number was 39.7 per day in the outpatient clinic and the portion of urological patients among the outpatients were 76.4%. Average patients number was 20.6 per month in the inpatient clinic and average number of urological surgery was 18.6. The portion of patients transferred from other departments of same institution or other healthcare institutions was 16.4%. The answer which shows good communication between other departments of same institution was 78.9% and facilitating relationship among other healthcare institutions was 47.4%. Analysis of 357 patients shows that the period of symptom development was 26.2 months and the period of prior treatment in other department or institution was 5.3 months. Bladder related disease was most common and the next order of frequency were prostate disease and urinary stone. The rate of concordance of final diagnosis between urology and other department or institution was 52.7%, and rate of concordance of medication was 23.0%. The positive answer as ‘helpful" for the prior treatment in the other department or institution was 41.2%. Conclusions: The department of Urology in secondary healthcare institution has several limitations such as relative lack of man power and expertise, lack of awareness of patients or other physicians to urology specialty, and insufficient communication with other departments or institutions. In many case, urological diseases have been managed in other departments and it takes much limitation to help the urological patients. Therefore urologists in secondary health care institution should try to upgrade their specialty and make effort to educate and promote urological concern as well as better communication with other medical departments.
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