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慶尙南道 市地域 民間醫院의 母子保健事業 推進實態 및 그 改善에 關한 調査硏究
金柄成,金公鉉,金炳星,朴亨鐘 대한보건협회 1992 대한보건연구 Vol.18 No.2
This study was carried out to review the current status of maternal and child health care (MCH) program implemented by the private clinics located in the cities in Kyungnam Province and to suggest alternative approaches to improve their on-going programs through a self-administered questionnaire. The subjects were 185 private physicians who operated their own clinics since 1990 and were general practitioner. Obstetrician/Gynecologist, or pediatrician. The survey was conducted by mail from 15 January to 25 February 1992. The response rate was 70.8 percent. Major results were as follows: 1. The major manpower for MCH of the studied clinics was physicians and nurse-aids. 32% of those employed one or more lab-technicians. No clinics had an independent building for MCH program. Most of studied clinics did not adequately install medical and laboratory equipments for MCH program except some of Ob/Gyn clinics. 2. 51.9% and 46.6% of the studied clinics did not provide consulting services and curative services to patients in relation to MCH respectively. 74% of them did not also provide any laboratory services. 3. Pre-and post-natal care services were provided in most Ob/Gyn clinics and general practitioners while growth measurement and immunization services were done in pediatric clinics. 4. 33% of the studied clinics had been opening either regular or irregular health education sessions for MCH. Ob/Gyn clinics put emphasis on clinical management and physiology of pregnancy and preparing delivery, but pediatric clinics did on infant rearing and immunization. 45% of the studied clinics had some kinds of health education materials for MCH program. 5. Blood presure, glucosuria and blood type were tested in 65% of the studied clinics:Ultrasonography and tests for hepatitis and fetal heart rate were provided in 40%: and tests for uterine cancer, gonorrhea and sypilis in 30%. Those tests were almost provided by Ob/Gyn clinics. 6. There were less than 10% of clinics which had been supported with drugs, equipments, or culture media for MCH programs from the government. Even though the government supply those materials to them free of charge to encourage their involvement, 40% of Ob/Gyn clinics and each 56% of general practice and pediatric clinics replied not to engage MCH programs linked with the Health Center.
Trends of the New Outpatients in a University-based Family Practice
김병성,김상혁,최현림,원장원 대한가정의학회 2011 Korean Journal of Family Medicine Vol.32 No.5
Background: Analysis of outpatient visits to primary care offers essential data for residency training by understanding ‘reasons for encounter (RFE).’ This study was designed to recognize the effect of population aging on demographic characteristics and RFEs. Methods: We included all patients who had visited family practice clinic in Kyung Hee University Hospital in Seoul during each first 5 working days of September, October, and November in 2001 and 2008. New patients included those who hadn’t visited within the last 6 months or more. Information on each patient’s age, sex, and reason for encounter was obtained from the electronic medical record. The RFEs were compared using International Classifi cation of Primary Care (ICPC)-2-E. Results: Mean age of overall outpatients was 50.5 and 52.4 years in 2001 and 2008 respectively. The number of new outpatient visits increased from 215 (21.3%) to 326 (29.7%) between 2001 and 2008 (P < 0.001) along with the number of patients aged 65 or more from 7.4% to 12.0% (P = 0.08). Mean age of established patients was 52.5 and 56.9 years (P <0.001), and the patients aged 65 or more was 14.1% and 35.8% (P < 0.001) in 2001 and 2008 respectively. Analysis by ICPC-2-E revealed a decrease in chapter A in 2008 (P = 0.03) and an increase in chapter F, L, and X (P = 0.01, 0.003, <0.001). Component 1 had increased (P = 0.01), and component 2 had decreased (P = 0.04) in proportion. Conclusion: Changes in population composition have brought a shift of the distribution of age in outpatients, more signifi cantly in follow-up patients. Comparison by ICPC-2-E showed changes in RFEs of new patients between 2001 and 2008.
Reduction Loss after Extension Block Kirschner Wire Fixation for Treatment of Bony Mallet Finger
김병성,노재휘,정기진,윤건희,박은석,박성용 대한수부외과학회 2018 대한수부외과학회지 Vol.23 No.4
Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford’s criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a sig-nificant relationship between gap or step-off and extension lag. Using Crawford’s evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.