No abstract available.
Delivery of Health Care*

No abstract available.
Methods*

No abstract available.
Cause of Death* ; Korea*

No abstract available.

No abstract available.
Fibronectins* ; Paraffin*

In spite of vigorous efforts to enhance appropriateness of blood usage in surgery, it is recognized that there are still not a few overuse and misuse of blood products in Korean hospitals. To assure appropriate use of blood, continuous monitoring and controlfling blood orders, particularly for surgical operations, should be implemented. The indicator of 'ratio of crossmatching to transfusion' (C/T ratio) has been focalized on in this regard. The authors investigated C/T ratio for eight hospitals, evenly distributed in their geographical location as well as size. Only elective surgeries operated from March 1 to May 31, 1995 were included for analysis. Standardized survey format was distributed, and retrospective reviews of medical records were performed by volunteer surveyors from each hospital after two sessions of pre- survey education. The results were as follows. Average C/T ratio, for all hospitals and all surgeries, was 1.76. Differences in C/T ratio by sex, months, clinical departments, blood components were not significant. However, the ratio showed increasing tendency with ages. The C/T ratio on the average was not higher, compared with the recommended guideline. However, due to study' s limitations ini standardization of survey method and verification of data, we could not conclude that current status of appropriateness of blood use is satisfactory. In addition, to pervasively use the C/T ratio as a quality indicator for blood use management, supplementary measures, such as standardization of data, should be adopted.
Surveys and Questionnaires ; Education ; Medical Records ; Quality Indicators, Health Care* ; Retrospective Studies ; Volunteers

It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount(total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners(GP), 107 regular family physicians(FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites(urban-rural). Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.
Age Factors ; Ambulatory Care ; Delivery of Health Care ; Female ; General Practitioners ; Health Expenditures ; Health Services ; Humans ; Insurance ; Korea ; Physicians, Family ; Prescriptions ; Specialization

The role of physicians in reducing health inequity has been regarded only partial and anecdotal by most policymakers. Clinicians, primary care physicians in particular, do not have sufficient opportunities to be engaged in activities dealing with health equity. However, physicians are playing a key role in providing health care and health-related programs, usually interwoven with inequities in health and health care utilization. As a result, a more active role for physicians must be identified under the scheme of a comprehensive strategy in combating inequity in health. From the perspective of mediating factors linking social determinants of health and inequitable outcomes in health and health care, health behaviors, access, and processes of care are identified as potential areas for physicians' engagement. 'Health equity capacity' is emphasized as a cross-cutting tool to empower physicians to address inequity in their clinical practices. More broadly, practicing physicians are able to support their colleagues and communities through diverse activities and participation: technical assistance, research and education, community involvement, and advocacy. Among them, raising awareness and changing perceptions are indicated as crucial factors facilitating physicians' contribution to minimizing inequity.
Clinical Competence ; Delivery of Health Care ; Health Behavior ; Health Status Disparities ; Healthcare Disparities ; Humans ; Negotiating ; Physicians, Primary Care ; Professional Role ; Socioeconomic Factors

No abstract available.

A clinical observation was made on forty-three cases of benign prostatic hypertrophy, admitted to the Department of Urology, National Seoul Hospital during the period from January 1, 1977 to December 31, 1980. The results were summerized as follows. 1. The incidence of benign prostatic hypertrophy was 10.9% to 396 total in-patients and 34.4% to male in-patients 50 years old or more. 2. Most of patients were in the 7th and 8th decades of life (83.7%) with a mean age of 73.5 years old. 3. The mean average hospital period was 12.4 days. 4. The mean period passed away from initial symptoms to visit was 2.8 years. Common symptoms and signs were frequency in 35 cases (81.4%), dysuria with small stream in 25 cases (58.1%), acute urinary retention in 23 cases (53.5%) and lower abdominal fulling sense and discomfortness in 13 cases (3.2%). 5. The mean volume of residual urine was 430ml. 6. Hematuria it 28cases (65.1%) and pyuria was revealed in 12 cases (27.9%). 7. I.V.P was performed in 34 cases and hydronephrosis was found in 5 cases (14.7%) and hydroureter in 4 cases (11.8%). Cystourethrography was performed in 31 cases, and elevated bladder base in 23 cases (74.2%) and trabeculation of bladder in 21 cases (67.7%). 8. Endoscopy was performed in 32 cases, The common findings were trabeculation in 28 cases (87.5%) and inflammations in 25 cases(78.1%). 9. Associated conditions with B.P.H. were hypertension in 6 cases (14.0%) and pulmonary tuberculosis in 5 cases (16.1%). 10. Management was done with retropubic prostatectomy in 16 cases, transurethral prostatectomy in 3 cases and suprapubic transvesical prostatectomy in 3 cases. 11. The mean weight of the removed adenoma was 34.2gm. 12. The mean duration of the indwelling catheter was 8.2 days. 13. The mean amount of transfused blood was 1. 78 pints. 14. Postoperative complications were urinary infection in lt cases (63.6%), temporary incontinence in 12cases (54.5%), epididymitis in 3 cases (13.6%), urethral stricture and rebleeding in each 2 cages (9.1%), delayed wound healing and pyrexia in each 1 case (4.5%). The mortality rate was 0%.
Adenoma ; Catheters, Indwelling ; Dysuria ; Endoscopy ; Epididymitis ; Fever ; Hematuria ; Humans ; Hydronephrosis ; Hypertension ; Incidence ; Inflammation ; Male ; Middle Aged ; Mortality ; Postoperative Complications ; Prostatectomy ; Prostatic Hyperplasia* ; Pyuria ; Rivers ; Seoul ; Transurethral Resection of Prostate ; Tuberculosis, Pulmonary ; Urethral Stricture ; Urinary Bladder ; Urinary Retention ; Urology ; Wound Healing