The level of copayment increased in order to stabilize the financial condition of the health insurance on 1986. An important question regarding the policy was whether the increase in the level of copayments reduced the utilization of medical services in the poor selectively. In spite of the importance of the research question, no study has been reported. This study was designed to find out changes in nuniU rs of physician visits, to explain charac teristics influencing the difference of utilization before and after the program. Finally the interaction effect between the program and the level of income was examined for the abover question. A total of 10,421 persons from eight institutions was selected as the study sample. Research findings are as follows. 1. The number of physician visits decreased by ten percent as a result of increasing the level of copayment. 2. The decrease was remarkable in some groups such as children, rural area and large family. 3. The most important factor which explained the difference was the number of physician visits before the introduction of the new program.. The more numbers of physian visits during the last year were, the more numbers of physian visits decreased after the program. 4. The interaction term between the program and the level of income was statistically significant in the multiple regression model which explained physician visits and its coefficient was negative. It means that an increase in copayment did not reduced the number of physician visits in the poor, selectively. 5. It can be concluded that imposing adequate copayment reduces the use of medical services as well as medical costs without serious damage in access especially for the poor pule.
Child ; Humans ; Insurance, Health

No abstract available.

BACKGROUND: Keloids may occur at any age, but tend tend velop between the ages of 10 and 30. The incidence and median age of onset are equal for both sexes. Keloids are common among the darker pigmented rices, but there have been a few clinia studies of keloids in Korea. OBJECTIVE: The purpcse of this study was to evaluate the variable clinical characteristics of keloids in Korea. METHODS: This clinical investigation was made with 223 of patients of keloid who had visited the Department of Derrnatology, Chonnam University Hosptal from January 1984 to December 1993. RESULTS: 1.The annual incidenie averaged over 10 years was 0.831 (361 cases of total 43,752 outpatients). 2.The ratio of male to female was 1: 0.94(Male. 115, Feila 108). 3.The mean age of the onset and at the first visit to our hospital were 24.5years and 29.2 years respectively. 4.In our series tte presternal area was the most commor saes, the shouder region next. Most keloids on the shoulder were related to BCG vaccination in ifoncy or chilhood. 5.The precipitating fa ctors associated with keloid were riaeeding dermatologic diseases(33.2 %), unknown(17.9%) rejection & vaccination(15.2%), operation(13.9%), burn(13.9%) and laceration(5.8%) in descending order. 6.Among preceeding as, iociated dermatologic diseases, acne w s the most common. 7. A positive family history is more likely in cases of mitile keloidal (p<0,001), and severe keloidal formation. 8.Most patients did not. complain of any symptorns(45.3%) nd a symptom of pain or tenderness(40.8%) was piesert rather than pruritus(13.9%). 9.The most prevaent tr eatment modality was intralesional injection with triamcinolone acetonide (84.3%). CONCLUSION: According, to this study, usually keloids occore in patients between 10 and 29 years of age, and most keloids were located on the antetio partion of the chest, shoulders, and face and scalp. A positive family history is more likely in as of multiple, severe keloidal for mation.
Acne Vulgaris ; Age of Onset ; Female ; Humans ; Incidence ; Injections, Intralesional ; Jeollanam-do ; Keloid* ; Korea ; Male ; Mycobacterium bovis ; Scalp ; Shoulder ; Thorax ; Triamcinolone Acetonide ; Vaccination

To evaluate the character, management and clinical results of the posterior capsular rupture during cataract surgery, we retrospectively studied the cataract surgeries that were performed between May 1989 and Decemeber 1991. We discovered 64 eyes in which the posterior capsule was torn. The overall incidence of this complication was 4.4%. Our chart review of these surgical procedure revealed that the tear occurred most frequently during the nucleus removal(44%), occured more frequently at the periphery than the center and the extent was mostly below one-third of the whole posterior capsular surface(75%). We performed vitrectomy(58%) and peripheral iridectomy(14%). Posterior capsular lenses were implallted in 56 cases. The predicted power of lens calculated with SRK-II fomula and manufacturer's A-constant was approximately 0.46 diopter less than actual postoperative refraction. Final visual acuity of 20/40 or better was achieved in 73% of the 64 cases. Our results revealed that when properly managed, a torn posterior capsule is compatible with an excellent visual outcome.
Cataract* ; Incidence ; Retrospective Studies ; Rupture* ; Visual Acuity

There are many procedures for treatment of injuries of acromioclavicular separation but there are still con- roversies concerning the best management of these injuries. With this in mind, we treated surgically 22 cases of acromioclavicular separation of which 3 cases were old type 2 and 19 cases were type 3 in the department of orthopaedic surgery, Eul Ji General Hospital from March 1977 to darch 1982. The results were as follows: l. Of 22 cases, 21 cases (95.5%) were male with peak incidence in the 3rd and 5th decades (90.9%). 2. The most common causes of the injuries were traffic accidents (63.6%) and followed by falling from height (22.7%). 3. The diagnosis in type 2 and type 3 injuries is based on the clavicular displacement and instability at the acromioclavicular joint. 4. Operative treatment consists of Weaver and Dunn method (54.5%), modified Phemister method (18.2%), Neviaser method (13.0%), Stewart method (9.1%) and modified Henry method (4.5%). 5. The operative procedure in old type 2 and typc 3 injuries is good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Diagnosis ; Hospitals, General ; Humans ; Incidence ; Male ; Methods ; Surgical Procedures, Operative

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

The nail has been considered to be the best human model to evaluate the general body state at all ages. The present study was disigned to measure the nail growth rate and to define the correlation of them with other values of nail size. The subjects were 373 males and 812 females whose ages from R months to 79 years. The results were as follows: 1. The linear elongation of the nails were most rapid in the 14 to 15 year-old age group. It decreased steadily as the subjects got older and olr1er. 2. Sex differences in the nail growth rate were not statistically significant. R. Where were no statistically significant differences in the linear growth rate of nails between right and left hands. 4. The middle finger nail grew more quickly than others, while the thumb and little finger nails grew more slowly. 5. Linear growth of nails were not significantly correlated to the thickness and length of nails and the length of lunulae.
Adolescent ; Female ; Fingers ; Hand ; Humans ; Male ; Sex Characteristics ; Thumb

It is interesting from a, clinical point of view that nail changes are often signs of dermatological and systemic diseass and rnay even be their leading sign. There is biological and biochemical evidence that studies of nails can serve to gauge the growth and metabolism not only of integumental appendages, but also of other bodily structures. The present study was performed to establish the standard nail sizes of healthy Koreans at successive ages, in addition to nail length, nail width, nail thickness, lunular length, lunular width and analyze of some of the factors which. might conceivably influence it. The correlation among individual nail sizes has been studied also. The subjects for this study were 373 males and 3I2 females from 8 months to 79 years of age. The results of this study were as follows; considerable individual variation in nail size was found. (countinue..)
Female ; Humans ; Male ; Metabolism

Subcutaneous granuloma pyogenicum (SGP) is a rare variant of granuloma pyogenicum. In general, it appears as a single subcutaneous nodule with a slight tenderness. We report herein an unusual case of SGP arising from the left palm of an 11-year-old girl. Two mild-tender bean-sized reddish or flesh colored subcutaneous nodules on the lateral border of the left palm, and medial side of 5th left finger, respectively, were noted on physical examination. Histopathologic examination revealed the findings of lobular capillary hemangioma, characterized by localized proliferation of capillary lined by a single endothelial cell layer. Intralesional injection of triamcinolone acetonide (TA) were performed for the treatment. However two new erythematous nodules developed at another area of the left palm, which disappeared without any treatment.
Capillaries ; Child ; Endothelial Cells ; Female ; Fingers ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Injections, Intralesional ; Physical Examination ; Recurrence* ; Triamcinolone Acetonide

Sebaceous gland carcinoma on thc extraocular area is an uncommon, locally malignant appendageal tumor of the skin, which is characterized by marked tendency of local recurrence after excision and not infrequent metastasis. Usual clinical lesion of sebaceous gland carcinoma on the extraocular area is a firm, raised, nontender tumor which is pink to reddish color in gross appearance and yellowish color in cut surface. Histopathologically, this tumor shows the characteristic pleomorphic sebaceous cells, which formed various shaped & sized irregular lobules and extended to deep tissues. The authors report a case of recurred sebaceous gland carcinoma, developed on the nose of a 61 year old man for 3 years duration. There was no evidence of metastasis.
Dronabinol ; Humans ; Middle Aged ; Neoplasm Metastasis ; Nose* ; Recurrence ; Sebaceous Glands* ; Skin