BACKGROUND: Rapid progress in medical science and technology has lengthened the average span of life in general population and accelerated the increase in the elderly. This gave rise to the expansion of chronic degenerative disease in the elderly, and then led to an increase in the utilization rate of health care facility and medical fee in sequence. METHODS: In order to grope for an effective control program of chronic degenerative disease and to find out the characteristics of disease structure and utilization patterns of health care facility in the elderly, the author analysed the 6,072,196 cases of insured medical record of Federation of Korean Medical Insurance Societies from January 1st to December 31st of the year 1991. RESULTS: Essential hypertension(5.94%) is the most common disease in the elderly. And what follows are gastritis and duodenitis(4.29%), acute bronchitis and bronchiolitis(3.68%), acute upper respiratory infection of multiple or unspecified site(3.47%) and diabetes mellitus(3.21%). Twenty most frequent diseases constitute the top 50.27% and one hundred constitute over 85% of all frequency of health care facility utilization. There are different patterns of diseases between two sexes. Pulmonary tuberculosis, chronic liver disease and cirrhosis, malignant neoplasm of stomach, chronic obstructive pulmonary disease, occlusion of cerebral arteries, sprains and strains of knee and leg, malignant neoplasm of trachea, bronchus and lung, other open wound of head, erythematosquamous dermatosis are more than 1.5 times higher in male by the standardized frequency ratio. There is a significant dissimilarity of disease structure between primary and other types of health care facility, which presents the point of reinforcement in primary care. The author has also noted elderly patients prefer secondary or tertiary health care facility in case of essential hypertension, diabetes mellitus, pulmonary tuberculosis, heart failure, duodenal ulcer, chronic liver disease and cirrhosis, funtional gastrointestinal disorder, hypertensive heart disease and chronic obstructive pulmonary disease which seems to be not so critical in most cases. CONCLUSIONS: Patients of chronic degenerative disease tend to pursue the high quality of medical care and irregularly utilize health care delivery system.
Aged* ; Bronchi ; Bronchitis ; Cerebral Arteries ; Delivery of Health Care* ; Diabetes Mellitus ; Duodenal Ulcer ; Fees, Medical ; Fibrosis ; Gastritis ; Head ; Heart Diseases ; Heart Failure ; Humans ; Hypertension ; Insurance ; Knee ; Leg ; Liver Diseases ; Lung ; Male ; Medical Records ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive ; Skin Diseases ; Sprains and Strains ; Stomach ; Trachea ; Tuberculosis, Pulmonary ; Wounds and Injuries

No abstract available.
Blood Pressure* ; Body Mass Index*

Porokeratosis is an uncommon autosomally dominant inher ted disorder. Clinically, it is characterized by nonhealing plaques that develop most comnorly on the limbs. We report a case of disseminated superficial porokeratosis in immunosuppre sed kidney transplant recipient. An abrupt and extensive eruption of porokeratosis was observed in a 46-year-old man 7 months after renal transplantation, while being treated with cyclosporin A and prednisone. The histological features were essentially the same as the typical cornoid lamella. Immunosuppression may exacerbate or initiate the developm nt of porokeratosis in patients predisposed to alterations of cutaneous growth dynamics.
Cyclosporine ; Extremities ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Middle Aged ; Porokeratosis* ; Prednisone ; Transplantation*

BACKGROUND: This study intends to clear that the current cost reimbursement system of Korean medical insurance of health care. METHODS: By using insured medical record of Federation of Korean Medical Insurance Societies used in the demand tendency research of the type of services from feburary 1st to 28th of the year 1990, authors analyze the characterist,ic of components of charges per case in the type of health care facilities. RESULTS: The charge per case in the out-patient care of primary health care facility is 13,498 won, which is 54.6% by comparison with the secondary health care facility and 30.7 % by comparison wit,h the tertiary health care facility. Among these charges the amount of the cost for medical examinations and oral drugs are 73.9% in the primary health care facility and 71.8% in the secondary and 67.5% in the tertiary. Consequently, the services in the primary care are chiefly composed with the medical examinations and oral drugs. In addition to this point the author also finds that the charge per case is 3.5 times, the cost for oral drugs is 5.6 times larger than those of primary care, and therefore tertiary health care facility conduct various diagnostic examinations and prescript more expensive. CONCLUSIONS: There is a difference of basic medical cost ratio between primary, secondary and tertiary health care facility. These points can be lead to the presumption that the diseases under the structure of current medical insurance are overlapped irrespective of the charact.erisitcs of the type of health care facilites, and this is profitable to the tertiary health care facilities which can conduct various types of services. In conclusion, the frame a policy is needed to encourage primary care which are nothing but simple structure of charges.
Delivery of Health Care ; Humans ; Insurance* ; Medical Records ; Outpatients ; Primary Health Care

No abstract available.
Carcinoma, Bronchogenic* ; Lung, Hyperlucent*

A clinical observation of the nail pigmentation change was made on 200 patients receiving cancer chemotheray who were seen at; the Department of Internal Medicine, Seoul National University Hospital, from January through May, 1986. The results were as follows: l. Among the 200 patients, 118 cases(59%,) showed nail pigmentation changes. 2. The patterns of nail pigmentation change were as follows: Parallel transverse band(70 cases 59.3%), longitudinal pigmentated band(32 cases, 27. 1%), brown arc(25 cases, 21. 2%), Proximal black pigmentation(10 cases, 8. 5%), diffuse pigmentation(5 cases, 4.2%), parallel transverse white line(5 cases, 4.2%), half and half nail(3 cases, 2. 5%), pigmentations with transverse white band(1 case, 0. 8%). 3. Various cambinations of nail pigmentation pattern were found in 33 patients (28. 0%). 4. 11 cases of the nail dystrophy with nail pigmentation change were observed: Longitudinal ridge(7 cases), transverse groove(3 cases), wavy transverse fissure (1 case).
Drug Therapy* ; Humans ; Internal Medicine ; Pigmentation ; Seoul

No abstract available.

No abstract available.

No abstract available.
Abortion, Induced* ; Contraception* ; Female

A clinical observation of cutaneous complications was made on 200 patients receiving cancer chemotherapy at the Department of Internal Medicine, Seoul National University from January through May, 1986. The results were as follows: 1. Among the 200 patients, 191 case(95. 5%) showed cutaneous complications 2. The cutaneous complications included the following; hyperpigmentation(14l cases, 70. 5%), alopecia(138 cases, 69.4%), nail change(118 cases, 59.0%), mucositis(47 cases, 23.5%), dryness of the skin(40 cases, 20.0%), seborrheic dermatitis(24 cases, 12. 2%), increase of seborrheic keratosis(11 cases, 5.6%), folliculitis or acneiform eruptions(9 cases, 4,5%), melasma(6 cases, 3.0%), gynecomastia(3 cases, 1.5%), vessel hardening or dimpling(3 cases, 1.5%), radiation recall(2 cases, 1.0%), hyperhydrosis(2 cases), photosensitivity(1 case, 0.5%), tissue necrosis(1 case), facial flushing(1 case), purpura(1 case) and obesity(1 case), 3 Steps were taken to determine the chemotherapeutic agents causing these cutaneous complications, though in some cases it was difficult in determining exaetlr which chemotherapeutic agent was the cause of the observed cutaneous complication.
Drug Therapy* ; Folliculitis ; Humans ; Internal Medicine ; Seoul