No abstract available.
Drug-Related Side Effects and Adverse Reactions*

No abstract available.
Anti-Bacterial Agents* ; Appendicitis*

No abstract available.
Anti-Bacterial Agents* ; Appendicitis*

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

OBJECTIVE: Author hypothesized that the presence of a chronic disease burden would change patients' use of health services. METHODS: This research used 4,020,172 medical payment requests(corrected for duplication) and a subset of 1,342,845 payment requests for chronic disease to analyze the pattern of health services utilization among the aged in Korea in 1991. Chronic disease was defined by ICD-9 codes as used in the US Health Services Interview Survey. Author traced the utilization of primary, secondary and tertiary facilities by diagnoses of patients. Thereafter author compared the utilization of health service by age groups, sex, and patterns of care in the chronically disabled. RESULTS: Our data showed that younger seniors are more likely to self refer to tertiary health care. Men are more likely to use tertiary care. On the other hand, women tend to use more primary care. Inpatient tertiary level service is strongly preferred over secondary or primary health services. Patients with chronically disabled had increased use of tertiary care facilities and more self-referrals for care. Secondary health service appeared to be under used. CONCLUSIONS: Comparing the results of utilization pathway of elder clients showed chronically disabled patients overutilize the health service and pursuit the multi-pathways. Especially, overused tertiary care by the elderly may play a part in overstraining of tertiary medical resources in Korea. Thus, there is a strong necessity to introduce long term care systems for the chronically disabled elderly in Korea.
Aged ; Chronic Disease ; Delivery of Health Care ; Diagnosis ; Female ; Hand ; Health Services* ; Humans ; Inpatients ; International Classification of Diseases ; Korea* ; Long-Term Care ; Male ; Primary Health Care ; Tertiary Healthcare

No abstract available.
Alcoholism* ; Hospitals, General* ; Humans ; Prevalence*

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

BACKGROUND : Lipoprotein(a)[Lp(a)] may be an independent risk factor for macrovascular disease in middle aged populations, but in elderly populations, Lp(a) levels to predict macrovascular risk is controversial. The purpose of this study is to evaluate the association of macrovascular disease with Lp(a) levels and lipid change in the elderly. METHODS : We have examined Lp(a) levels, lipid change and clinical, biochemical profile in 114 patients with macrovascular disease and 55 control subjects. Macrovascular disease was defined as ishemic heart disease and/or peripheral vascular disease, peripheral vascular disease was defined as arteriosclerosis obliterans, diabetic foot and/or cerebrovascular disease. RESULTS : Hypertension, diabetes were more prevalent and median Lp(a) levels, fasting blood glucose and HDL-cholesterol were significant higher in patients with macrovascular disease than control subjects, but there were no significant differences in age, body mass index, total cholesterol and triglycerides levels. Lp(a) levels were positively weak correlated with fibrinogen levels, but not correlated with age, body mass index, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides levels. In logistic regression analysis, there was no independent risk factor for ischemic heart disease, whereas diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. CONCLUSION : Serum Lp(a) levels was not independent risk factor for macrovascular disease, but diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. Therefore, the relationship between Lp(a) and lipid change and macrovascular disease in the elderly were different from middle aged subjects.
Aged* ; Arteriosclerosis Obliterans ; Blood Glucose ; Body Mass Index ; Cholesterol ; Diabetic Foot ; Fasting ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Lipoprotein(a)* ; Logistic Models ; Middle Aged ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Risk Factors ; Triglycerides

Tinea faciale is a dermatophyte infection of glabrous skin of the face except moustache and beard areas of the adult male. Generally it is not considered to be unique entity, and is included under Tinea corporis. However, T. faciale is somewhat different from T. corporis in its clinical manifestation, age and sex distribution and composition of causative fungi. Because superficial fungal infection of the face has not been emphasized, there is a low index of suspicion and often incorrect diagnoses are made. This clinical and mycological investigation was made with 36 cases of Tinea faciale among out-patients in dermatologic clinic of St. Pauls hospital, Catholic Medical College, from October, 1980 to September, 1981. Following results were obtained: 1. The incidence of Tinea. faciale was 0.67% among 5,406 out-patients and 3.7% among 973 superficial fungal infections. 2. The ratio of male to female patient was 1: 2.6 and incidence rate among divided age groups was the highest in under 9(36.1%) and 10-19(16.7%), 20-29(16.7%) in order(Table 1). 3. Central clearing was showed in 43.5% of the patients, annular or circular features in 65.2%, scales in 69.6%, papules in 39.1%, pustules in 17.4% and 73.9% of the patients had singie lesion(Table 3). 4. Coexisting fungal infection was found in 10 patients(27.8%) among 36 cases a,nd the most common coexisting fungus was Microsporum canis (Table 6). 5. The incidence of causative fungi in descending order were as follows: Microsporum canis(43.8%), Trichophyton rubrum (25%), Trichophyton mentagrophyte(15.6%) Microsporum gypaeum(9.4%), Trichophyton interdigitale(6.2%) (Table 4).
Adult ; Arthrodermataceae ; Diagnosis ; Female ; Fungi ; Humans ; Incidence ; Male ; Microsporum ; Outpatients ; Sex Distribution ; Skin ; Tinea* ; Trichophyton ; Weights and Measures

No abstract available.