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

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.
Anti-Bacterial Agents* ; Appendicitis*

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

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.
Abortion, Induced* ; Contraception* ; Female

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

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.

No abstract available.