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.
Progeria*

No abstract available.
Child* ; Humans ; Rhabdomyosarcoma*

No abstract available.
Child* ; Humans ; Thyroid Gland* ; Thyroid Neoplasms*

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.

No abstract available.

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

No abstract available.
Escherichia coli* ; Escherichia* ; Humans ; Urinary Tract Infections* ; Urinary Tract*

Air pollution in the traffic areas in Seoul during the winter season was studied. The average level of sulfur dioxide concentration was 0.24 ppm through the day. Lowest was 0.14 ppm at 2~4 P.M. when the highest vertical temperature gradient was indicated, and 0.33~0.29 ppm during 10 P.M. to 8 A.M. at night. Average level of dust was 4.65 mppcf (2.1~12.8 mppcf) and higher levels were shown at 10 A.M., 6 P.M. and 10 P.M. as 5.44, 4.73 and 5.01 mppcf respectively. The noise level in the main traffic areas was 73.5 db in the average during this survey, 75.1 db in the daytime and 65.6 db in the night (11 P.M. ~7 A.M.) in the average. Various air pollutants in auto-exhaust gases and noise of automobiles were studied, since those are main sources of nuisance in the traffic areas. Carbon monoxide in the "Corona" taxi, formaldehyde in the jeep, and carbon monoxide, formaldehyde and sulfur dioxide in the "Senara" taxi were measured respectively in high concentration and there was no significant difference in other gases among the various type of vehides. As regards average Overall noise level at ordinary driving speeds, heavy vehicles emitted much more noise (30 KPH) (82.2~83.5 db) than light vehicles such as taxi (40~5O KPH) (71.5-80.2 db). The noise level when starting heavy vehicles was higher 88.5 db(94.2 phon) on the average and that of light vehicles was lower 69.4 db (76.2 phon). There were two types of automobile horn noise in the octave band; one was in 1,000 cps and the other 2,000~4,000cps. The average horn noise level of automobiles was 98 db (107.8 phon), with 106 db (11.05 phon) maximum and 88.8db (99.5 phon) minimum. In the epidemiological study of CO poisoning in urban areas, there were 260 deaths out of 532 patients in 201 incidents of poisoning occurring on a total of 128 days during January 1964 to Dec. 1966. The concentration of co in the main living rooms and kitchens was detected as 58 and 112 ppm respectively, and the level of carboxyl-hemoglobin in the blood of housewives was relatively high, 11.2% on the average. In outside air maximal concentration of CO was 80 ppm in Shinchon-Dong an urban area.
*Air Pollution ; Korea ; *Noise