This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.
Angina Pectoris ; Carbuncle ; Communicable Diseases ; Diabetes Mellitus ; Duodenitis ; Fissure in Ano ; Gastritis ; Humans ; Hypertension ; Insurance ; Internal Medicine ; Outpatients* ; Pediatrics ; Referral and Consultation*

Sjogren's syndrome has been considered to be an autoimmune disease affecting various organs including salivary and lacrimal glands. It occurs most commonly in middle-aged women, and less than 20 cases with primary Sjogren's syndrome have been reported in children. An 11-yim-old boy presented with recurrent annular erythema on the face that had been present for 2 years. A schirmers test showed a positive result. ANA was detected at a dilution of 1:640. Anti-Ro/SSA and anti-La/SSB antibodies were also detected. On histological examination, lymphocytes were infiltrated in the periappendegeal areas as well as the papillary and reticular dernis. The skin findimg is uncommon in children, but has become a characteristic feature of childhood Sjogrens syndrome with anti-Ro and/or anti-La antibodies.
Antibodies ; Autoimmune Diseases ; Child ; Erythema* ; Female ; Humans ; Lacrimal Apparatus ; Lymphocytes ; Male ; Sjogren's Syndrome* ; Skin

The purpose of this study is to verify severity of asthma in asthmatic patients through through the arterial blood gas analysis. Subjects were consisted of 103 patients (74 boys and 29 girls), between 2~13 years of ages. Clinically, asthmatic patients were classified into 6 groups, i, e., group 0(no rhonchi), group 1(rhonchi only), group 2(mild attack), group 3(moderate attack), group 4(severe attack), group 5(respiratory failure with disturbance of consciousness). PH kept normal range in the group 0, group 1, group 1 and group 3,but began decrease in the group 4.There was linear fall in Po2 and began decrease in the group 3. HCO3- maintained normal level through the whole range. BE showed acidemia on the whole, and began distinctive decrease in the group 4 and group 5, especially. Hypoxemia, hypercapnia and acidemia were common in patients in severe attacks with disturbance of consciousness.
Anoxia ; Asthma ; Blood Gas Analysis* ; Child* ; Consciousness ; Humans ; Hydrogen-Ion Concentration ; Hypercapnia ; Reference Values

To determine the incidence rate of accidents and its associated factors, a prospective survey was carried out in a rural area of a total of 1,360 residents for 1 year from January 1 to December 31, 1988 in Shin-am Ri, Jungdong Myun, Sangju Kun, Kyeongpook Province. Data for accidents were collected by the community health practitioner who is working at Primary Health Post in Shin-am Ri. A total number of accident cases was 85 among 1,360 persons during one year study period, and annual incidence rate was 62.5 per 1,000 persons. The highest incidence rate of accident was observed in the age group of 30-39 was 179.8. The incidence rate of accident in male was 86.5 which was about 2 times that in female. In male, the highest incidence rate was seen in 30-39 age group and in female, 60-69 age group. The highest incidence rate of accident was observed in spring (29.4%) and summer (29.4%), and the lowest in fall (17.7%). The highest incidence rate of accident was observed in Friday (24.5%) by day of week, and between 9 a.m. to 12 a.m. by time zone. The most frequent use of medical facilities was Primary Health Post (51.8%) and the next was clinic (38.8%). Mean duration of treatment was 9.8 days. The accident occurred in the room and kitchen (23.5%), in the yard and barn (23.5%), on the road (22.4%), and in the rice field and dry field (20.0%). The causes of accident were motor vehicle accident (20.0%), piercing or cutting (20.0%), collision or fighting (12.9%), and poisoning (11.8%) in order of frequency. The most common type of injury was open wound which was 43.5%. The most common tool of accident was farm machine which was 23.5%. The most common injured part of body was extremity 55.3%.
Agriculture ; Extremities ; Female ; Gyeongsangbuk-do ; Humans ; Incidence ; Male ; Motor Vehicles ; Poisoning ; Prospective Studies ; Wounds and Injuries

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.
Daegu ; Family Characteristics ; Health Expenditures* ; Humans ; Insurance

BACKGROUND: The goal of this study was to examine the health behaviors of nurses and provide basic information on health promotion for nurses. MATERIALS AND METHODS: A self-administered questionnaire survey was completed by 340 nurses working at a university hospital in Daegu, Korea from March 6 to March 30, 2006. The questionnaire included demographic characteristics, working environment, health behaviors, self-assessed health status, and the practice of health promotion activities according to the work group(shift group vs. non-shift group). RESULTS: There were significant differences in 'regular diet', 'drinking', 'ordinary health management', 'regular exercise', 'leisure activities', 'rest', and 'feeling of fatigue' between the two groups. The score for the practice of health promotion activities of the non-shift group was 121.9, which was higher than the 115.4 for the shift group. By field of practice of health promotion activities, there were significant differences in 'self-realization' and 'nutrition' between the two groups. CONCLUSION: The shift group did not appear to have enough time to take care of their health. It is therefore important to provide a working environment in which nurses are encouraged to increase their interest and efforts to maintain healthy behaviors. In addition, programs for education and training should be developed to help nurses adopt healthy life styles and enhance their self-esteem.
Daegu ; Education ; Health Behavior* ; Health Promotion ; Korea ; Life Style ; Surveys and Questionnaires

The AIDS is a serious health problem worldwide today and also in Korea. Increasing knowledge and modification of behavior by health education is an important goal of human immunodeficiency virus(HIV) prevention strategies. And school health education is an important part of health education. This study was conducted to evaluate the knowledge and attitude about AIDS in teachers and professors in Taegu City and to provide the basic data for school health education. A self-administered questionnaire was given to 1,124 teachers and professors from April to June 1992. Indeed, the majority of the teachers and professors have a lot of knowledges about AIDS, but many of them also have misconceptions. The level of knowledge about AIDS was positively associated with attitude toward infected students. The sources of knowledge about AIDS were mainly TV, newspapers and magazines, but a few of the subjects obtained their knowledge from health education programs. This study suggest., that the reinforcement of health education for the teachers, professors and students be needed to provide the accurate knowledge on AIDS and adequate knowledge sources and materials for school health education on AIDS should be developed.
Daegu* ; Education ; Health Education ; Humans ; Korea ; Periodicals ; Periodicals as Topic ; School Health Services

No abstract available.
Bronchial Arteries* ; Hemoptysis*

A case-control study was conducted to investigate the association between the risk of cancer and selenium concentration in blood and toenails. Seventy three patients and two hundreds eighty three controls were selected at the Yeungnam University Hospital between May and September in 1991. The selected cases were patients who had been hospitalized for stomach or colon cancer at the Department of General Surgery. The controls were people who visited to check physical examination at the Automated Mediscreening Center. The selenium concentration in whole blood and toenails were measured by atomic absorption spectrophotometer equipped with graphite furnace atomizer. The following information was ascertained for all cancer patients and controls: sex, age, body mass index, blood pressure, total serum cholesterol, and history of smoking and drinking. The mean selenium concentration in blood and toenail for all cancer patients were 143.6±10.8 µg/l and 1.04±0.62 µg/g and for the controls. 167.0±14.5 µg/l and 1.15±0.55 µg/g, respectively. The difference in blood and toenail selenium concentrations of the two cancer sites was not statistically significant. Metastasis did not influence the concentration of selenium in blood and toenails. In the multiple logistic regression analysis, the blood selenium concentration (aOR: 0.888, 95% CI: 0.860-0.918), age, BMI and total serum cholesterol were significant variables for risk of cancer, but the selenium concentration in toenail was not shown to be a significant variable in this regression analysis. The coefficient for blood selenium concentration adjusted for age, sex, diastolic blood pressure, total serum cholesterol, body mass index and smoking was -0.1184 (p<0.01). These findings suggest that low selenium concentration is associated with gastrointestinal cancers. Further epidemiologic studies including important variables such as other antioxidant micronutrients will be necessary.
Absorption ; Blood Pressure ; Body Mass Index ; Case-Control Studies ; Cholesterol ; Colonic Neoplasms ; Drinking ; Epidemiologic Studies ; Gastrointestinal Neoplasms ; Graphite ; Humans ; Logistic Models ; Micronutrients ; Nails* ; Nebulizers and Vaporizers ; Neoplasm Metastasis ; Physical Examination ; Selenium* ; Smoke ; Smoking ; Stomach

The purpose of the study was to assess the morbidity pattern and the medical care utilization behavior of urban residents in the poor area. The study population included 2,591 family members of 677 households in the poor area of Daemyong 8 Dong, Nam-Gu, Taegu and 2,686 family members of 688 households, near the poor area in the same Dong, were interviewed as a control group. On this study the household interview method was applied. Well-trained interviewers visited every household in the designated area and individually interviewed heads of households or housewives for general information, morbidity condition, and medical care utilization with a structured questionnaire. Individuals were interviewed from 1 to 30 December 1988. The major results were summarized as follow: The proportion of the people below 5 years of age was 4.2% of the total study population and 5.5% were above 65 years of age in the poor area. This was slightly higher than in the control area. The average monthly income of a household in the poor area was 403,000 won versus 529,000 won in the control area. Fifty-eight percent of the residents in the poor area and sixty-one percent in the control area were medical security beneficiaries, but the proportion of medical aid beneficiaries was 7.8% in the poor area and 4.6% in the control area. The 15-day period morbidity rate of acute illnesses was 57.1 per 1,000 in the poor area and 24.2 per 1,000 in the control area. Respiratory disease is the most common acute illness in both areas. The most frequently utilized medical facility was the pharmacy among the patients with acute illnesses in the poor area. Among them 58.1% visited pharmacy initially while 38.4% of the patients in the control area visited a clinic. Among persons with illnesses during the 15 days, 8.8% in the poor area and 4.6% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 3.5 days in the poor area and 3.3 days in the control area. Initially of the medical facilities in Daemyong 8 Dong, The pharmacy in the poor area and the clinic in the control area were most commonly utilized. The most common reason for visiting the hospital was 'regular customers' in the poor area and 'geographical accessibility' in the control area. The one year period morbidity rate of chronic illness in the poor area was 83.0 per 1,000 population and 28.0 per 1,000 in the control area. Disease of nervous system was the most common chronic illness in the poor area while cardiovascular disease in male and gastrointestinal disease in female were most prevalent in the control area. The most frequently utilized medical facility was the pharmacy among the patients with chronic illnesses in the poor area. Among them 24.2% visited the pharmacy initially while 34.7% of the patients in the control area visited the out-patient department of the hospital within a 15-day period. Among the patients with chronic illnesses 34.9% in the poor area and 16.0% in the control area did not seek any medical facility. Mean duration of utilization of medical facilities was 9.2 days in the poor area and 9.9 days in the control area within a 15-day period. Initially of the medical facilities in Daemyong 8 Dong, the pharmacy in the poor area and the hospital in the control area were most commonly utilized. The most common reason for visiting the hospital, clinic, health center or pharmacy in the poor area was 'geographical accessibility' while the reason for visiting herb clinic was 'good result' and 'reputation' in both areas.
Cardiovascular Diseases ; Chronic Disease ; Daegu ; Family Characteristics ; Female ; Gastrointestinal Diseases ; Head ; Humans ; Male ; Methods ; Nervous System ; Outpatients ; Pharmacy