OBJECTIVES: This study aimed to evaluate the primary care quality of a public health center in a rural area using the Korean Primary Care Assessment Tool (KPCAT). It also examined some methodological issues in applying the KPCAT and interpreting its results. METHODS: Seventy-nine patients who had visited their doctor more than four times responded to the KPCAT questionnaire. Descriptive statistics and a radar chart were used in analyzing data. Sign test was used to test the KPCAT score difference by don't know option scoring methods. RESULTS: Median and interquartile range of the public health center's KPCAT scores were forty-five and sixteen points, respectively. Only the median of the first contact domain reached the expected value of seventy-five points. The proportions of those who scored under the expected value were under fifty percent in two of four comprehensiveness items, all of three coordinating function items, two of five personalized items and all of four family/community orientation items. There were some methodological issues including, how to score don't know option and make sure response scale consistency. CONCLUSIONS: There was much room to improve the primary care quality of the rural public health center. Especially, improvement is needed in the domain of coordinating function and family/community orientation. We also hope that methodological improvement of the KPCAT contributes to more valid and reliable primary care assessment.
Community Health Centers ; Hope ; Humans ; Primary Health Care* ; Process Assessment (Health Care) ; Public Health* ; Research Design ; Rural Health Services

BACKGROUND/AIMS: Currently, screening colonscopy is widely performed in the medical field. The initial time of screening is recommended at an age of 50 years, but the age to cease screening is unknown. Accordingly, we have investigated the diagnostic yield of colonoscopy according to indications in the elderly, and we evaluated if screening colonoscopy is useful in the elderly. METHODS: We recruited asymptomatic individuals undergoing screening colonoscopy according to age (2830 subjects aged 50-74 years and 111 subjects > or =75 years-old), The colonoscopy findings of the study subjects were compared. In addition, colonoscopy findings of asymptomatic subjects more than 75 years-old were compared with the findings of symptomatic subjects with the same age. RESULTS: The yield for overall neoplasia and advanced adenoma was higher in the group of subjects > or =75 years-old than in the 50-74 years age group (overall adenoma: 49.54% versus 24.98%, p<0.001; advanced adenoma: 16.2% versus 8.23%, p=0.003). The overall frequency of neoplasms was higher in asymptomatic subjects > or =75 years-old than in symptomatic subjects > or =75 years-old (49.54% versus 28.19%, p<0.001). CONCLUSIONS: The prevalence of advanced adenoma increased with age. Screening colonoscopy was still significantly effective in elderly subjects > or =75 years-old. The lack of a decline in the frequency of adenoma, including advanced adenoma, justifies continuing screening colonoscopy in the elderly.
Adenoma ; Aged ; Colonoscopy ; Humans ; Mass Screening ; Prevalence