Cha, Heong Soo; Shin, Myung Seop; Park, Han Seop; Kim, Won Kyeong; Kim, Yun Jin

Journal of the Korean Academy of Family Medicine 1995;16(4):217-227.
Published online April 1, 1995.

Heong Soo Cha, Myung Seop Shin, Han Seop Park, Won Kyeong Kim, Yun Jin Kim

의원급 ( 일차진료 ) 의 의료장비 보유율과 임상검사 시행율의 조사 (Original articles : A Study of Medical Equipment Possession Rate and Laboratory Test Performance Rate in Private Practice Clinics ( Primary Care ))

차형수, 신명섭, 박한섭, 김원경, 김윤진

동국대학교의과대학 가정의학과

Abstract

Background
: In Korea we did not have the report on the rate of possenssion and usage of medical equipment and the rate of performance of laboratory test in private clinics. In this stydy, we investigated items related to possession of medical equipment and performance of laboratory test. We also tried to know about the contents and level of primary care in the community.

Methods : From August 5, 1993 to September 25, 1993, of the registered 338 members of the Korean Association of Family Medicine Physicians in the Pusan, we chose 240 doctors of private clinics to be a part of our study. We analyzed 120 replies from our questionnaire that included absence or presence of 104 items of medical equipment, their frequency of use, and laboratory test of 60 techniques including those done at the clinic, requested at another hospital and not routinely done.

Results : In our study 50% replied, and of those that replied 106 were men(88.3%), 14 were women(11.7%) and the mean age was 56.5 years old. Besides Family Medicine other departments involved as the practice style were Internal Medicine(62.5%), Pediatrics(61.7%), Obstetrics and Gynecology(39.2%), General Surgery(29.2%), Dermatology(20%) and Urology(18.3%). Medical equipment in which both the rate of possession and usage were high included basic items ; thermometer, blood pressure guage, adult stethoscope, weight scales, glove, headlamp, X-ray view box, and reflex hammer, examination and diagnostic items ; urine analysis multisticks, microscope, X-ray machine, centrifuge, blood sugar sticks, pregancy test kits, surgery and treatment items ; dressing car, hot air and autoclave sterilizer. Equipment that were high in the rate of possession but low in usage included basic items such as resuscitation kits, ophthalmoscope, color vision cards, visual acuity chart, nasal speculum, and also surgical and treatment items such as oxygen tank, enema equipment, nelaton and foley catheter. Equipment in which the rate of possession was low but usage was high included electrocardiogrape, computer and ultrasonogrape. Outpatient laboratory tests that were performed greater than 40% in the private clinics included protein, sugar, RBC and WBC analysis of urine, and analysis of Hb and WBC in blood. Test requested to outside the private clinics greater than 40% included blood chemistry of GOT, GPT, total bilirubin, total cholesterol, globulin, albumin and immunological tests for HBsAg and HBsAb.

Conclusion : We can understand the medical equipment possession rate and laboratory test performance rate of private clinics responsible for the primary care of the community. It also forms the basic data for the present condition of medical equipment and laboratory practice in private clinics(primary care).

초록

연구배경 : 우리나라에서 의원급이 보유한 의료방비의 이용실태 및 임상검사 히행에 관한 조사가 없었다. 본 연구에서는 의료장비 및 임상건사 목록을 작성하여 의원급의 의료장비의 보유율 및 사용율과 임상검사 시행율에 관하여 조사하였다.

방법 : 1993년 8월 5일부터 9월 25일까지 대한가정의학회 부산지부에 등록된 회원 338명중 의원급의 개원의사 240명을 대상으로 104종류의 의료장비 보유유무 및 사용빈도와 60종류의 외래 임상검사중 직접 시행하는 검사, 의뢰하는 검사, 시행하지 않은 임상검사에 관해 설문조사하여 응답한 120례를 분석하였다.

결과 : 대상자의 응답율은 50%였고 성별로는 남자가 106명(88.3%, 여자가 14명(11.7%)이었다. 가정의학과(35.8%)외의 표방 진료과목별 빈도순으로는 내과(62.5%), 소아과(61.7%), 산부인과(39.2%), 일반외과(29.2%), 피부과(20%), 비뇨기과(18.3%) 등의 순이었다. 의료장비중 보유율과 사용율이 모두 높은 장비는 일반장비로는 체온계, 혈압계, 성인용 청진기, 체중계, glove, 보조등, X-ray view box, 반사용 망치 등이었으며 검사 및 진단장비로는 소변검사용 스틱, 현미경, X-ray 촬영기, 원심분리기, 혈당검사용 스틱, 임신반응검사 시약 등이었으며 수술 및 처치장비로는 드레싱 카, 자불 소독기, 고압멸균소독기 등이었다. 보유율은 높고 사용율이 낮은 장비는 일반장비로는 응급처치함, 검안경, 색맹표, 시력표, 비경 등이었으며 수술 및 처치장비로는 산소통, 관장기기, 1회 도뇨기, 지속 도뇨기 등이었다. 보유율은 낮고 사용율이 높은 장비는 심전도기, 진료용 컴퓨터, 초음파 영상 진단기 등이었다. 외래 임상검사중 직접 검사율이 40%이상되는 검사로는 혈액화학검사로는 혈액화학검사는 GOT, GPT, total bilirubin, total cholesterol, globulin, albumin이었으며 면역혈청검사는 HBsAg, HBsAb였다.

결론 : 지역사회의 일차의료를 담당하고 있는 의원급의 의료장비 보유율 및 사용율 그리고 임상검사 시행율을 알 수 있었고 아울러 의원급의 의료장비 및 임상검사의 현황에 관한 기초자료가 되리라 생각한다.