Background
: The present it is getting to be on aged society there is increasing that hospital has higher rate for place of death than home. Because we can expect that many patients who are faced with death come to hospital or hospice in the future, we have studied preferred place of death with an old women in seoul to have essential material of plan to understand asking for medical service of death, to divide medical manpowers and equipments and to supplement and to revise of medical educations.

Methods : Through the internet, 71 schools for the elderly . Of 277 an old woman who attending the schools out of 7 schools. We research into preferred place of death by self answering way through the June to July in 2000.

Results : The average age was 72.4 years. Of 277 respondents, 87 respondents(32.46%), reply their homes as a place of death and 166(61.94%) reply hospital, 15(6.5%) reply hospice, missing is 9. Statistical significance has connections with only level of education. The highest reason(47.5%) why respondents choose the hospital or hospice is only to reduce their children’s burdens. Unlike respondents that education attending period is below 6-year, the relative risk of choosing the hospital or hospice between respondents who are 6-9year and above 9-year is each of 3.66, 5.58.

Conclusion : This research shows that an elderly women I seoul prefer hospitals or hospice to homes as their place of death.

Background
: For Chronic HBsAg-positive patients are a well-known high risk group of primary liver cancer necessitation periodic follow-up examination. This study was performed to evaluate the effectiveness of a reminding letter on the compliance with scheduled follow-up examination in chronic HBsAg-positive patients.

Methods : A randomized controlled clinical trial was conducted at a Family Practice Clinic in Samsung Medical Center located in Seoul from February 1998 to January 1999. A total of 178 HBsAg-positive patients who had no other clinical illnesses and were scheduled to take follow-up examination were randomly assigned to a control (88 subjects) and a letter reminder group (88 subjects).
The outcome measure and attendance at the scheduled follow-up examination were determined through the medical chart review and telephone. Demographic and clinical characteristics were checked through the medical chart review.

Results : The attendance rate was 62.2% among the 82 patients who were actually receiving the letter reminders. Compared to the attendance rate of 37.5% among the control group, it was significantly higher. Even after controlling the demographic and clinical characteristics through the multiple logistic regression analysis, the letter reminder was significantly related to the increased compliance for a scheduled follow-up examination. Frequency of previous visit was also positively related to increased compliance.

Conclusion : These results suggest that the letter reminder can significantly improve compliance with a scheduled follow-up examination in HBsAg-positive patients.

Background
: 　Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections.

Methods : In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview.

Results : The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI= 1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)possibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%).

Conclusion : Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influenced by patient's age, number of clinic-visit, and clinical symptoms and signs.

Background
: Although adult immunization is as important as childhood immunization, is being inadequately performed. However, previous studies concerning adult immunization could not be sufficiently evaluated because studies were restricted to the residents in rural area or those who have visited a doctor.

Methods : We conducted a study by telephone interview which included 201 households(375 adult family members)selected by systematic sampling from the yellow pages of Kangnam-gu and Sungbuk-gu districts of Seoul. The types of immunization covered in this study were immunizations against hepatitis B, influenza, pneumococcus, and hemorrhagic fever with renal syndrome(HFRS). Immunization status of all adult household members, cognition of the need for immunization and of interviewees were surveyed. Sex, age, area of residency, education, medical history of study subjects were considered as factors related to the cognition of the need for immunization and immunization performance.

Results : The cognition rates of immunization were as follows : hepatitis B 85.1%, influenza 45.8%, pneumonia 38.3%, and HFRS 33.8%. In the people over 65 years old, the cognition rate against influenza and pneumococcus were 6.25%, 6.25% respectively and for those who have chronic disease. 80.0%, 20.0%, respectively. The cognition rates of immunization was significantly higher among those subjects who were young, well educated, and those residing in Kangnam-gu district.
The immunization performance rate of hepatitis B was 62.5%, influenza 5.6%, pneumonia 0.8%, and HFRS 1.1%. 75.8% of subjects vaccinated against hepatitis B had received at least three times. The immunization performance rate of influenza and pneumococcus by the immunization indication are as follows : 8.0%, 0.0%, respectively in the subjects over 65 years old, and 11.1%, 0.0% respectively in the people who have chronic diseases. The immunization performance rate of hepatitis B was higher among young, well educated subjects living in Kangnam-gu district. But age, education, area of residency played no apparent role in the case of other types of immunization.
The immunization performance rate of those who felt the need for immunization as significantly higher than that of those who did not. To assess the factors which relate to the correct cognition for immunization necessity, we used a multiple logistic regression test. For all types of immunization surveyed, sex(females) and age(young) seemed to be significantly related to the correct necessity cognition. Medical history of chronic disease was also related to the correct necessity cognition for immunization against hepatitis B and influenza.

Conclusion : This study reveals that among living in urban area the immunization performance rate and the correct cognition rate concerning the necessity for adult immunization was generally very low. Therefore, an active publicity and public education will be needed to increase the level of correct necessity cognition for immunization in which the disease status, sex, and age of vaccinee are considered. And more active effort to increase the cognition for immunization necessity performance is required.

Background
: If two or more doctors prescribe for one patient, each doctor must be careful to minimize the number of drugs and the frequency of admistration, and also be careful to avoid duplicating drugs, The purpose of this study is to evaluate the appropri-ateness of prescription for the patient who visits two or more doctors.

Methods : In a tertiary hospital, outpatients who received prescriptions simultaneously from two or more doctors were selected, and the number of drugs, the frequency of admi-stration and duplication of drugs were evaluated.

Results : The number of eligible patents was 887. The number of drugs was 5.2 for pa-tients who visited 2 doctors, and 8.1 for patients who visited 3 doctors. 13% of patients who visited 2 doctors received more than 8 drugs, and 32.6% of patients who visited 3 doctors received more than 10 drugs. The frequency of administration per day was 3.7 for patients who visited 2 doctors, and 5.0 for patients who visited 3 doctors. 12% of patients who visited 2 doctors had to take drug more time 6 times a day. 9.2% of total patients recei-ved duplicated drugs. The duplication of drugs was more frequent among patients who vis-ited 2 doctors than who visited 3 doctors.

Conclusion : For the patients who visited two or more doctors, the number of drugs and frequency of admistration was inappropriate and duplication for drugs was found, therefore the doctors should make more efforts to avoid inappropriate prescription.

Background
: In Korea, doctors are tend to prescribe digestive system drugs to the patients who have no digestive symptoms. The purpose of this study was to describe the prescription tendency toward digestive system drugs among residents of family practice.

Methods : Among outpatients who were consulted by residents of family practice in S hospital form Jan. 1995 to Jul. 1996, the patients without digestive symptoms were selected and their medical records were reviewed about prescribed drugs.

Results : The total number of eligible patients were 308. The number of residents who examined the eligible patients were 25 and they consulted average 12.3(S.D 5.1, range 5-21) patients. The proportion of patints who were given digestive system drugs was 43.2%. The proportions were 48.3%, 35.4% and 54.8% in patients who were examined by 1st, 2nd and 3rd grade reridents, respectively. There were no differences in the proportions between patients & sex groups, among patients & age groups, and also among groups of number of major drugs. The proportion was 58.6% in patients with common cold, 39.4% in patients with respiratory diseases other than common cold, 70.2% in patients with musculoskeletal diseases, 50.5% in patients with headache, 45.0% in patients with neurosis. The three most common categories of digestive system drugs were enzyme digestives, motility regulators and antacids. The proportion of total prices of digestive system drugs to total price of prescribed drugs was 19.8% in all patients and 36.3% in patients who were given digestive system drugs.

Conclusion : Residents of family practice in S hospital were tend to prescribe digestive system drugs to the patients who have no digestive symptoms and therefore there need more efforts to improve prescription behavior.

Background
: The reference is an important part of medical article. To be useful, it must be accurate. The purpose of this study was to evaluate the accuracy of references in the Journal of the Korean Academy of Family Medicine.
Method: 100 references were randomly selected from the articles of the Journal of the Korean Academy of Family Medicine issued from No.1993 to Oct. 1994. Each reference was verified for citation errors and quotation errors. Citation errors were classified as se-vere, intermediate and trivial. Quotation errors were classified as complete, partial and oth-ers.
Result: Among 91 references which were verified for citation errors, 37.4% had severe errors, 19.8% had intermediate errors, and 14.3% had trivial errors. There was difference between domestic and foreign literatures in the distribution of citation errors(X²-test, P=0.03). Among 82 references which were verified for quotation errors, 15.9% had complete errors, 12.2% had partial errors, and 13.4% had other errors. There was no difference be-tween domestic and foreign literatures in the distribution of quotation errors.(X²-test, P=0.44). Among 154 statements which were verified for quotation errors, 11.0% had complete errors, 7.2% had partial errors, and 9.1% had other errors. There was no difference be-tween domestic and foreign literature in the distribution of quotation errors according to statements(X²-test, P=0.10).

Conclusion : This study showed that the rate of citation error and the rate of quotation error were unacceptably high. It is necessary that contributors and editors should make more efforts to enhance the accuracy of the references.

To assess the injection preference of patients and its related factors, 332 patients who visited Yeoncheon Health Center Hospital during the preiod of 16th June through 30th June 1990 were studied by means of questionnaire and review of medical records.
The results were as follows.
1. Of total 332 patients, the proportion of injection preference group was 226(68.1%).
2. The proportion of injection preference group according to disease group was 26(86.7%) in sensorineuro-psychiatric diseases, 49(81.7%) in musculoskeletal diseases, 46(69.7%) in gastrointestinal diseases, 52(65.0%) in respiratory diseases, and 8(47.1%) in cardiovascular diseases.
3. There was a tendency that injection preference was higher in patients who were older, who were low-educated and who had no history of side effect of injection. Age, education level and history of side effect of injection were significantly related to injection preference.(P<0.01)
4. The beliefs that 'Injection makes faster recovery from illness than p.o. medications.','Illness that was not recovered by p.o. medications had better be treated with injection.' and 'Side effect of injection is more dangerous than that of p.o. medications.' were significantly related to injection preference.(P<0.01)
In conclusion, in order to induce the injection preference to favorable direction, health education is necessary to change the patients' beliefs about injection and this effort is more important in patients who are older, who are low-educated, and who have no histroy of side effect of injection.