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Journal of the Korean Academy of Family Medicine 1986;7(3):16-32.
Published online March 1, 1986.
1차의료에서 가정의들이 시행하는 검사에 관한 연구
최병순,허봉열,홍재웅
서울대학교병원 가정의학과 서울대학교 보건대학원
Abstract
The objectives of this study were to examine the differences of dependency on laboratory tests, and of laboratory cost and contents for the diagnosis of health problems among family physicians.
The family physicians examined in this study were classified into three groups according to the duration of their clinical training - fellows, third-year and second-year residents. This study analyzed the medical records of 999 patients with 1,316 health problems cared by family physicians at the Department of family Medicine, Seoul National University Hospital during the period from March 2 to August 31, 1985.
The mixes of health problems and of patients regarding to age, sex and payment status of medical cost were similar among the above mentioned three physician groups.
The major findings from this study were summarized as follows.
1. The proportions of patients ordered laboratory tests were 54.0% among the patients cared by fellow physicians. These proportions of patients cared by third-year and second-year residents were 55.8% and 63.3%, respectively. These differences in the proportion of patients were not statistically significant.
2. The average laboratory cost per a problem for all patients was 6,308 won. There were no significant differences in the average laboratory cost of patients according to physician groups and their payment status for medical care cost. Some trends were found in the average laboratory cost calculated by means of the cost per a problem among the patients only ordered laboratory tests.
3. There were no significant differences in the proportion of patients ordered laboratory tests and average cost and items of laboratory tests for the patients with same halth problems such as abdominal pain, cough, chest pain and elevated blood pressure among the patients cared by each group of physician.
But some varieties were found for the health problems such as malaise and ill-defined condition.
The conclusion derived from the above findings was that the family physicians' dependency on laboratory tests for the case of health problems was not different among the fellow, third-year resiednts and second-year residents. The reasons for these similar behaviors of physician groups can be explained by the short differentials in their clinical experiences and their common specialty.
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