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Journal of the Korean Academy of Family Medicine 1988;9(12):1-14.
Published online December 1, 1988.
환자의 의사방문 동기에 관한 연구 -한 대학병원 가정의학과 외래환자를 중심으로-
배철영 윤방부
연세대학교의과대학 가정의학교실
Abstract
In order to investigate real reason to see a physician a study was carried out with 218 consecutive patient-initiated visits to a university family medicine center using structured questionnaire from May 1 to Aug. 31, 1988. The following results of analysis of 218 data were obtained.
1. 127 patients of sample group were female, and 91 patients were male with mean age of 34.9 years.
2. Physician and patient agreed about the reason for the decision to see a physician in 49.5 perecnt of encounters. Agreement rate rate was highest for visits in terms of health maintenance. For the pediatric patients agreement rate was 68.0 percent
3. Physician felt that 29(13.3%) of the patients decided to come because of psychosocial reasons. Their sociodemographic characteristics and reasons to see a physician were different between psychosocial/group and non-phychosocial group. In detail, the psychoscial group was composed of more women than men, and did not include any pediatric patients. Further there were more patients without medical insurance and more atheist in psychosocial group.
Even though there was no difference of marital status betwwn two groups, two divorced women were included in psychosocial group.
In psychosocial group, the reasons presented by patients were existence(18), persistence(6) and health maintenance(5).
4. Eight patients decided to see their physician because of reasons unclassified by Weyrauch's taxonomy. Five came because of administrative purposes, one because of obtaining information about the complicaton after open heart surgery and one because he wanted specific medicine for baldness.
5. The reason to see a physician was influenced by sex, age, medical insurance, level of education, religion, chronicity of illness, past history of treatment and lay consultation. But occupation, mean monthly wage and marriage did not affect their reason to see a physician significantly.
6. 48.6 percent of sample group used lay consultation, 51.4 percent did not. Of the patients consulting with someone, they chose friends to make decision(28.3%) then their spouse in order (22.6%). The lay consultation was significantly affected by age and marriage. The frequency of lay consultation was higher in adults than children, and unmarried patients than married patients.
According to the results we obtained we might conclude that the real reasons to see a physician were different from the reasons presented patients. Especially, it was obvious that sociodemographic characteristics and the reason to see a physician were different between psychosocial group and non-paychosocial group. Further empirical studies considering factors that influence on the reason to see a physician and rational design of new taxonomy including undefined part of Weyrauch's taxonomy should be performed in the future.
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