Abstract
Background
: The research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future.
Methods : This research conducted a self-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients per practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations.
Results : The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a year. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel, and only 56.2% of the patients insisted the same. There was also a significant difference between two values.(P<0.05).
Conclusion : The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients and high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.
초록
연구배경 : 의사-환자간의 진료의 한 형태인 전화의료상담이 개원가에서 이루어지고 있는 실태를 알아보고, 추진되고 있는 주치의등록제의 서비스 항목으로서의 전화의료상담에 대한 의사-환자간의 기대와 인식 차이를 파악함으로써 합리적이면서 만족스러운 전화의료상담의 나아갈 방향을 찾고자 하였다.
방법 : 1990년 8월부터 9월까지 강릉시에서 일차진료를 시행하는 개원의 44명 전원과 의원당 방문환자 각 20명에게 자기기입형 설문조사를 실시하였다. 일반 특성과 전화 상담 경험의 빈도, 내용, 시간, 만족도, 주치의등록제하에 실시될 전화의료상담에 대한 찬성여부 및 기대 내용 등에 대한 의사-환자간 인식의 차이를 비교 분석하였다.
결과 : 의사용설문지는 70.5%, 환자용설문지는 17.2%의 응답률을 보여주었다. 개원의들이 40.7%는 적극적인 전화상담을 하였고, 55.6%는 수동적 전화상담을 하였으며 3.7%는 전화상담을 하지 않았다. 시간은 3분이하가 74.2%였다. 환자들은 전화상담의 경험이 전혀 없다가 62.9%, 1년에 1-2회로 아주 가끔이다고 34.4%가 응답하였다. 전화상담에 대한 인식으로는 의사업무이므로 한다가 48.4%, 바쁘지만 어쩔 수 없이 한다가 48.4%, 의사의 의무가 아니다가 3.2%였다. 주치의등록제하에서 전화상담의 찬성입장으로는 28.60%가 의사의 고유업무이니까 찬성한다고 하였고, 71.4%는 경제적인 보상이 주어지면 찬성하는 입장이었다. 의사와 환자의 전화의료상담에서의 기대와 인식차이에서는 개원의는 45.2%만이 주치의등록제하의 전화상담시행을 찬성하였고 환자들은 70.9%가 시행을 찬성하고 있어 의사와 환자간의 유의한 차이가 있었다(p<0.05). 개원의의 83.9%는 전화상담을 유로화시켜야 한다고 하였고 환자는 56.2%가 유로화시켜애 한다고 하여 유의한 차이가 있었다(p<0.05).
결론 : 개원의들은 어떠한 형태이던 전화의료상담에 임하고 있는 반면 환자들의 대부분 전화의료상담을 하고 있지 않는다고 하였다. 제도화되는 전화상담에 대해서는 경제적인 보상이 주어지지 않은 경우 의사들의 심리적 거부감이 있었으나 환자들은 경제적인 문제와는 상관없이 전화의료상담에 대한 기대가 높았다. 전화의료상담이 제도화되면 전화상담의 수요공급간의 마찰이 예상된다.
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