가족주치의 시범사업의 효과

Abstract

Background : The national health care system where primay care health service functions properly, provide better medical outcomes in individual health service as well as national health policy. This is quasi experimentally designed, prospective study for the purpose of developing a model of primary health service in Korea. We provided Family Registration Program reinforcing primary health care for 1 year in order to assess medical outcomes and verify the benefit of the program.

Methods : Three board certified family physician assigned to 263 families, 1057 people provide 6 items of medical service reinforcing accesibility, comprehensiveness, continuity, accountability for 1 year. After the program the use of the medical services was reviewed by the medical records, to assess the quality of care during the program two self reporting questionnaire surveys was perfor-med by Continuity, Comprehensiveness, Personal relationship Questionnaire(CCPQ) before and after the program. Another self reporting questionnaire survey was also performed to assess the factors relating the use of the program.

Results : Over the seventy percents of families utilized at least one service item, most frequently using service item was medical service in outpatient department, total number of visit was 695 by 161 people in 102 families. The number of beeper call was 226, 75.3 per a family physician. The reason of beeper call were medical problem(59.7%), services to inform laboratory result(25.9%), and appointment for medical service(13.7%). The scores of CCPQ before and after program were 6.48±1.48 and 8.66±1.76, which meant that better quality of medical service was provided during the program. The reason for under-utilization of the program were 'No health program'(52.9%), 'Not Familiar with how to use the program' (34.3%), 'Felt sorry to call'(20.6%), which meant many families misunderstood the program. Over the seventy percents families had visited other physicians' offices during the program by the reasons of 'Near home' (56.7%), 'Already have a regular doctor'(26.9%). Sixty eight percents families satisied the program and 88.1% of families willed to participate in the re-registraion program.

Conclusion : By the fact that most of families registered were satisfied with familiy registration program, we conclude that this program provided quality care and could be settled in our medical system, but still remains a lot of efforts to make to have such a program known to public and utilized by many people.