高雄醫學院家庭醫學科門診的內容

The Content of Ambulatory Family Practice in Kaohsiung Medical College Hostipal

黃洽鑽(Chia-Tsuan Huang) ； 劉宏文(Hong-Wen Liu) ； 黃忠信(Chung-Shin Hwang)

《The Kaohsiung Journal of Medical Sciences》 8卷3期 (1992/03) Pp. 175-184

https://doi.org/10.6452/KJMS.199203.0175

摘要

為了進一步瞭解高雄醫學院家庭學科門診就診病人的資料及尋求改進門診服務、教育和研究等方面的方針和方法，我們調查了從1984年1月至1991年2月止來本科就診的14064個病人，就其基本資料(包括性別、年齡、保險類別、病人來源和居住地區)和健康疾病問題(包含25679個診斷數及148994個診斷就診數)，按ICHPPC-2密碼系統分類，輸入電腦套裝軟體DBASE-Ⅲ Plus來加以統計分析。結果發現：(一)基本資料方面：男女病人所佔的比率各為49.1％及50.9％；病人年齡分佈以16～40歲這尋58.9％最多，41～65％歲組次之佔22.4％，小於16歲者為12.0％，而大於65歲組佔6.7％；具有保險病人佔62.8％，其中以勞保者最多，而不具保險者有26.9％；病人來源方面以本科病人介紹者佔22.4％最多，其他依序為本院員工介紹、工廠體檢轉介、其他醫生介紹、透過媒體者…等；病人居住地區的分佈，以高雄市58.8％最多，高雄縣及屏東縣市分別為19.6％及6.5％。(二)健康疾病問題方面：在25679個診斷數中，最常見的前30名診斷共佔69.3％，而前10名的診斷就佔全部的48％，依序為身體檢查、急性上呼吸道感染、腹痛、無併發症高血壓、免疫預防、B型肝炎帶原者、背痛、焦慮疾患、病毒性肝炎及腸躁症。而在148994個診斷就診數中，若以疾病診斷的就診平均值來分析本科的醫療作業習性時，發現常來門診追持續性照顧的前10名診斷全是慢性病，依序為糖尿病 、高血壓併發其他器官疾病、無併發症高血壓、痛風、甲狀腺機能亢進、十二指腸潰、結核病、脂肪代謝疾患、其他消化性潰瘍及憂鬱疾患等。總之，藉由本研究的結果，的確對往後家庭醫學的訓練 與發展在臨床服務、教學和研究方面提供很多參考方針，同時也可藉此研究與國內其他教學醫院之家庭醫學科以及基層醫療單位相互參考。

並列摘要

To understand the content of ambulatory family practice and find effective ways to improve clinical service, education end re-search in the Department of Family Medicine of Kaohsiung Medical College Hospital, we surveyed 14064 patients from Jan. 1984 to Feb. 1991 and analysed (a) their basic demo-graphic data including sex, age, insurance type, source and residential district and (b) clinical health problems covering 25679 diagnoses and 148994 diagnostic visits. Clinical health pro-blems were recorded by the ICHPPC-2 code system. Results of basic demographic survey were as follow: 49.1% of patinets was male and 50.9% female; 58.9% fell in the age group of 16-40 years and 22.4%, 12.0% and 6.7% of patients fell into the age groups of 41-65, under 16 and over 65 years respectiverly; 62.8% was insured usually by labor insurance and 26.9% had no insurance; the commonest referrals were other patients, colleagues, company per-sonnel, doctors, media....etc.; 58.8% lived in Kaohsiung City and 19.6% in Kaohsiung county. As for clinical health problems, the data showed the commonest thirty diag-noses cncountered at our clinic accounted for 69.3% of 25679 diagnoses and the commonest ten diagnoses in descending order were medical health examination, acute URI, abdominal pain, uncomplicated hypertension, prophylactic immunization, hepatitis B carrier, back pain, anxiety disorder, viral hepatitis and irritable bowel syndrome. By calculating the average value of each diagnosis in a sample of 148994 diagnostic visits to evaluate the habits of practice, we found that the commonest ten diagnostic visits at clinic in descending order were diabetes mellitus, hypertension involving traget organ, uncomplicated hypertension, gout, hyperthyroidism, duodenal ulcer, tuber-culosis, lipid metabolism disorder, other peptic ulcer and depressive disorders; all were chronic diseases. We concluded it was very important and helpful for the development of family medicine program and primary care unit to understand the content of their own am-bulatory parctice.

並列關鍵字

ambulatory ； family practive ； dignostic visit