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KMID : 0857019990140010081
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Kosin Medical Journal
1999 Volume.14 No. 1 p.81 ~ p.89
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ANALYSIS OF REFERRAL CONTENTS IN OUTPATIENT DEPARTMENT OF FAMILY MEDICINE
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Kong Eun-Hee
Cha Hyeong-Soo
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Abstract
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Background : More energetic activities of family physicians had been doing as the role and contents of medical care in department of family medicine have been enlarged since establishment of health care delivery system. The appropriate use of the referral process is an art that contributes to improved patient care when utilized properly by family physicians. We tried to obtain data for education of medicine and for establishment of family medicine as a specialized subject by analyzing the referral contents of ambulatory care in department of family medicine of university hospital.
Methods : We review the medical record of the 9,432 patients who visited outpatient department of family medicine of Kosin university Gospel hospital from November, 1, 1997 to October, 31, 1998.
Results : A total of 9,432 patients visit outpatient department of family medicine, from which 2,340 patients were referred without family doctors’ diagnosis and treatment. The remainder 7,092 patients were gave medical treatment by family doctor, from which 590 patients were referred. So the rate of referral was 8.3%. The most common reason for referral was for diagnosis and treatment(50.8%), and then for only treatment(30.5%), request by patient(ll.0%). The most common reason for referral by doctors need was lump/mass of breast(7%), and then infectious hepatitis(6.2%), local swelling/mass(5.3%), cirrhosis/other liver disease(2.8%). The status of diagnostic process at the time of referral, diagnosis and no treatment was most common status(40.5%), and then objective problem(no diagnosis, no treatment)(30.8%), during treatment(7.1%), complication developed(0.5%). The 4 most common diagnoses after referral were infectious hepatitis(6.4%), fibrocystic disease of breast(3.6%), fibroadenoma of breast(3.2%), liver cirrhosis(2.7%).
Conclusions : The rate of referral was 8.3%. The most common disease problem by International Classification of Primary Care (ICPC) was female genital system(24.7%), digestive system(23.7%), musculoskeletal system(l0.3%), respiratory system(9.0%). The most common reason for referral by doctors need was lump/mass of breast(7%), and then infectious hepatitis(6.2%), local swelling/mass(5.3%), cirrhosis/other liver disease(2.8%). The 4 most common diagnoses after referral were infectious hepatitis(6.4%), fibrocystic disease of breast (3.6%), fibroadenoma of breast (3.2%), liver cirrhosis ( 2.7%).
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KEYWORD
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referral, reason for referral, diagnosis after referral
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