The Factors Associated with the Selection of a Regular Doctor

BACKGROUND: The rapid increase in population of old people has been emphasized as a serious social problem even in medical world. Geriatric disease has special characters that can be mentioned as a non-contagious chronic degenerative disease. 'Regular Doctor System' can be considered as one of the efficient ways to care for it continuously. The purpose of this study was to promote the introduction of family doctor system gradually and care of geriatric disease through examination of old people's thinking about 'Regular Doctor System'. METHODS: The result of this study was based on the questionnaire survey on 292 old people(aged 65 and more, response rate 73%) at 2 welfare centers in Seoul, located at Yeongdeungpo-gu and Guro-gu, and 1 college for old people, for 2 weeks from May, 2003. The contents of surveywere consisted of many questions for understanding of old people's thinking about 'Regular Doctor System'. The response method was self-reported. RESULTS: Comparing with other age group surveys, this old people's survey has special character that it has higher affirmative answer rate for the question of 'Do you have a regular doctor?'. The old people's favorite natures of regular doctor were considerateness( 26.9%) and kindness(26.2%). And the most desirable service from their regular doctor was comprehensive health examination( 45.2%). The factors reflecting on selecting of doctor were separately questioned into two aspects, as factors related to doctor's behavior and the others. Among the factors related to doctor's behavior, the effect of medical treatment(22.7%) was top ranked and 'being aware of my disease'(17.3%), 'easy explanation'(15.5%) were followed. The other factors were medical specialty(24,1%), easy access(19.3%) and short waiting time(10.5%). The reasons for changing of doctor were 'to receive specialist's medical treatment'( 37.2%), 'no improvement of patient's condition'(13.1%) and 'distrust of diagnosis'(9.0%). CONCLUSION: The old people wanted considerate and kind attitude from their doctors. The factors, related to doctor's behavior that the old people wanted, were 'good effect of medical treatment', 'being aware of my disease well' and 'easy explanation'. The other factors they wanted were medical specialty, easy accessibility and short waiting time.

Factors related to the follow-up of class II patients on the pap smear

BACKGROUND: Cervical cancer is the second most commonly diagnosed cancers in women and is responsible for about 14 percent of all female cancer found in Korean women. Early detection is very important because the likelihood of a complete cure is greater, and among the early screen only tools to detect cervical cancers, a Pap smear is most widely used. It has the clinical significance to follow - up patients whose results are classified as class II in their Pap smear. Thereto we tried to find the factors associated with follow-up in class II patients. METHODS: On Pap smear practiced from Jan. 1, 2000 to Dec. 31 in a University Hospital, 159 patients Pap smear results were categorized as class II, and among the 159 patients, we were able to collect data from 107 patients who voluntarily answered a phone survey. The categories in the survey were the followings : follow- up for the Pap smear, age, age of marriage, presence of menopause, age of menopause, occupation, family history of chronic diseases or cancers, educational level, presence of concomittant diseases, income, average hospital visit frequency in a year, belief of general health, and reason for doing follow- up and reason for not doing it. RESULTS: Among 107 patients, only 62 patients (57.9 Percent) did follow-up for their Pap smear results. The reasons were doctors follow-up recommendation for Pap smear results and regular health check-up, and the two main reasons not doing follow-up were nonexistence of further symptom and financial distress. In a single variable analysis, the higher educational level, individual income, and hospital visit frequency, the more People had follow-up. But in multiple logistic anarsis, only individual income was statistically significant. CONCLUSION: The follow-up rate was as low as 57.9 percent, and the reasons why they did not follow-up were mainly the lack of understanding about the clinical significance of class II result on the Pap smear. Therefore, an advertisement and public education Programs to general public about cervical cancer will make more patients follow up their result on the Pap smear, especially to the low income and low education class people.