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J Korean Acad Fam Med. 1999 Apr;20(4):368-376. Korean. Original Article.
Lee JW , Choi JH , Huh YH , Kim KM , Bae KW , Lee SY , Kim YJ .
Department of Family Medicine, Medical College, Pusan National University, Korea.

BACKGROUND: Physicians who provide primary care should be trained specifically to manage the problems encountered in a primary care practice. This study was carried out to know the resident's concerns and problems during outpstient care by analysing case discussions as an outpatient teaching. METHODS: We used 533 records discussed by 3 resident's teams for 1 year. Of discussion contents, symptoms or diseases were classified into codes and chapters using the ICPC(lnternational Classification of Primary Care) coding system and the main topics of discussion into 12 types. We compared data among 3 resident's teams and also between the discussed contents and the diseases of patients who visited a family practice for 1 year. We used relative discussion ratio to compare data. RESULTS: Of 533 discussed records, 106 kinds of symptoms or diseases were used and the 20 most common kinds accounted for 61.7%. Contents about menopausal sympto/complaint were 47 records(8.8%) and was the most frequent. Digestive part was the most frequent chapter(22.0%). Distribution of discussed main topics were diagnosis(35.5%), medication(26.8%), other treatment(11.6 %), follow-up(5.8%), etc. There was some difference among 3 resident's teams by chapters and topics. Visiting patients were 3,436 persons with 79 kinds of symptoms and diseases and prior 20 kinds accounted for 86.6%. Visited patients were some what different with the discussed contents by chapters. CONCLUSIONS: Contents of case discussion in ambulatory setting were some what different among each teams and more diverse than the visiting patients The residents could exchange many informations and find problems during ambulatory care. We think case discussion can be a good method for outpatient teaching.

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