가정의들의 일차의료에 대한 신념 및 수행분석

Abstract

Background : This study was conducted to evaluate belief and practice levels of family physicians concerning primary care, to find significant variables that affect those levels and to know opinions of primary physicians whether primary care is settled or not.

Methods : The target population were those family physicians having finished their three-year residency course in family medicine after 1989. Out of 2,075 people, the addresses 945 were identified of This was a sample population. We excluded 62 persons who worked in medical school. The questionnaires were set twice during July to September in 1998, and contents were constructed of general characteristics, items of belief and practice level of five areas of primary care(1977, IOM, Accessi-bility, Comprehensiveness, Continuity, Coordination, Accountability).

Results : Response rate was 32.1% (total : 270 : 1st respondents : 226 : and 2nd : 44). Average belief level concerning principles of primary care was 4.45 point(5 point scale), and according to area rate continuity, coordination, comprehensiveness, accountability, accessibility. Which was significant(p=0.00). Strength of belief : accessibility, comprehensiveness, coordination, accountability, continuity, which was significant(p=0.00). The highest concordance between belief and practice was accessibility(p=0.00) and the highest practice level(p=0.00). Compared with the unsatisfied group, the satisfied group had higher practice level(p=0.00). Compared with the not-open group, the open group had higher practice level(p=0.00). Significant variables that affect practice level were belief level, opening, satisfaction(r2=0.27, p=0.00). The opinion of whether primary care was settled was mostly negative(95.8%).

Conclusion : Although, family physicians were revealed to have relatively high belief and practice level concerning primary care, their opinions about primary care setting were negative. There is a lot of significant gap between individual level as family physician and societal level in primary care. More studies need to be conducted to determine the causes of such difference. ( J Korea Acad Fam Med 1999;20:1741-1751)