공중보건의의 고혈압 진단 및 치료과정 평가

송윤미; 김윤; 조홍준; 정희숙; 김용익

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자료유형: 학술저널

저자정보: 송윤미 (삼성의료원 가정의학과) 김윤 (서울대학교 의과대학 의료관리학교실) 조홍준 (울산대학교 의과대학 가정의학과) 정희숙 (대한공중보건의사협의회) 김용익 (서울대학교 의과대학 의료관리학교실)

저널정보: 한국의료질향상학회 한국의료질향상학회지 한국의료질향상학회지 제3권 제1호

발행연도: 1996.1

수록면: 126 - 143 (18page)

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Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

#Hypertension #Quality Assessment #Clinical Guidelines #Public Health Doctor

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