During its development, family practice in Taiwan has been housed at the university/college hospitals, and different settings have served as the main bases for service and teaching. To demonstrate the progress made in the family medicine clinic at the Chung Shan Medical College Hospital and to evaluate the appropriateness of this kind of family practice setting, our patient population of 616 was investigated. There were 5177 patient encounters during the period from September 1987 to August 1989. Of 616 patients, 52.3were male, the average age was 38.5 years, 85.1lived in Taichung, where the hospital located, and 60.1were insured. A total of 117 families, containing 310 members, made up 50.3the patient population. Most patients (64.0) visited us after introductions by their relatives or friends. There was an average of 4.2 visits per patient per year, and only 6.3of patients were lost to follow-up after their first visits. The three leading causes for visits to the Family Medicine Clinic were general medical examination (14.5), acute upper respiratory tract infection (13.6), and peptic ulcer diseases (8.0): these comprised 36.1of all patients' problems. The average referral rate among the 5177 patient encounters was 2.9. Patient education about treatment of diseases, immunization against hepatitis B, and screening for liver cirrhosis/hepatoma in hepatitis B antigen carriers were the most common preventative encounters in our clinic. In conclusion, university/college hospitals are certainly not the best site for service and teaching of family practice, since they are not based on ambulatory care. However, such settings have the advantages of higher credibility, better recruitment, and greater accessibility to facilities and support system of the hospitals.
展开▼
