A Study on the Utilization of a Rural Health Subcenter for Primary Health Care

일개 농촌지역주민의 면보건지소 이용실태에 관한 고찰 -경기도 남양주군 수동면-

We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).