• Health Policy and Management
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• v.2 no.2
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• pp.57-89
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• 1992

This study is aimed both to reorient the Health net-works focused to Health Subcenters in times of development of local autonomy in Korea and to collect the fundamental data such as attitude and practice of the directors of Health Subcenter. The materials are collected from 134 out of 258 sampling directors of Health Subcenters with a questionaire by mailing(respond rate 51.9%). The major findings of this fundamental data are as follows. 1. Current average number of outpatients cared by a director of Health Subcenter is found to be 21.6. 2. The directors of Health Subcenter have little deducted hours for Public Health Programme. 3. Number of the Preventive Health Programme worked by a director of Health Subcenter is from 0 to 3. The most major group worked only 1 programme marked at 69.4%. 4. The directors of Health Subcenter express approval opinin marked at 80.2% that their qualification to appoint has to finish intern course. 5. The average diagnosis allowance a month is approximately twenty hundred thousand won. 6. Most of Health Subcenter(market at 94%) adopted a self-supporting account system. 7. The most complaining subject of directors of Health Subcenter is their working environment. The second complaining subject is governmental officier's interference. 8. The average number of outpatients cared by a director of Health Subcenter is found to be certain differentials by their marriage and the duration of employment. Some proposals of development on Health Subcenter based on the result of this research is as follows : 1. The reorganization on Health Subcenter under line of National Health Center Net-work 2. The psychological reorientation of directors of Health Sucenter and officers. 3. Autonomy management of Health Subcenter. 4. Reorientation of status on directors of Health Subcenter.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.97-106
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• 1994

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the inhabitants in Kogsung district, a questionnaire survey was carried out for objects of 708 population. The results observed were as follows; 1. The annual utilization rate of a rural health subcenter for a basic health service unit was 27.5 per 100 persons, and annual mean visiting times was 1.43 times. 2. The most frequent disease by, annual health subcenter utilization illness was respiratory disease(26.5%), and the next was musculoskeletal disease(23.9%), gastrointestinal disease(15.9%) by order. 3. Favorite reasons for community health subcenter utilization were lower medical cost(23.4%), near distance from living place(20.7%) and lower disease severity(19.5%) by order. But disfavorite reasons for it were non effective treatment(26.2%), insufficient equipment(25.4%) and absence of specialist(17.4%) by order. 4. Insufficient items about community health subcenter utilization were restriction of treatment limit(47.1%), lower reliance(22.4%) and not punctral(21.8%) by order. 5. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization were age, educational level and the nearest medical facility class. 6. There was no difference between recognition for a community health subcenter's work and actual utilizing service, and desirable works for it were disease preventing service, disease control of elderly and sanitation control by order. These results suggested that to increase the utilization of rural health subcenter and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, expansion of health equipment and recognition about access time.

• Journal of agricultural medicine and community health
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• v.14 no.1
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• pp.30-36
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• 1989

In order to desirable attitudes of health subcenter personnel, affecting to utilization of a rural health subcenter for primary health care, a study carried out, through analyzing the specific survey datas of 228 out of 1151 total house-holders in a rural community, Su-Dong Myun, Yam-yang-ju kun, Kyung-Gi Do in Korea, and the medical re-cords of total out-patients of health subcenter in this district during 1981-1988. The following results were obtained: 1) The annual utilization rate showed decreasing tedency such as 723 per 1,000 inhabitants in 1981, 652 in 1982, 618 in 1985, 54H in 1984 and 341 in 1987, since 1981. 2) The utilization Rate in 1987 was unusually the lowest with 341 per 1,000 inhabitants in decreasing tendency, steadily. 3) In advatage on utilization of health subcenter for primary health care in a rural area, 68.8% of the respondents answered that it was in comprehensive health care with the highest rate and next order in near distance from living place with 16.7% in easy and simple process to utilize with 9.2% and in lower medical cost with 5.3%. 4) The order of desirable image of rural health subcenter personnel for primary health care was of good attitude(57.0%), of good skill(29.0 %) and of wide knowledge(14.0%), 5) The order of desirable image of doctor for primary health care in rural health subcenter was of good skill(.44.3%), of good attitude(36.8%) and of wide knowledge(18.9%), and nurse was of good attitude(76.8%), of good skill(14.0 %) and of wide knowledge(9.2%). 6) The percentage order by good attitudes of rural health subcenter personnel was the highest in responsibility(38.2%), kindness(26.3% ), proprieties(14.9%), sincerity(12.7%) and notion of duty hours(6.6%). 7) The statistical datas in health subcenter was written and kept, without distinction of definition of new and old patients, by month and for suitable method of medical expenses of medical insurance and medicaid by clerical convenience. 8) In future, the organization of health subcenter must be unified, systematized and rationlized for primary health care. Health subcenter must be organized by 3 parts of function(medical care, health service and clerical affair) and then function of health subcenter will be more activated by clerical activities.

• Journal of agricultural medicine and community health
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• v.16 no.1
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• pp.3-9
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• 1991

In order to find out status of health care for community residents with special reference to organization and man power in a rural health subcenter, a study was carried out, through analyzing the data, operated by health subcenter during 1973~1990 in a rural area, Su Dong-Myun, Nam Yang Ju-Gun, Kyung Gi-Do, Korea. The following results were obtained : l) The Number of Population in Su Dong-Myun is decreasing and household is increasing chronologically. 2) In 1989, the characteristics of population composition rate in Su Dong-Myun were shown : the groups of Age, 65 and over was high rate(9.8%) and 0~4 was low rate(5.3%) decreasing chronologically. 3) Since 1972, services of Su Dong-Myun health subcenter have been carried in the 3 functions(medical treatment, health care management and clerical work) with supports of Ewha Woman's University through the participation of community residents organization. 4) The Number of Su Dong-Myun health subcenter personnel in 1990 was 5 persons(public health doctor l, public health dentist l, health worker l, dental technician l and assistant nurse l) and of these, health worker who must have the huge charge of health care management, has been worked at Myun-office as a public official, in condition, decreased from 3 in 1980 to 2 in 1981 and from 2 to 1 in 1985. 5) Health service Activities of Su Dong Myun health subcenter obtained good results in it's achievement during 1975-1985, but since 1986, it has been in condition of lower stepping. 6) Since 1977, annual medical utilization rate showed decreasing tendency such as 900 per l,000 population in 1977, 846 in 1979, 723 in 1981, 343 in 1973 and 34l in 1987. 7) A proposal : (l) Organization of health subcenter must be unified and systematized by government, so that health subcenter can carry out primary health care for community residents through responsibilities and authorities. (2) Teaching programs in educational process must be reorganized, according to periodical request. considering relative importance to primary health care in health care needs of community residents.

• Health Policy and Management
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• v.6 no.2
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• pp.131-148
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• 1996

This study was carried out by using questionnaires with 200 general doctors serving as the director of health subcenter in Kyongsangbuk-do Province as of January 1995. The results are summarized as follows. It was shown that the general characteristics consisted of 53 directors in the lst year(26.5%), 85 in the 2nd year(42.5%) and 62 in the 3rd year(31.0%). The percentage spent on their medical service showed that 73.0% of those directors spent more than 90% on their medical service. Based on their general service attitiude, 0% answered that the director of the health subcenter completes the given duties as the director, and 24.5% did that the director has the sense of responsibility and duty. Multiple answers concerning inconvenience and difficulties of the health subcenter director showed that less monthly salary accounted for 75.5%, no administrative power for 50.0%, insufficient medical instruments for 35.5%, insufficient budget for 30.0%, respect. In conclusion, in order for the health subcenter to meet the function as the primary medical clinic, it is required to arange the plans to inspire the public health doctors' service desire to that they can give the medical service as good as the private primary medical clinics, to convert existing concept of the public health doctors' placement in Myon administrative district into new concept in Gun by breaking from a uniform placement, and to consider an intensive placement according to the relevant projects so that preventive health activities can be planned and carried out.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.31-36
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• 1984

In order to know about the utilization of health subcenter in a Korean rural community, a study was carried out through analyzing the records on the outpatients in Su-Dong Health Subcenter during 5 years from 1978 to 1982, and the following results were obtained. 1. The annual utilization rate of health subcenter of Su-Dong Myun showed decreasing tendency such as 946.6 in 1978, 886.4 in 1979, 736.5 in 1980, 708.3 in 1981 and 609.1 in 1982 per 1,000 people. 2. In terms of annual utilization rate of health subcenter by sex, utilization rate of female was higher than that of male such as in 1978 (male 908.6, female 986.3), 1979 (male 819.2, female 956.7) and 1981 (male 686.0, female 731.5) except 1980(male 790.0, female 683.3) and 1982(male 632.7, female 585.0). 3. Every year the 5 major diseases of the new patients cared in health subcenter were the same as follows; Diseases of the Respiratory System, Diseases of the Digestive System, Diseases of the Skin and Subcutaneous Tissue, Accident Poisoning and Violence, and Diseases of the Nervous System and Sensory Organ. 4. In terms of annual utilization rate of health subcenter by age, utilization rate of $0{\sim}4$ year group was highest every year such as 3,666.0 in 1978, 3,232.5 in 1979, 2,819.0 in 1980, 2,361.4 in 1981 and 2408.7 in 1982 per 1,000 people. 5. The average visiting times per case to health subcenter were not much different every year such as 1.75 times in 1978, 1.79 times in 1979, 1.69 times in 1980, 1.79 times in 1981, and 1.80 times in 1982. 6. The monthly utilization rates per 1,000 people of health subcenter had two peaks in February(40.9 in 1980 and 86.4 in 1981) and July(84.6 in 1980 and 72.1 in 1981) except 1982. 7. The distribution of new patients by the source of medical fee payment was follows; community health organization member 86.9%, medicaid program 6.5%, and medical insurance 6.6% in 1980 and community health organization member 76.8%, medicaid program 11.4%, and medical insurance 11.8% in 1981 and community health organization member 78.2%, medicaid program 14.8% and medical insurance 13.2% in 1982.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.65-77
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• 1999

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

• Journal of agricultural medicine and community health
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• v.19 no.1
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• pp.31-39
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• 1994

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%).

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.107-120
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• 1979

In order to determine the knowledge of, attitudes to, and practice of housewives toward health care in a rural area, a survey with questionnaire was carried out with 87 housewives who were sampled randomly from 6 villages in Sudong Myun, from April 16th to 21st, 1979. The following results were obtained. 1. Of the housewives studied, 61.5% knew that B.C.G. is a vaccine for T.B prevention and 12.3% knew that D.P.T. is a vaccine for diphtheria, pertussis, and tetanus. 2. The vaccination rate of the children under six-year of the housewives studied was: polio 83.1%, B.C.G. 75.4%, D.P.T. 66.2%, and measles 55.4% respectively. 3. The vaccination rate was higher in children in the area near from the health subcenter than in there of the area further away. 4. Out of 87 respondants, 87.5% knew one or more methods of contraception for spacing children. These were: loop 69.0%, oral pill 66.7% and condom 14.9% respectively. 5. Out of 87 respondants, 82.2% knew the methods of contraception for sterilization. These were: laparascopy 87.5% and vasectomy 16.9%. 6. Out of 87 respondants those who had experience using contraceptive methods were 70.1% and present users were 47.1%. 7. Contraception practice rate was higher in the group of housewives having middle school education or above than those having primary school education or less. 8. Functions of the health subcenter listed by respondants were: patients care 72.4%, family planning 31.0%, vaccination 23.0%, T.B. control 3.4%, health education 3.4%, infant birth delivery assistance 1.1% respectively. 9. Housewives who knew that there is a village health voluntary worker in their own village were 63.2%(55), and 58.2% of those who knew appreciated her activities. 10. Purposes of expenditure of Myun community health development funds listed by respondants were: aid for patient care 34.5%, aid for health subcenter operation 16.1%, and aid for Myun health development 6.9% respectively. 11. It seems that both of the distance from the health subcenter and the utility rate level of the village health voluntary worker are co-related to the B.C.G. vaccination rate of children. 12. It seems that both of the distance from the health subcenter and the utility rate level of the village health voluntary worker are not co-related to the rate of contraception practice.

• Journal of Preventive Medicine and Public Health
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• v.12 no.1
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• pp.13-23
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• 1979

A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.