• 제목/요약/키워드: household economic status

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2001년 국민건강영양조사에 나타난 아침식사유형에 따른 식사의 질과 건강상태 (Breakfast Consumption Pattern, Diet Quality and Health Outcomes in Adults from 2001 National Health and Nutrition Survey)

  • 심재은;백희영;문현경
    • Journal of Nutrition and Health
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    • 제40권5호
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    • pp.451-462
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    • 2007
  • 본 연구는 한국 성인의 아침식사유형과 주식유형에 따른 식사의 질과 건강상태를 비교분석하기 위하여 수행되었다. 연구 자료는 2001년도 국민건강영양조사자료 중 $30{\sim}49$세 남자 1,641명, 여자 1,765명의 자료를 이용하였다. 대상자들의 아침 섭취여부 및 아침식사의 유형에 따라 사회인구학적 특성, 영양소 및 식품섭취, 대사증후군 관련 건강상태지표를 분석하였다. 아침식사의 유형은 섭취하는 주식에 따라 'RICE' (밥식), 'BREAD' (빵식), 'NOODLE' (면식), 'OTHERS' (기타식)로 분류하였고 그 밖의 혼합유형은 분석에서 제외하였다. 분석된 주요 결과는 다음과 같다. 아침식사를 거를 때, 영양소의 충분한 섭취라는 측면에서 하루 식사의 질이 아침식사를 섭취하는 것에 미치지 못하는 것으로 나타났다. 그러나 아침식사를 거를 때와 섭취할 때 건강지표상의 의미 있는 차이는 찾을 수 없었으며, 아침식사를 섭취하는 경우 주식을 중심으로 섭취하는 식사의 구성에 따라 몇 가지 의미 있는 차이를 관찰하였다. 첫째, 아침식사유형이 빵식인 대상자들의 월 가구소득이 높았으며, 특히 여자대상자에서는 아침식사의 유형이 면식인 대상자의 평균 월 가구소득이 가장 낮았다. 둘째, 아침식사유형 간 만성질환 유병율의 분포에는 차이가 없었으나, 각 건강지표의 평균수준에 차이가 있었다. 남자 대상자에서는 아침식사유형이 빵식일 때 혈중 총 콜레스테롤이 높은 수준을 나타내었다. 여자대상자에서는 이러한 특징이 관찰되지 않았고 아침식사유형이 면식인 대상자의 HDL수준이 낮고 공복 시 혈당이 높았으며 통계적으로 의미 있는 차이를 나타내었다. 셋째, 남녀대상자 모두에서 빵식인 아침식사는 지방 에너지의 비중이 높았으며 미량 영양소의 밀도는 낮은 수준이었다. 하루 중 다른 끼니의 섭취를 통해 부족한 미량영양소의 섭취는 보충되었으나 이와 함께 총 에너지 섭취가 증가하는 결과를 초래하였고, 지방의 에너지 비율은 여전히 높은 수준이었다. 여자대상자에서는 아침식사유형이 면식일 때 아침식사의 에너지 섭취수준이 낮았고 아침식사를 거르는 경우를 제외하고 미량영양소의 섭취가 부족할 가능성이 가장 높았다. 넷째, 식사유형별 식품섭취 양상에 차이를 나타내었으며 밥식인 경우 다른 주식유형에 비해 섭취하는 식품의 구성이 다양하였다. 위와 같은 결과는 주식의 종류 및 함께 섭취하는 식품의 구성과 그 다양성에 따라 영양섭취결과와 건강상태 지표상에 차이가 있으며, 성호르몬에 따른 성별 차이의 영향을 간과할 수 없음을 보여주었고, 나아가 주식의 선택과 식사의 구성에 미치는 사회경제적 수준의 영향이 고려되어야 할 것으로 생각되었다. 그러나 같은 유형의 주식을 중심으로 식사를 구성하더라도 식품의 선호도에 따라 다양한 구성이 가능하므로 궁극적으로는 건강한 식단에 대한 연구와 이에 대한 영양교육이 중요하며, 이때 생활환경과 성별에 따른 차이가 고려되어야 함을 확인할 수 있었다.

만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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장기요양서비스 수요의 결정요인 (Determinants of Demand for Long-Term Care)

  • 정완교
    • KDI Journal of Economic Policy
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    • 제31권1호
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    • pp.139-167
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    • 2009
  • 본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다.

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1920~30년대 근대 척독집 소재 여성 서간에 나타난 젠더 의식과 그 의미 (Gender Consciousness and its Meaning shown in Women's Epistolary Literature Published in Modern Study Materials for Writing Letters in Chinese in 1920~30s)

  • 홍인숙
    • 동양고전연구
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    • 제56호
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    • pp.267-295
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    • 2014
  • 본 논문은 1920~30년대 근대 척독집에 실려 있는 여성 서간문의 자료 상황을 정리하여 제시하고, 척독집 소재 여성 서간문에 나타난 젠더의식의 특징적 양상을 분석하였다. 이를 위해 20~30년대 대표적인 척독집 다섯 종에 실려 있는 여성 서간 55편의 자료 상황을 정리하여, 서간의 대상이 주로 가문의 '남성'이고 '답서'의 형태라는 점을 지적하였다. 이는 척독집 저자들이 여성의 한문 서간을 주도적인 의사소통의 매체로써보다는 남성과의 피할 수 없는 소통의 필요 상황에 대응하게 하기 위한 수단으로 인식하고 있다고 보았다. 척독집 내 여성 서간에 나타난 젠더 의식의 양상은 첫째, 여성들을 가족 내적 위치와 역할로 호명하고 재설정함으로써 전통적인 성별 질서를 재확인하고 있다는 것이다. 두 번째 젠더 의식의 양상은 근대적 젠더 질서를 반영한 듯한 여성 학업 소재가 실상 매우 제한적이고 회의적인 시선 하에서 언급되고 있다는 것이다. 세 번째 젠더 의식의 특징적 양상은 척독 소재 여성 서간에서 유독 '경제 활동에 대한 훈계'라는 모티프가 두드러진다는 점이며, 이러한 설정은 척독집 저자들이 생계 유지와 가계 관리의 책무를 여성에게 전가하는 한 방편이라고 보았다. 척독집의 여성 서간은 근대 여성 한문 글쓰기의 가능성을 보여준다는 점에서 주목되는 자료이지만, 본고의 분석에 따르면 철저히 남성중심적 상상력 안에서 재단된 여성 형상과 여성 글쓰기를 보여주는 텍스트이다. 즉 여성 서간 텍스트는 척독집 자료군의 보수적 회귀성을 더 선명하게 읽어볼 수 있게 하는 의의를 가진다.

제7기 (2016-2018년) 국민건강영양조사 자료를 이용한 식생활평가지수 준수와 대사증후군 위험요소 및 대사증후군 발생 관계 연구 (Benefits of adherence to the Korea Healthy Eating Index on the risk factors and incidence of the metabolic syndrome: analysis of the 7th (2016-2018) Korea National Health and Nutrition Examination Survey)

  • 최선아;정성석;노정옥
    • Journal of Nutrition and Health
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    • 제55권1호
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    • pp.120-140
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    • 2022
  • 본 연구는 제7기 (2016-2018) 국민건강영양조사자료를 이용하여, KHEI 점수와 대사증후군 위험요소 및 대사증후군의 발생 관련성을 연구하고자 하였다. 연구대상자는 제7기 국민건강영양조사 참여자 중 20-59세의 성인으로 연구에 이용한 변수의 결측치가 없는 8,345명을 최종대상으로 분석하였다. KHEI의 총 평균은 100점 만점에 61.06점, 남성의 총 평균은 59.63점, 여성의 총 평균은 62.50점으로 여성이 남성보다 유의적으로 KHEI 총 평균이 높았다. KHEI의 3개 영역 중 '권고하는 식품 및 적정성 평가영역'과 '절제영역'에서 여성이 남성보다 유의적으로 점수가 높았다. KHEI 점수에 따른 일반적 특성을 파악하기 위하여 KHEI 점수를 4분위수로 나누었으며 남녀 모두 연령대와 가구소득이 Q1그룹에서 Q4그룹으로 갈수록 유의적으로 높았으며, 현재 흡연 비율은 유의적으로 낮았다. 남성은 교육수준과 경제활동상태에서 Q1그룹에 비해 Q4그룹이 대학교 졸업이상 비율과 경제활동 참여율이 유의적으로 높았다. 여성은 음주여부, 우울증여부, 외식횟수에서 Q4그룹이 Q1그룹보다 현재 음주, 우울증 유병자비율과 1일 1회이상 외식 비율이 유의적으로 낮았다. 식품안정성에서는 남녀 모두 Q1그룹이 Q3그룹보다 '식품안정군'이 유의적으로 낮았다. 대사증후군과 관련된 영양소 섭취 실태에서 남녀 모두 Q1 그룹의 에너지 필요 추정량 미만 섭취자 비율이 유의적으로 높았으며, 탄수화물, 단백질, 비타민 C, 칼슘, 비타민 B1, 비타민 B2, 니아신은 평균필요량 미만 섭취자 비율이 유의적으로 높았고, 식이섬유소는 충분 섭취량 미만 섭취자 비율이 유의적으로 높았다. 남성의 공복혈당은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 BMI는 Q4그룹이 Q2그룹보다 유의적으로 낮았으며, 수축기 혈압은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 총콜레스테롤은 Q4그룹이 Q1그룹보다 유의적으로 높았다. 대사증후군 위험요인에서 남성의 고중성지방혈증 유병률은 Q1그룹이 Q4그룹보다 유의적으로 높았으며, 고혈당 유병률은 Q3그룹이 Q1그룹보다 유의적으로 높았다. 여성의 고혈압 유병률은 Q3그룹이 Q1그룹보다 유의적으로 높았으며 대사증후군은 Q2그룹이 Q1그룹보다 유의적으로 높았다. KHEI 점수에 따른 대사증후군 위험요인과 대사증후군 연관성 연구결과, 남녀 모두 KHEI 총점수가 높을수록, 20-29세가 50-59세에 비해 대사증후군 위험요소 및 대사증후군의 발생위험이 유의적으로 낮았다. 교육수준, 소득수준, 흡연, 음주, 우울증 여부는 성별에 따라 다른 양상을 보였다. 교육수준에서 남성은 저HDL콜레스테롤혈증, 고혈당의 발생위험이 유의적인 차이를 보였으며, 여성은 우울증이 있는 경우가 없는 경우보다 고중성지방혈증은 1.81배, 고혈당은 1.90배, 대사증후군은 2.50배로 발생위험이 유의적으로 높았다. 남녀 모두 소득수준이 '하'일 때 '상'에 비해 고중성지방혈증, 대사증후군의 발생위험이 유의적으로 높았으며 특히, 여성은 복부비만, 고혈당, 고혈압을 남성은 저HDL콜레스테롤혈증 발생위험이 유의적으로 높았다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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