• Journal of Korean Academy of Rural Health Nursing
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• v.1 no.1
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• Journal of agricultural medicine and community health
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• v.16 no.2
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• pp.125-133
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• 1991

The medical insurance system has been adopted in rural areas in 1988. Since then, the utilization of medical care services has increased rapidly in rural areas. According to the various study on medical care utilization, the people in rural areas used more curative care services than urban areas. The purpose of this study was to analyze the utilization and expenses of medical care services in designated rural areas : Choonseong Gun, Kangwon Province ; and Soonchang Gun, Cheonbuk province in Korea. Medical care utilization of medical care beneficiaries showed slightly increase, while there was a decrease of 18% and more for the medicaid. Regarding selection of medical care institutions, medical care beneficiaries used more hospitals and clinics than health center networks, but the health center networks was used more by the medicaid. However, the hospitalized Soonchang health center was able to provide more curative care to the people than the other two health centers. More than 50% of the patients treated by hospitalized health center were residents of the place in which health center was located.

• The Korean Journal of Rehabilitation Nursing
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• v.7 no.2
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• pp.140-148
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• 2004

Purpose: This study was conducted to identify the relationships of self-esteem, health status and self-care, and compare them between the rural and urban elderly. Method: The subjects were 126 persons with age over 65: rural(69 persons) and urban(57 persons). The data was collected from 1st Sep to 10th Oct, 2004 by questionnaires, and was analyzed with t-test, ANOVA, Least Significant Difference and Pearson's correlation coefficient in the SPSS-Win 10.0. Results: The level of self-esteem, health status and self-care of the elderly in rural were lower than those of the elderly in urban. The higher group self-esteem in the rural elderly shows more health status and self-care than the lower group. Significant differences between two groups in the urban elderly were not found. Self-esteem, health status and self-care were positively correlated each other in the rural elderly. Significant correlations were found between self-esteem and health status, and between self-esteem and self-care in the rural elderly. Conclusion: Self-esteem forms the foundation of psychosocial health and provides a measure for the quality of life of the elderly in long term care. As nursing is in a unique position to promote self-esteem, the nurse can plan and provide nursing intervention with the consideration of characteristics of the rural and urban elderly to promote the self-esteem, health status and self-care of the elderly.

• Journal of agricultural medicine and community health
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• v.17 no.1
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• pp.17-24
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• 1992

The medical care insurance system has been adopted in rural areas in 1988, since then, the utilization of medical care services has increased rapidly in rural areas. The government has restructured the 15 health centers, which are located in remoted rural areas and these 15 health centers were strengthend to provide the curative care to the residents in order to meet the curative can demand of the residents. Besides the reorganization of the health centers, the government has implemented the oriental medical care demonstration project at the health center in a designated rural areas. This study was aimed to analyze the utilization and expenses of medical and oriental medical care services in a designated rural areas. Number of annual visits of residents to health centers in 1991 showed slightly decreased compared with that in 1989. However number of annual visits to the hospitalized health centers was an increase of 49.3%~64.5%. Regarding the coverage of curative care for the residents in rural areas, the hospitalized health centers are functioning more effective than that of health center. Expenses per case of medical care rendered by health center was lower than that of oriental medical care, while the expenses of the medical care was quit higher than that of oriental medical care in the hospitalized health centers. According to the above mentioned study results, the hospitalized health centers were more effective and suitable to provide a curative care to the residents than the health centers, and also the oriental medical care could be needed to be provided by public health network in the near future.

• Journal of Korean Academy of Rural Health Nursing
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• v.4 no.1
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• pp.41-50
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• 2009

By the rural area health care special law in 1980, Primary health care posts were established in rural areas as fundamental elements of the national health system. Nurses have been deployed to the posts after taking an education course mandated by the special law. However, health care posts have confronted environmental changes over the past 30 years such as an aging and decreasing rural population and advanced traffic systems, which make it necessary to reshape their form and role. Therefore, some guidelines are suggested for future role enlargement of health care posts by analyzing their current management and duties. The guidelines are as follows: 1) enlarging the portion of prevention and management of chronic degenerative diseases, 2) development and practice of diverse health promotion programs, 3) extension of primary health care for the increasing older population, 4) development of health programs for married immigrants, 5) practice of timely maternal child health programs, 6) development of adequate health care posts for low-income people in rapidly urbanizing rural areas and in poor areas in big cities, and 7) revision of laws and institutional arrangements for the role enlargement of health care posts to match social changes and customer needs.

• Journal of Korean Academy of Rural Health Nursing
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• v.18 no.2
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• pp.92-98
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• 2023

Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.

• Journal of agricultural medicine and community health
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• v.2 no.1
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• pp.30-35
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• 1977

Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

• Health Policy and Management
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• v.8 no.1
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• pp.183-202
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• 1998

This study is to investigate patient's choice of health care and the demand for Korean traditional medicine care in rural areas in 1995. It tried to evaluate the effect of out-of-pocket expenditure, travel time, and waiting time on improving care-seeking and substituting clinical medicine for pharmacy care and Korean traditional medicine care in rural areas. The statistical model of this study is conditional logit to estimate effects of choice-specific and individual-specific characteristics on the choice of type of services. This study used, as explanatory variables, average out-of-pocket payment, travel time, and waiting time of services required to use the services. The model was empirically tested using data from 1995 Korean National Health Survery. The results showed that rural Koreans responded to out-of pocket payment and travel time. Increases of out-of-pocket payment and travel time decreased the probability to choose care in rural Korea. Rural Koreans were more likely to seek care than others with low out-of-pocket payment and travel time. The probability of choosing Korean traditional medicine were higher among the members of the households with higher education level and older persons, while they were lower in the households with large family than others compared with the probabilities of choosing public health facilities. The result of this study implies that policy on use of health care in rural Korea can be focused in managing travel time and out-of-pocket payment.

• The Korean Journal of Community Living Science
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• v.17 no.1
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• pp.87-99
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• 2006

The purpose of this study was to explore the relationship between self-rated health and Activity of Daily Living (ADL) and self-care behavior of rural elderly in Korea, focused on the difference among three distinctive living arrangements; living alone, living only with his/her spouse, and living with their married children. For this purpose, data were gathered from a nationwide survey, a total of 586 elderly aged 65 or older and living in rural area, using the structured questionnaire. Also, self-care behavior were categorized into 4 groups; life-style practice, medical self-care, adaption to functional limitation, and emotional management. The major findings are as follows; 1) Rural elderly perceived their health little and more 'bad' but their ADL capacity were 'not difficult', especially among elderly living with spouse. 2) The level of 20 items in self-care behavior ($1{\sim}5$score) was ranged from 2.51 to 3.81 score. The behavior level of regular exercise, setting up additional phone, taking a nutrient, and testing BP or pulse regularly were low but that of taking a medicine according to prescription, close contact with other people, and regular eating were proportionally high. 3) The majority of self-care behavior were correlated with subjective health positively but medical self-care behavior were correlated with subjective health or ADL negatively. Based on these results, policy implications are discussed.

• Journal of Korean Academy of Rural Health Nursing
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• v.14 no.2
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• pp.30-37
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• 2019

Purpose: This study was done to develop a comprehensive health promotion program based on the primary health care post, and then to examine the effectiveness of the program for rural elders. Methods: A single group pre-test post-test design was used, for 3 months and the 51 participants received the comprehensive health promotion program based on the primary health care post. Effectiveness of the intervention was measured immediately after the comprehensive health promotion program. Results: There were significant differences between pre-test and post-test on cognitive function (p=.001), depression (p=.001), systolic blood pressure (p=.001), blood sugar (p=.013), and cholesterol (p=.018). Conclusion: The comprehensive health promotion program based on the primary health care post was found to be effective for rural elders by improving cognitive function and physiological indicators and decreasing their depression.