• Korea Journal of Hospital Management
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• v.12 no.4
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• pp.119-142
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• 2007

Although Korea joined OECD in 1996, there has still seen much unbalance in medical care and welfare standard between urban and rural area. The unbalance of medical demand between urban and rural area deepened low utilization of rural hospitals. So it caused many hospital's failure and conversion in rural area. Many rural hospitals are in difficulty managing business because of low medical demand along with the shortage of medical manpower, medical equipment and facilities. The objectives of this study were to reveal the cause of low utilization of hospitals in rural area, and to increase utilization of those hospitals. In this study the improvement methods of rural hospital's utilization were presented by examining were placed in difficult management condition, in respect of hospital's management conditions, manpower input, patient medical treatment record, financial record, and actual output. The causes of rural hospital's low utilization were as follows; 1) changes in number and structure of population 2) rural people's preference for large hospitals and hospitals which located in urban area 3) rural hospitals lacking in hospital management skill. Consequently rural hospital's operation condition got more and more deteriorated. To raise rural hospital's utilization, method for social policy, method for health policy, and intrinsic method of hospitals were presented in turn. For rural residents to utilize medical service conveniently, it is necessary for rural hospitals operated normally. So government must insist that rural hospitals solve the problems which come out from their internal management problems. And also these rural hospitals should be supported and nurtured by the government until their management is operated normally.

• Health Policy and Management
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• v.10 no.1
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• pp.148-173
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• 2000

This thesis is a kind of case report on the managerial difficulties and strategies to overcome them for the rural hospitals in Korea. We examined environmental situations and SWOT(Strength, Weakness, Opportunity, Threat) of the hospitals, and suggested some strategies to improve the hospital business through analysing secondary data and brief survey to staffs and patients at 3 case hospitals. Among the strategies were included establishment of their identity as community hospitals, positioning towards high-touch services rather than high-tech services to improve their competence. For this positioning, patient satisfaction should be emphasized to make rapport with the residents in the community, and a few service areas should be selected and strengthened. Emergency care and geriatric health services are recommended to be covered strongly, because rural hospitals are usually the one and only hospital in the region and rural communities have aged population structure. In addition to these, networking is necessary among rural hospitals nationwide and with local clinics and tertiary hospitals near urban areas. And also, complementary role division with community health post should be developed to lessen the competitive relationship between public and private sectors. To support these strategies, fresh organizational culture should be built up to make hospital staff creative and enthusiastic on their job. Finally, inducement of governmental assistance will be necessary to make the environment advantageous to the rural hospitals.

• Perspectives in Nursing Science
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• v.6 no.1
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• pp.67-76
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• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• Journal of the Korean Institute of Rural Architecture
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• v.12 no.4
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• pp.29-36
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• 2010

The purpose of this study is to have detailed data of the distribution, locations, and the amount of people in the waiting line of the nursing home. Also, we studied the accessibility to the facilities by using Web GIS to analyze the transit time it takes from the nursing home to health center and hospitals. We can provide the basic data that could contribute when future plans for the nursing homes' locations, health and medical policy are made. The results are as follows. 1. The nursing homes are stiffly concentrated in regions of Seoul and Gyeongi-do where large number of the elderly covered by long-term care insurance and the waiting line was very long for the elderlies to enter the nursing homes. In these cities of Ulsan and Jeju where number of the elderly covered by long-term care insurance is relatively small, there were less facilities. 2. The nursing homes located in urban areas had higher occupancy rate and higher number of people in the waiting line. 3. The average time taken by driving from the nursing homes and health center was 10 minutes and there was not a noticeable difference between the cities. Driving from the nursing homes to hospitals in rural areas took 22 minutes which is 2.5 times of the time taken for urban areas. Daegu-si and Incheon-si had relatively short distance from the nursing homes and the hospitals while Jeju-do had the furthest. For rural areas, it is needed for health center to be equipped with a wider medical coverage, have closely connected with hospitals to minimize the differences they have from ones in rural areas. It is also needed to have ambulances equipped for tele-medical examination and treatment system.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.15-27
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• 2003

Objectives: This study was conducted to compare the medical care patterns of hypertensive patients between rural and urban areas. Methods: We selected one rural county(Region A where there were 19 public health centers; one health center, 8 health sub-centers and 10 community health posts) and two urban districts(Region B and C where there was no health sub-center and community health post) in Daegu city. Region B had similar socioeconomic characteristics with rural county A while region C had different characteristics. The medical insurance records of 14,422 incident patients (2,501 in region A, 4,873 in region B and 7,048 in region C) with diagnostic code of hypertension from September 1998 to August 1999 were reviewed. Incident patient was defined as a patient who had no record of medical fee claim for hypertension to the national health insurance corporation in past 6 months and visited a medical facility for hypertension for the first time. The data for annual visit days, annual prescription days and annual total medical expenses were abstracted. The medical care pattern was categorized by the number of annual visit days and prescription days. The most proper care group was defined as the patient who visited 6-15 days with 240 prescription days or more in a year. Results: The type of medical facilities for the most visit was clinics, 373.% and it was followed by general hospitals, 28.2%; public health centers, 24.7%; and hospitals, 9.8% in region A(p<0.05). In region B, it was clinics, 63.1% and followed by general hospitals, 27.6%; health center, 5.2%; and hospitals, 4.1%(p<0.05). In region C, it was clinics, 53.8% and followed by general hospitals, 35.0%; health center, 6.3%; and hospitals, 4.9%(p<0.05). Annual mean total medical expenses per patient was highest in region C(won195,993) and followed by region A(won191,683) and region B(won178,713). The proportion of the most proper care group was 7.7% in region A, 5.2% in region B and 6.7% in region C(p<0.05). According to the type of medical facilities for the first visit, the proportion of the most proper care group was highest(14.7%) in the patients of public health centers, and it was followed by general hospitals, 8.8%; clinics, 3.6%; and hospitals, 2.0% in region A(p<0.05). In region B, it was highest in general hospitals, 9.7% and followed by hospitals, 4.0%; health center, 3.6%; and clinics, 3.4%(p<0.05). In region C, it was highest in general hospitals, 10.1% and followed by clinics, 5.2%; hospitals, 4.1%; and health center, 3.1%(p<0.05). Conclusions: The proportion of proper care for hypertension was higher in rural area and it was attributed to the care of health center, sub-centers and community health posts which appeared to follow patients better than hospitals and clinics.

• Journal of Korean Academy of Rural Health Nursing
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• v.9 no.2
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• pp.45-58
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• 2014

Purpose: To determine the knowledge and treatment compliance with hypertension, directions for the aspects of implementation, and related factors to patients with hypertension using Primary Health Cares and Private Clinics Hospitals. Method: General characteristics and High blood pressure-related properties(17 questions), Hypertension knowledge measures(20 questions), and Treatment Compliance(22 questions) were used. Result: 1. The patients of Private Clinics Hospitals had statistically significantly higher drinking habits than Primary Health Care centers. The patients of Private Clinics Hospitals had statistically significantly higher rate of no family history of hypertension than Primary Health Care centers. 2. Primary Health Care centers had statistically significantly higher knowledge of hypertension than Private Clinics Hospitals. Primary Health Care centers had statistically significantly higher treatment compliance than Private Clinics Hospitals. Conclusion: Both Primary Health Care centers and Private Clinics Hospitals are high medication compliance but low lifestyle compliance with hypertension. We need to recognize the importance of lifestyle compliance, to apply proper programs and to provide therapists' aggressive intervention.

• Journal of Nutrition and Health
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• v.10 no.1
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• pp.38-43
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• 1977

This study was designed to find out the status of low sodium diet in 27 hospitals located in Seoul and rural areas. The study was conducted from the beginning of June, 1976 to October, 1976. The differences in Na, protein and calorie contents between the hospitals in Seoul an ones in rural areas, and between the medical college attached hospitals and general ones, were compared by means of t-test. Correlation coefficient were made among Na, protein and calorie. In order to find out which food group is the major source of Na in the diet, six food groups were divided and Na content in each was calculated. The results showed that average daily Na intake of 27 hospitals was 2,382mg which is regarded as mild restriction. Average daily protein and calorie intakes were 94gm and 2,438 cal respectively. About 60% of hospitals restricted sodium at mild level $(2,300mg{\sim}4,600mg)$ and 33% at moderate $(1,000mg{\sim}2,300mg)$ and only 7% of the subjects were Planning strict sodium restriction $(250mg{\sim}500mg)$ There was statistically significant differences in Na contents between Seoul and rural areas. But no significant difference was found between medical college attached hospitals and general ones. The correlation between the average daily intakes of Na and protein was found not to be significant but protein and calorie intakes were related each other. When the total sodium intakes divided into six groups, about 74% were supplied by condiments (Food group 6th).

• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.188-202
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• 1996

Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.

• Journal of Korean Society of Rural Planning
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• v.21 no.3
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• pp.59-66
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• 2015

The objective of this study was to investigate the perception of walking environment and use of neighborhood facilities of rural female elderly, who are the most susceptible to ambulatory problems. The study showed that parks, senior centers and hospitals were among the most frequently used neighborhood facilities by rural female elderly, while bus stations and senior centers were recognized as the closest facilities. Frequency of use was higher for paid sports facilities rather than parks. Hospitals and health centers were facilities that were desired to be in close proximity. Social support, self-efficacy, and attitude were the factors that affected walking environment. Street trees, accessibility to parks, and street lights were factors that showed a positive relationship with total time of walking activity while perceived crime rate and slopes were perceived as environmental challenges for groups that walked under 150 minutes per week. One factor that negatively affected walking was the lack of sidewalks on streets. Providing parks and walking trails within neighborhood, pleasant walking environments, and safe sidewalks would contribute to improved perception of neighborhood and walking of older rural women.

• Journal of Korean Society of Rural Planning
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• v.25 no.3
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• pp.19-27
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• 2019

The purpose of this study was to determine whether public services in rural areas performed the functions of public interest value that benefited all residents of rural areas. Therefore, the results were derived through spatial distribution and population characteristics analysis at the level of basic living service facilities. As a result, the status of spatial distribution in the Favorable and Vulnerable areas of rural villages and the status of population distribution in the vulnerable areas was analyzed for retail, child care and medical facilities. In the case of retail facilities, it was found that more than 80.0% of the country's farming villages were distributed in the favorable areas that could be reached within 15 minutes. In the case of child care facilities, 91.5% of the total number of favorable areas could be reached within 15 minutes, and the distribution of child care facilities nationwide was deemed proper. In the case of medical facilities, 90.8% or more villages could be reached within 15 minutes of travel time as a lawmaker, and in the case of hospitals and emergency medical services, 92.7% of hospitals and 68.2% of emergency medical services were analyzed as favorable areas. Through these results, the government intends to establish objective spatial data in rural areas to provide basic information on policy directions and contribute to planning.