• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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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.

• Research in Community and Public Health Nursing
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• v.31 no.3
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• pp.234-243
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• 2020

Purpose: This study is aimed to identify the health-related quality of life for children with a mentally ill parent. Methods: The 13 participants were school-aged children whose parents were registered at the D Regional Mental Health Welfare Center. Data were collected using one-on-one interview with illustration cards and analyzed by content analysis. Results: The participants were living a difficult life in anxiety amid a reversal of parent-child role, such as doing housework and taking care of their parents. The study revealed a love-hate family relationship that the participants wanted parental recognition and attention but they were frustrated by insufficient parental care and sibling conflict. Nevertheless, they only had each other themselves to trust and rely on. Their mixed health awareness and negative emotions were influenced by parents. Some of participants were exposed to dangerous environment such as domestic violence, and they need support system for help in difficult situations. Sometimes they felt happy by satisfying physiological, social, and self-esteem needs. They also showed a positive potential that they were matured more than peers through the experience of overcoming difficulties. Conclusion: Not only were there not enough attention and support for the children with mentally ill people, but they were also exposed to an environment that threatens their physical or mental health. Therefore, to improve their health-related quality of life, there should be some integrated support of the community health system to cope with the challenges they face.

• Journal of the Korean Institute of Intelligent Systems
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• v.17 no.5
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• pp.619-625
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• 2007

As low power, low cost wireless communication technology like Bluetooth, Zigbee, RFID has been put to practical use together with the wellbeing trend, the concern about ubiquitous health care has been greatly increased and u-Health is becoming one of the most important application in the sensor network field. Especially, development of the medical services to be able to cope with a state of emergency for solitary senior citizens and the aged in silver town is very meaningful itself and their needs are also expected to continuously increase with a rapid increase in an aging population. In this paper we demonstrate the feasibility of extracting accurate heart rate variability (HRV) measurements from photoelectric plethysmography(PPG) signals gathered by a ring type pulse oximeter sensor attached to the finger. For this, we made 2 types of ring sensor, that is reflective and pervious type, and developed the remote monitoring system which is able to collect HR data from ring sensor, analyze and cope with a state of emergency.

• Journal of People, Plants, and Environment
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• v.24 no.6
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• pp.573-584
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• 2021

Background and objective: This study was conducted with 10 men and women in their 50s-60s to investigate the effect of agro-healing activities on the improvement of mental health. Methods: The experimental group participated in total 8 sessions of agro-healing activities, once a week for 2 hours each, at a care farm in Wanju-gun. Physiological measurements were taken with an electroencephalogram (EEG), Salivettes samples, and blood pressure before and after the activities. Results: As a result of analyzing the changes in brainwaves of the experimental group before and after agro-healing activities, relative slow alpha (RSA), relative fast alpha (RFA), and ratio of alpha to high beta (RAHB), the indices of stability and relaxation, increased after the program with statistical significance. Also, the ratio of SMR to theta (RST) of the attention index increased on the right frontal lobes, temporal lobes, and left occipital lobes, and relative low beta (RLB) increasd on the frontal lobes, temporal lobes, and occipital lobes after the program with statistical significance. The sympathetic nervous system activity, which is a stress index, decreased after the program, whereas the parasympathetic nervous system activity, which is a relaxation index, increased, showing statistical significance (p < .05). As a result of analyzing the changes in blood pressure after the program, systolic blood pressure and diastolic blood pressure decreased from prehypertension to normal blood pressure, showing statistical significance. SThese results indicate that participating in agro-healing activities at a care farm for the 50-60s helps reduce stress and improve stability and relaxation as well as attention. Conclusion: Thus, developing and applying customized agro-healing programs for participants will have a positive effect on brain activity and psychophysiological improvement by relieving tension and stress. However, there are limitations in generalizing the results of this study since most of agro-healing farms have low accessibility that leads to a low level of participants.

• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

• Journal of Korean Ophthalmic Optics Society
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• v.5 no.1
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• pp.165-171
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• 2000

The purpose of this study is to determine the prevalence of cataracts in a rural area of Kyung-Buk province. Cataract is the main cause of blindness and visual impairment in the world. Recently, the number of age-related cataract surgeries has increased remarkably. In spite of such an increase in the number of patients, there are still many cataract patients with highly deteriorated visual function who have had no occasion to receive an ocular examination. In order to screen such patients the author assessed 636 individual(1272 eyes) aged 50 years or more who had wanted to be examined generally in two area. Chilgok and Munkyung, Kyung-Buk province using a simplified cataract screening system recently proposed by Sasaki et al. Kanazawa Medical University in Japan. The results obtained are as follows. The number of visual impairment patients in this study group was 493(77.5%). They were screened by cataract screening system. Primary screening examination detected 448 subjects to be suspected of cataract while the subsequent secondary examination narrowed this number of subjects to 308(48.4%). Final number of subjects to be diagnosed of cataract was 421(66.2%). The rate of incidence, according to the age, was 27.5% in the 50 year-olds age group, 62.5% in the 60's age group, 86.1% in the 70's age group and 94.3% in the 80's age group and upwards. This results concluded that cataract is the main cause of blindness and visual impairment and is an important public eye health care problem of aged population in rural Korea. Methods of tackling the cataract problem(both backlog and incident), and other eye health needs are recommended. The need to extend eye health service to the rural areas is emphasized.

• Proceedings of the SCSK Conference
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• 2003.09b
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• pp.464-478
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• 2003

Free radicals and reactive oxygen species (ROS) caused by UV exposure or other environmental facts play critical roles in cellular damage and aging. The extract of tinged autumnal leaves of maple tree(Acer palmatum) has proven to be a powerful antioxidant. The Acer palmatum extract is very effective on the stabilization of biological membranes( containing unsaturated fatty acid). We studied photoprotective effect of the extract against UVB-induced cytotoxicity in human keratinocytes. The extract improved cell viability comparing to control after UVB irradiation. In the determination test of pro inflammatory cytokines the extract decreased expression of interleukin 1 a and 6, which play an important role in inflammation and skin erythema caused by UV. We also studied property of varying cosmetic formulations on the percutaneous absorption of the extract. After 24 hour in vitro penetration study, the content of the extract was more highly detected in skin residue part. This result showed the extract had relatively high compatibility of skin in our emulsion system. On human skin, after appling the product containing the extract we obtained a good result of antiwrinkle effect by skin visiometer. In conclusion, the Acer palmatum extract is a photoprotective and very effective in stressed and aged skin care. And we can predict the extract mainly affects on the skin cell and tissue in our emulsion system.

• Korea journal of population studies
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• v.18 no.2
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• pp.51-69
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• 1995

The Swedish welfare state has been the model for others to emulate the archetypical example of state intervention. The state interventions are presented in the form of legal acts. These social welfare acts can be classified according to the demographic transition theory. According to the Bogue's theory, the demographic transition in Sweden took place in four stages : the pre-transitional stage before 1810; the early transitional stage from 1810 to 1860; the mid-transitional stage from 1860 to 1930; the late transitional stage from 1930 to now. As we look into the social welfare acts in Sweden, the relief of the poor was the major concern of the early transitional stage, the care of workers was the major concerns of the mid-transitional stage and the care of the families was the major concerns in the late transitional stage. The Korea's transition period can be devided as follows; the pre-transitional stage before 1960; the early transitional stage from 1960 to 1969; the mid-transitional stage from 1970 to 1987; and the late transitional stage from 1987 to now. In Korea, the major concern of the early transitional stage was the care of the officials and the workers; in the mid-transitional stage the care of the aged and the handicapped were the major concerns. And in the late transitional stage the expanding of the welfare clients was the major concern. If we compare the results of both countries, the relief of the poor, the care of the workers and the care of the families will be the major concerns in Korea, because the social welfare acts in Korea are extended to specific groups and not to the whole population. The acts related to these social issues have been arranged in 120 years in Sweden. But Korea had to do the same work in 27 years. So the burden of making those social acts will be four times heavier. If we want to extend the benefits of the social system to the general population, we need to look at the design and approach of the swedish model. The reason why swedish social acts constitute an international model has more to do with the uniqueness of its design and approach. First of all, it is characteristic by its universalism, secondly by its emphasis on social services and thirdly by its productivitism. Also the swedish welfare state supported by a high-tax system called the earnings-related welfare system. In order to achieve an effective welfare state, we Koreans should pay attention to the relief of the poor, the care of the worker and the families. We should also focus on a good system design and prepare appropriate budgets.

• Korean Journal of Social Welfare
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• v.61 no.3
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• pp.77-101
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• 2009

As a case study in the field of policy implementation research, this study focuses on how the logic of consumer choice and provider competition operates on the front line of policy processing. To find the implementation process of the program, 39 interview data were analyzed, including voucher users, care workers, social workers in 4 agencies and local public officers in one of the district in Seoul, and relevant officials from the Ministry for Health, Welfare and Family affairs and the Center for Social Service Management. The main results are as follows: In the level of policy implementation, user choice and competition, which was the main logic behind the implementation of the voucher program, did not occur as expected by policy makers. Instead of user choosing his/her provider, it was found that the providers were choosing its users. Secondly, the case study found that providers have formed a caucus which allocated the local users equally amongst the providers. In this process, local public officers have supported the meeting by providing them with a list of users. Such results may be interpreted as a habitual execution from the tradition of supply-side subsidy, rather than the way of implementation in the market system. Thirdly, although voucher users could not choose their preferred agency in the first stage of service, some other choices exists so that users may choose their preferred care-giver and time for service. Finally, the change of agency and care-giver in the way of delivering services were observed.

• 한국노년학
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• v.38 no.4
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• pp.837-851
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• 2018

This study aimed to investigate the relationship between frailty and health care utilization in a cross-sectional design of a population-based sample of community-dwelling older adults. We used the data of 516 participants who dwell in Daejon, aged between 65 and 84 years old. Using K-frailty index, frailty status were measured and categorized as three groups: robust, prefrail, and frail. Logistic regression analysis was used to examine if frailty affects emergency department(ED) visit or hospitalization. In addition, negative binomial regression was used to examine the association between outpatient visits and frailty. Our results showed that the frail elderly increased the ED visit and the number of outpatient visit significantly after controlling for demographic characteristics, socioeconomic status, the number of chronic diseases, and self-rated health status. Considering that frailty is an important independent factor affecting health care utilization, more attention is required to prevent the frailty in our health care system.